TRACHEOESOPHAGEAL SPEECH - PREDICTORS OF SUCCESS AND SOCIAL VALIDITY RATINGS

Purpose: The purpose of this study was to examine long-term success ra tes and predictors of success for patients who had undergone either pr imary or secondary tracheoesophageal puncture. An additional aim was t o compare judgments of communication effectiveness made by a speech-la nguage pathologist with those made by the patient or significant other . Patients and Methods: Thirty-six laryngectomees were initially rated on a 5-point functional communication scale. These ratings resulted i n the formation of two distinct groups that were identified as ''succe ssful'' and ''unsuccessful.'' The groups were compared on the basis of age at time of surgery and 10 categorical variables that have been im plicated in the success or failure of tracheoesophageal puncture surge ry. Results: Results indicated that nearly two thirds of the patients had successful communication at an average of approximately 4 years po sttracheoesophageal puncture. For the 13 patients judged as ''unsucces sful,'' reduced vision, limited arm/hand movement, and history of radi otherapy were found in significantly greater numbers. When communicati on profile ratings made by a speech-language pathologist were compared with those made by the patient or significant other (P/SO), approxima tely one-third varied by at least ''1'' scale value, with the vast maj ority resulting in comparatively higher ratings by the speech-language pathologist. Conclusion: The findings of this study are in general ag reement with previously published success rates for tracheoesophageal puncture and attest to the long-term nature of these success rates in a majority of patients. Additional investigation is necessary to ident ify factors that may contribute to discrepancies between clinician exp ectations and those of the patient or significant other. Copyright (C) 1998 by W.B. Saunders Company.