Permanent Tracheostomy Care and social Stigma in Nigeria
DOI:
https://doi.org/10.61841/n3ye7w27Keywords:
Permanent Tracheostomy, post tracheostomy care, Stigmatisation, Social integrationAbstract
Lifesaving therapies may sometimes require the surgical removal or interference with a normal body structure that is obvious to the people in the immediate social environment. These may elicit some unsavory reaction, from people around, causing adverse psychological effects on the patients concerned. Permanent tracheostomy is one of such surgical procedures; though intended to be life-saving, may end up being a permanent disability. Permanent tracheostomy is done for patients with permanent recurrent laryngeal nerve damage post-thyroidectomy, post- laryngectomy (due to oropharyngeal cancer), head and neck trauma and some neck cancers. Due to the small percentage of surgical, hospital attending patients needing tracheostomy, the special concerns of these patients have been easily overlooked. These group of patients have peculiar problems managing the tracheostomy, starting from prolonged hospital stay, and multiple hospital admission both contributing to their cost burden. Few publications have been done in our environment on the psychological impact on adults and children who end up with this surgery as in other climes. Outside the initial Problems of negative attitude of immediate family, speech difficulty and nonavailabilty of tracheostomy tube parts to enhance speech; Social stigmatization is a source of grave concern, which requires concerted efforts at rehabilitation and social re-integration. The travails of the permanent tracheostomy patient is mitigated, not only by highly skilled and specialized medical care; but also by advocacy groups for such a minority ailment: unlike sickle cell, hypertension, and diabetes that over time have become familiar to the populace. Advocacy groups can help in ensuring availability of tracheostomy accessories to aid speech, thereby making the tracheostomy patient attractive in the community and aiding meaningful social integration. This would make them a voice for the “voiceless”; to mitigate the effects of stigmatization and discrimination in the Nigerian society.
Downloads
References
1. Akenroye M. I., Osukoya AT. “Permanent Tracheostomy: Its Social Impacts and Their Management in Ondo State, Southwest, Nigeria.” Nigerian Journal of Clinical Practice.2013; 16: 54–58.
2. Garrubba M, Turner T, Grieveson C. “Multidisciplinary Care for Tracheostomy Patients: A Systematic Review.” Critical Care.2009; 13: R177–R177.
3. McCormick M E, Ward E, Roberson DW, Shah RK, Stachler RJ, Brenner MJ. “Life after Tracheostomy: Patient and Family Perspectives on Teaching, Transitions, and Multidisciplinary Teams.” Otolaryngology – Head and Neck Surgery.2015; 153: 914–920.
4. Kaub-Wittemer, Steinbuchel NV, Wasner M, Laier-Groeneveld G, Borasio GD. “Quality of Life and Psychosocial Issues in Ventilated Patients with Amyotrophic Lateral Sclerosis and Their Caregivers.” Journal of Pain and Symptom Management.2003; 26: 890–896.
5. Antonelli M, Michetti V, Di Palma A, Conti G, Pennisi MA, A. Arcangeli A, Montini L, et al. “Percutaneous Translaryngeal versus Surgical Tracheostomy: A Randomized Trial with 1-yr Double-Blind Follow-Up.” Critical Care Medicine.2005 33: 1015–1020.
6. Brigger, M T, Hartnick CJ. “Drilling Speaking Valves: A Modification to Improve Vocalization in Tracheostomy Dependent Children.” Laryngoscope.2009; 119: 176–179.
7Daudia, A., and K. P. Gibbin. “Management of Tracheostomy.” Current Paediatrics. 2006; 16: 225–229.
8. Donnelly F, Wauchula R. “The Lived Experience of a Tracheostomy Tube Change: A Phenomenological Study.” Journal of Clinical Nursing.2006; 15: 1115–1122.
9. Bule B, and Frings D. “The Role of Group Membership Continuity and Multiple Memberships on Mental Well-Being amongst Post-Operative Stoma Patients.” Psycho-Oncology. 2016; 25: 726–728
10. Walts PA, Murthy SC, DeCamp MM. Techniques of surgical tracheostomy. Clin Chest Med. 2003; 24:413–22.
11. Adetinuola EJ, Bola AY, Olanrewaju MI, Oyedotun AA, Timothy OO, Alani AS, et al. Tracheostomy in South Western Nigeria: Any change in pattern? J Med Med Sci. 2011; 2:997–1002.
12. Amusa YB, Akinpelu VO, Fadiora SO, Agbakwuru EA. Tracheostomy in surgical practice: Experience in a Nigerian tertiary hospital. West Afr J Med. 2004; 23:32–4.
13. Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy. A new simple bedside procedure; preliminary report. Chest. 1985;87:715–9.
14. Alladi A, Rao S, Das K, Charles AR, D’Cruz AJ. Pediatric tracheostomy: A 13-year experience. Pediatr Surg Int. 2004; 20:695–8.
15. Primuharsa Putra SH, Wong CY, Hazim MY, Megat Shiraz MA, Goh BS. Paediatric tracheostomy in hospital university Kebangsaan Malaysia – A changing trend. Med J Malaysia. 2006; 61:209–13.
16. Kremer B, Botos-Kremer AI, Eckel HE, Schlöndorff G. Indications, complications, and surgical techniques for pediatric tracheostomies – An update. J Pediatr Surg. 2002;37:1556–62.
17. Jasper A.O, Orhohoro O.I: From the Road (Highway) To the Operating Theatre and Intensive Care Unit- The Beauty of Holistic Trauma Care: Nigerian Research Journal of Clinical Sciences Vol. 6; June 2018.
18. Randolph GW, Dralle H, International Nerve Monitoring Study Group Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement. Laryngoscope. 2006; 121:S1–S16. doi: 10.1002/lary.21119.
19. Barczyński M, Randolph GW, Cernea CR, Dralle H, Dionigi G, et al International Neural Monitoring Study Group External branch of the superior laryngeal nerve monitoring during thyroid and parathyroid surgery: International Neural Monitoring Study Group standards guideline statement. Laryngoscope. 2013; 123(Suppl 4):S1–S14. doi: 10.1002/lary.24301
20. Lorenz KJ .Rehabilitation after total laryngectomy-a tribute to the pioneers of voice restoration in the last 2 centuries. Front. Med 2017:4; 81
21. Wrapson J, Patterson N, Ivana Nakarada-Kordic I, Reay S. A life-changing event: patients’ personal experiences of living with a long-term tracheostomy. Design for Health 2017, 1:2, 256-271, DOI: 10.1080/24735132.2017.1386432
26. Ewang E Nigeria Passes Disability Rights LawOffers Hope of Inclusion, Improved Accesshttps://www.hrw.org/news/2019/01/25/nigeria-passes-disability-rights-law
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
