Abstract:

Objective This research，which focuses on the experience of patients living in voiceless conditions with voice restoration failure after total laryngectomy，aims to provide a basis for nursing and intervention tactics for the patients. Methods The purposive sampling method was used to select 17 patients as the research participants. The patients，who had total laryngectomy in the department of head and neck surgery in a tertiary A cancer hospital in Beijing from June 2019 to March 2021，participated in a training class using esophagus for pronunciation，but failed in voice restoration and the medics by other auxiliary voice aids. The researchers conducted semi-structured interviews with the patients and used Colaizzi 7-step analysis to sort out，summarize and refine the data. Results The patients who lived in voiceless conditions with voice restoration failure after total laryngectomy，have the experience in following 4 aspects，including palpable stigma，eager for medical professional guidance，good family support to benefit patients，and expectations for social understanding and support. Conclusion This population faces many problems and also has many needs. Therefore，it is necessary for the nurses to pay much attention to the psychological changes of the patients，as well as their main concerns and feelings，and to provide targeted nursing guidance and social support.

Key words: Total Laryngectomy, Voice Restoration Failure, Voiceless Experience, Living Experience, Qualitative Research, Nursing Care

摘要： 目的 了解全喉切除复声失败患者无声生存的真实体验，为制订相关护理干预策略提供依据。方法 采用目的抽样法，选取2019年6月—2021年3月在北京市某三级甲等肿瘤医院头颈外科行全喉切除手术后参加食管发音班复声失败，并运用其他辅助发声工具不能顺利发声的17例患者进行半结构式访谈，采用Colaizzi 7步分析法对访谈资料进行分析、归纳、整合和主题提炼。结果 全喉切除复声失败患者无声生存体验主要包括4个主题:①病耻感明显;②渴望医护人员的专业指导;③良好的家庭支持使患者获益;④期待社会的理解与支持。结论 全喉切除复声失败患者无声生存期间存在多方面的问题和需求，护士应密切关注此类患者的心理变化，重视其主诉和生存感受，给予有针对性的护理指导和多维度的社会支持。

关键词: 全喉切除, 复声失败, 无声生存, 生存体验, 质性研究, 护理