The effect of speaking valve application on patients' quality of life and caregiver burden in tracheostomized patients

Yıl 2025, Cilt: 16 Sayı: 1, 211 - 216, 25.03.2025

Demet Aygün , Burak Manay , Merve Savaş , Alperen Şentürk , Hakan Parlak , Serkan Bengisu

https://doi.org/10.18663/tjcl.1651922

Öz

Aim: The tracheostomy procedure significantly impairs patients' emotional state, communication skills, and quality of life. This study aimed to evaluate the differences in quality of life scores after the application of a speaking valve in adult tracheostomy patients and the changes in caregiver stress levels using the Zarit Caregiver Burden Scale (ZCBS).
Material and Methods: This retrospective study included 36 patients who had a speaking valve applied. The World Health Organization Quality of Life Scale-Short Form Turkish Version (WHOQOL-BREF-TR), which evaluates the patients' self-reported quality of life, and the ZCBS scores of their caregivers were retrospectively collected before and two weeks after the application of the speaking valve.
Results: The mean age of the participants was 56.3 ± 17.0 years (range: 21-82 years), and 55.6% (n = 20) were male. Compared to the Easy Breath condition, the mean WHOQOL-BREF-TR score increased after the application of the speaking valve (Easy Breath: 46.4 ± 7.8 vs. Post-speaking valve: 72.2 ± 14.8; p < 0.001), while the mean ZCBS score decreased (Easy Breath: 52.8 ± 12.8 vs. Post-speaking valve: 33.2 ± 5.4; p < 0.001). In this context, both tracheostomy patients and their caregivers had higher quality of life scores after the application of the speaking valve compared to the Easy Breath condition.
Conclusion: The use of a speaking valve in tracheostomy patients is associated with improved quality of life and reduced caregiver stress levels.

Anahtar Kelimeler

speech, speaking valve, tracheostomy, quality of life

Trakeostomi hastalarında konuşma valfi uygulamasının hastaların yaşam kalitesi ve bakım veren yükü üzerindeki etkisi

Öz

Amaç: Trakeostomi işlemi hastaların duygu durumunu, iletişim becerilerini ve yaşam kalitesini ciddi derecede bozmaktadır. Bu çalışma trakeostomili yetişkin hastalarda konuşma valfi sonrası yaşam kalitesi skorlarındaki farklılıkları ve bakım verenlerin yaşadığı stres düzeylerindeki değişimi Zarit Bakıcı Yükü Ölçeği (ZBYÖ) ile değerlendirmeyi amaçladı.
Gereç ve Yöntemler: Bu retrospektif çalışmaya konuşma valfi takılmış 36 hasta dahil edildi. Konuşma valfi takılmadan önce ve takıldıktan 2 hafta sonra yaşam kalitelerini değerlendirmeye yönelik hastanın kendi yaşam kalitesini değerlendirdiği Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği-Kısa Formu Türkçe Versiyonu (WHOQOL-BREF-TR) ve hastaların bakım verenlerine ZBYÖ skorları retrospektif olarak toplandı.
Bulgular: Çalışmaya dahil edilen katılımcıların ortalama yaşı 56,3 ± 17,0 yıl (aralık: 21-82 yıl) olup, %55,6’sı (n = 20) erkekti. Konuşma valfi sonrası Easy Breath durumuna kıyasla ortalama WHOQOL-BREF-TR puanı artış gösterirken (Easy Breath: 46,4 ± 7,8 vs. Konuşma valfi sonrası: 72,2 ± 14,8; p < 0,001), ortalama ZBYÖ puanı ise azalma gösterdi (Easy Breath: 52,8 ± 12,8 vs. Konuşma valfi sonrası: 33,2 ± 5,4; p < 0,001). Bu bağlamda konuşma valfi sonrası trakeostomi hastalarının ve bakım verenlerinin yaşam kalitesi ölçeği puanı Easy Breath durumuna kıyasla daha yüksekti.
Sonuç: Trakeostomili hastalarda konuşma valfi kullanımı, artan yaşam kalitesinin yanısıra azalan bakım verenlerin stres düzeyleri ile ilişkilidir.

Anahtar Kelimeler

konuşma, konuşma valfi, trakeostomi, yaşam kalitesi

Kaynakça

• Lian S, Teng L, Mao Z, and Jiang H. Clinical utility and future direction of speaking valve: A review. Front Surg. 2022;9:913147. DOI: 10.3389/fsurg.2022.913147.
• Dawson D. Essential principles: tracheostomy care in the adult patient. Nurs Crit Care. 2014;19(2):63-72. DOI: 10.1111/nicc.12076.
• Kim YK, Lee SH, and Lee JW. Effects of Capping of the Tracheostomy Tube in Stroke Patients With Dysphagia. Ann Rehabil Med. 2017;41(3):426-33. DOI: 10.5535/arm.2017.41.3.426.
• Phookan J and Talukdar R. A Study on Quality of Life in Post-tracheostomised Patients. Indian J Otolaryngol Head Neck Surg. 2023;75(2):848-56. DOI: 10.1007/s12070-023-03511-z.
• Aksoy E and Ocakli B. Long-Term Survival of Patients with Tracheostomy Having Different Diseases Followed up in the Respiratory Intensive Care Unit Outpatient Clinic: Which Patients are Lucky? Turk Thorac J. 2019;20(3):182-87. DOI: 10.5152/TurkThoracJ.2018.18120.
• Kumar V, Malhotra V, and Sinha V. Evaluation of Individual Quality of Life (QOL) Among Patients with Tracheostomy Using WHO-QOL BREF Questionnaire. Indian J Otolaryngol Head Neck Surg. 2022;74(Suppl 3):5207-16. DOI: 10.1007/s12070-020-02052-z.
• Speed L and Harding KE. Tracheostomy teams reduce total tracheostomy time and increase speaking valve use: a systematic review and meta-analysis. J Crit Care. 2013;28(2):216 e1-10. DOI: 10.1016/j.jcrc.2012.05.005.
• Freeman-Sanderson AL, Togher L, Elkins MR, and Phipps PR. Quality of life improves with return of voice in tracheostomy patients in intensive care: An observational study. J Crit Care. 2016;33:186-91. DOI: 10.1016/j.jcrc.2016.01.012.
• Pandian V, Cole T, Kilonsky D, et al. Voice-Related Quality of Life Increases With a Talking Tracheostomy Tube: A Randomized Controlled Trial. Laryngoscope. 2020;130(5):1249-55. DOI: 10.1002/lary.28211.
• Akbal Y and Nural N. Palyatif ünitesinde bakım veren olarak trakeostomi ile karşı karşıya kalmak: olgu sunumu. Sürekli Tıp Eğitimi Dergisi. 2023;32(4):328-33.
• Eser E, Fidaner H, Fidaner C, Eser SY, Elbi H, and Göker E. WHOQOL-100 ve WHOQOL-BREF'in psikometrik özellikleri. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi. 1999;7(Suppl 2):23-40.
• İnci F and Erdem M. Bakim verme yükü ölçeği’nin türkçe'ye uyarlanmasi geçerlilik ve güvenilirliği. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2006;11(4):85-95.
• Sutt AL, Anstey CM, Caruana LR, Cornwell PL, and Fraser JF. Ventilation distribution and lung recruitment with speaking valve use in tracheostomised patient weaning from mechanical ventilation in intensive care. J Crit Care. 2017;40:164-70. DOI: 10.1016/j.jcrc.2017.04.001.
• Sutt AL, Caruana LR, Dunster KR, Cornwell PL, Anstey CM, and Fraser JF. Speaking valves in tracheostomised ICU patients weaning off mechanical ventilation--do they facilitate lung recruitment? Crit Care. 2016;20:91. DOI: 10.1186/s13054-016-1249-x.
• Lewin JS, Montgomery PC, Hutcheson KA, and Chambers MS. Further experience with modification of an intraluminal button for hands-free tracheoesophageal speech after laryngectomy. J Prosthet Dent. 2009;102(5):328-31. DOI: 10.1016/S0022-3913(09)60185-2.
• Frohlich MR, Boksberger H, Barfuss-Schneider C, Liem E, and Petry H. [Safe swallowing and communicating for ventilated intensive care patients with tracheostoma: implementation of the Passy Muir speaking valve]. Pflege. 2017;30(6):387-94. DOI: 10.1024/1012-5302/a000589.
• Lichtman SW, Birnbaum IL, Sanfilippo MR, Pellicone JT, Damon WJ, and King ML. Effect of a tracheostomy speaking valve on secretions, arterial oxygenation, and olfaction: a quantitative evaluation. J Speech Hear Res. 1995;38(3):549-55. DOI: 10.1044/jshr.3803.549.
• Yanti LA, Dewi VR, and Bahar E. Comparing Voice Related Quality of Life scores between fenestrated and speaking valve cannula users. Oto Rhino Laryngologica Indonesiana. 2023;53(2):129-36.
• Karaca T, Altinbas Y, and Aslan S. Caring for Patients With a Tracheostomy at Home: A Descriptive, Cross-sectional Study to Evaluate Health Care Practices and Caregiver Burden. Wound Manag Prev. 2019;65(3):22-29.
• Hu P, Yang Q, Kong L, Hu L, and Zeng L. Relationship between the anxiety/depression and care burden of the major caregiver of stroke patients. Medicine (Baltimore). 2018;97(40):e12638. DOI: 10.1097/MD.0000000000012638.
• Blanco V, Guisande MA, Sanchez MT, Otero P, Lopez L, and Vazquez FL. [Caregiver burden and associated factors in family caregivers in the Community of Galicia, Spain]. Rev Esp Geriatr Gerontol. 2019;54(1):19-26. DOI: 10.1016/j.regg.2018.03.005.
• Karaca T, Altinbas Y, and Aslan S. Tracheostomy care education and its effect on knowledge and burden of caregivers of elderly patients: a quasi-experimental study. Scand J Caring Sci. 2019;33(4):878-84. DOI: 10.1111/scs.12684.
• Hacıoğlu DÖ, Hacıoğlu C, Mart ÖÖ, and Yıldızdaş D. The Caregiver Burden of Mothers of Patients Who Received Tracheostomy in a University Hospital Pediatric Intensive Care Unit. 2022.