Preoperative Counseling in Salvage Total Laryngectomy: Content Analysis of Electronic Medical Records

Nikhila Raol, Elizabeth Lilley, Zara Cooper, Jayme Dowdall, Megan A. Morris

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: To study preoperative counseling in patients undergoing salvage total laryngectomy (STL). Study Design: Case series with chart review. Setting: Tertiary care academic hospital. Subjects and Methods: We reviewed charts of patients ≥18 years undergoing STL between 2005 and 2015. Fifty-eight patients were identified. Notes written within 2 months prior to surgery by head and neck surgical oncologists, radiation oncologists, medical oncologists, speech-language pathologists, social workers, and nurse practitioners were extracted and coded into 4 categories. Coded content was then analyzed using a simple tally within content areas. Results: Nonphysicians documented patient values and priorities, exclusive of treatment desires, more frequently. These topics included apprehension about family obligations, fear about communication, questions regarding quality of life, and anxiety regarding job continuation. Physician notes documented priorities regarding preferences for surgical treatment. No patients were seen by palliative care preoperatively, and only 14% (n = 8) patients had documentation of an end-of-life discussion. Conclusions: Preoperative counseling for STL patients that included nonphysicians had a higher frequency of discussion of patients’ priorities. This suggests including these types of providers may lead to more patient-centered care. A prospective study evaluating patient and physician perceptions of preoperative counseling can better identify where discrepancies exists and help conceptualize a framework for preoperative counseling in STL patients and other patients undergoing high-risk surgery.

Original languageEnglish (US)
Pages (from-to)641-647
Number of pages7
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume157
Issue number4
DOIs
StatePublished - Oct 1 2017

Fingerprint

Laryngectomy
Electronic Health Records
Counseling
Physicians
Patient-Centered Care
Nurse Practitioners
Tertiary Healthcare
Palliative Care
Documentation
Fear
Neck
Language
Anxiety
Communication
Head
Quality of Life
Prospective Studies

Keywords

  • preoperative counseling
  • recurrent head and neck cancer
  • salvage laryngectomy

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Preoperative Counseling in Salvage Total Laryngectomy : Content Analysis of Electronic Medical Records. / Raol, Nikhila; Lilley, Elizabeth; Cooper, Zara; Dowdall, Jayme; Morris, Megan A.

In: Otolaryngology - Head and Neck Surgery (United States), Vol. 157, No. 4, 01.10.2017, p. 641-647.

Research output: Contribution to journalArticle

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