An examination of the counselling experiences of a sample of patients in Ireland before undergoing total laryngectomy surgery

This study was designed to examine the pre-operative counselling experiences of patients undergoing a total laryngectomy (complete removal of the larynx) for treatment of head and neck cancer (HNC), together with their carers and Speech and Language Therapists (SLTs) in Ireland. People undergoing a total laryngectomy surgery require pre-operative counselling to prepare them for physical and psychological changes arising from treatment. To date there is no written consensus about the content or format of counselling, nor is there a standardised approach from SLTs. International research about counselling remains limited, with the few studies published being of poor methodological quality, and mainly representing expert opinion. However, from those published studies, there are persistent reports of shortfalls in clinical practice. We collected, described and analysed the pre-operative counselling experiences of a representative sample of total laryngectomy patients in Ireland, their carers, and specialist SLTs, to characterise current practices and to identify deficiencies. Purposefully recruited patients, carers and SLTs attended three focus groups (FGs). Data were collected and interpreted and convergent/divergent themes were identified. Marked deficiencies were identified in pre-operative counselling practices for this sample of laryngectomy patients and carers. SLTs identified themselves as the main information providers for patients but could not identify any unique contribution. Patients’ and carers’ views were largely aligned and they clearly identified key information that should be provided for future patients and carers. This is the first study from Ireland to examine pre-operative counselling experiences of HNC patients and carers. Further research is required, as it would be useful to reproduce this study internationally, across different healthcare systems. We identify a need to improve the counselling skills of SLTs working with the Irish HNC population to improve the lived experiences of patients and carers.