Living with dysphagia : striving hard to preserve oral feeding

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Living with dysphagia : striving hard to preserve oral feeding

 

Author: Wong, Kit Ripley
Title: Living with dysphagia : striving hard to preserve oral feeding
Degree: M.Sc.
Year: 2008
Subject: Hong Kong Polytechnic University -- Dissertations.
Nasopharynx -- Cancer -- Radiotherapy.
Nasopharynx -- Cancer -- Patients.
Deglutition disorders -- Treatment.
Department: School of Nursing
Pages: ix, 118 leaves : col. ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2232397
URI: http://theses.lib.polyu.edu.hk/handle/200/4430
Abstract: Nasopharyngeal Carcinoma (NPC) had very high prevalence in Hong Kong compared to other countries and regions in the world. Radiotherapy is the major treatment modality and achieves high disease cure rate. However, post-radiotherapy side effects affect the lives of the survivors after recovery from the disease. This study aims to explore how dysphagia, a long term complication of radiotherapy, impacts on the lives of this group of cancer survivors. A mixed method with quantitative survey and qualitative interview was adopted in the study. With quantitative survey using MOS SF-36, the quality of life of NPC survivors was noted to be depressed compared with their age-matched healthy peers. Across the eight domains of SF-36, NPC survivors scored low in seven domains in comparison to normal population while their score in the mental health domain was close to normal range. Qualitative content analysis of interview verbatim revealed four main areas of concerns, which were transformed into the main themes of the qualitative study: swallowing difficulty in transition, feeding as progressively diligent and hard work, from eating with companion to feeding in isolation, and wandering between fear and hope. NPC survivors gave a rich description of their gradually deteriorating swallowing function, both structurally and functionally. Their experience depicted that feeding was no longer an easy task to them. They experienced progressive exhaustion due to the changes in their feeding process and pattern. However, they still strived hard to learn and adapt to the deteriorating swallowing ability, with the ultimate aim of maintaining oral feeding as far as possible. The adverse effects of dysphagia extended to affecting the psychosocial aspects of the NPC survivors. They were increasingly withdrawing from various social and leisure activities as their swallowing difficulty progressed. Lots of fears arose and impacted on their psychological wellbeing. Albeit the negative impacts, the NPC survivors maintained hope and unconsciously used it as a coping strategy throughout their battle in preserving their oral feeding ability. The qualitative and quantitative arms of the study complemented and supplemented each other and enhanced a deeper understanding of the impacts of dysphagia in the life of NPC survivors. The findings shed light on the holistic management planning for NPC survivors.

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