Identifying areas for improvement in laryngectomy care: insights from concept mapping with patients

Care for individuals with laryngectomy (IWL) is complex, requiring access to specialized multidisciplinary services along the full care continuum. However, evidence supports that challenges are experienced by some IWL accessing supportive care, with current care systems not addressing patients' postoperative and long-term needs, contributing to poor outcomes and increased patient and caregiver burden. This study explored perceptions of IWL about overall health services and speech-language pathology (SLP) care to identify and prioritize opportunities for supportive care optimization. Concept mapping methodology was used to identify what IWL perceived were important to support their care. Through the multistep concept mapping process, qualitative and quantitative data were used to identify, then prioritize, critical elements of care that IWL feel should be optimized in the care pathway. Fourteen IWL from two health services generated 32 unique statements. Hierarchical cluster analysis revealed that statements fell within seven clusters: (1) comprehensive healthcare professional access and support; (2) psychological care and trust in healthcare; (3) supporting adjustment to life after surgery; (4) managing the treatment and recovery pathway; (5) communication restoration and peer-support; (6) inpatient care; and (7) no underlying theme. The Go-Zone map revealed 15 statements that were rated highest for importance, with the majority of these focusing on improving psychological care and adjustment postsurgery. IWL identified and prioritized actions to enhance services relating to preoperative education, psychological care, access to healthcare professionals, peer support, and financial supports. These findings can be used to inform an enhanced care pathway for IWL.