Cuidados de traqueostomía para adultos y ancianos en el entorno domiciliario: una revisión de alcance

Cordeiro, Aldenora Laísa Paiva de Carvalho; Santos, Jade Alycia Ribeiro e; Barroso, Ana Clara Leite; Donoso, Miguir Terezinha Vieccelli; Mata, Luciana Regina Ferreira Pereira da; Chianca, Tânia Couto Machado

Aldenora Laísa Paiva de Carvalho Cordeiro

Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Básica, Belo Horizonte, MG, Brazil.

https://orcid.org/0000-0002-0310-0096

Jade Alycia Ribeiro e Santos

Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, MG, Brazil.

https://orcid.org/0000-0002-0077-5610

Ana Clara Leite Barroso

Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, MG, Brazil.

https://orcid.org/0000-0002-2069-9731

Miguir Terezinha Vieccelli Donoso

Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Básica, Belo Horizonte, MG, Brazil.

https://orcid.org/0000-0002-5497-9520

Luciana Regina Ferreira Pereira da Mata

Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Básica, Belo Horizonte, MG, Brazil.

https://orcid.org/0000-0002-5080-4643

Tânia Couto Machado Chianca

Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Básica, Belo Horizonte, MG, Brazil.

https://orcid.org/0000-0002-8313-2791

Corresponding author: Aldenora Laísa Paiva de Carvalho Cordeiro, Rua Cassiano Campolina, 437, apto. 301, Bairro Dona Clara, 31260-210 – Belo Horizonte, MG, Brazil, alaisapc@hotmail.com

ASSOCIATE EDITOR

Cristina Lavareda Baixinho

DATABASE	STRATEGY
LILACS	(traqueostomia OR tracheostomy OR traqueostomía OR trachéostomie) AND (“Assistência Domiciliar” OR “Home Nursing” OR “Atención Domiciliaria de Salud” OR “Soins à domicile” OR “Ambiente Domiciliar” OR “Home Environment” OR “Ambiente en el Hogar” OR “Enfermagem Domiciliar” OR “Home Health Nursing” OR “Cuidados de Enfermería en el Hogar” OR “Soins infirmiers à domicile” OR “Home Care”) AND ( db:(“LILACS” OR “BDENF” OR “IBECS” OR “BINACIS” OR “campusvirtualsp_brasil” OR “CUMED” OR “INDEXPSI” OR “MedCarib” OR “SES-SP” OR “SMS-SP” OR “SOF” OR “colecionaSUS”))
MEDLINE VIA PUBMED	(Tracheostomy) AND (“Home Nursing” OR “Home Environment” OR “Home Health Nursing” OR “Home Care”)
CINAHL	(Tracheostomy) AND (“Home Nursing” OR “Home Environment” OR “Home Health Nursing” OR “Home Care”)
COCHRANE	(Tracheostomy) AND (“Home Nursing” OR “Home Environment” OR “Home Health Nursing” OR “Home Care”)
GOOGLE SCHOLAR	(Tracheostomy OR Traqueostomia) AND (“Home Nursing” OR “Assistência Domiciliar”)
PEDro	(Tracheostomy)
EMBASE (Via Portal Capes)	(Tracheostomy) AND (‘Home Care’ OR ‘Home Environment’)
SCOPUS (Via Portal Capes)	(Tracheostomy) AND (“Home Nursing” OR “Home Environment” OR “Home Health Nursing” OR “Home Care”)
WEB OF SCIENCE (Via Portal Capes)	(Tracheostomy) AND (“Home Nursing” OR “Home Environment” OR “Home Health Nursing” OR “Home Care”)
GREY LITERATURE	STRATEGY
CAPES catalog of theses and dissertations	(Traqueostomia) AND (“Assistência Domiciliar”)
OASISBR	(Traqueostomia) AND (“Assistência Domiciliar”)
OpenGrey	(Tracheostomy) AND (“Home Nursing”)

Title	Year/country	Aim	Type of study	Main results
[E1] A systematic review of patient and caregiver experiences with a tracheostomy(¹1. Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. Patient. 2018;11(2):175–91. doi: http://doi.org/10.1007/s40271-017-0277-1. PubMed PMID: 28914429. https://doi.org/10.1007/s40271-017-0277-... ).	2018, New Zealand.	To understand current knowledge related to the experience and quality of life of adults living with a tracheostomy and their caregivers, in order to improve care.	Systematic review.	Five main themes emerged from the research: (1) care, support and management of a tracheostomy; (2) speech and communication; (3) well-being and quality of life; (4) disfigurement and body image; and (5) stigma and social isolation.
[E2] Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río (Description and management of the tracheostomized patient in home hospitalization: experience in the Complejo Asistencial Doctor Sótero del Río.)(¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... ).	2022, Chile.	To describe the profile and management of patients with tracheostomies who are hospitalized at home.	Descriptive, retrospective.	The objective of teaching tracheostomy management and education was applied to 87 of the 96 participating patients and covered general tracheostomy and stoma care, knowledge of the device and management of emergencies and decannulation situations.
[E3] Cuidados para a prevenção de complicações em pacientes traqueostomizados (Care to prevent complications in tracheostomized patients(¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ).	2019, Brazil.	To analyze the evidence of care for the prevention of complications in tracheostomized patients.	Integrative review.	Factors related to endotracheal suction, tube and skin cleanliness and health education were the main strategies for minimizing the risk of complications.
[E4] As necessidades de aprendizagem dos pacientes laringectomizados (The learning needs of laryngectomized patients)¹³13. Zago MMF, Casagrande LDR. As necessidades de aprendizagem dos pacientes laringectomizados. Rev Gaúcha Enferm. 1992;13(2):17–7. PubMed PMID: 1297160.).	1992, Brazil.	Reporting on the learning needs of laryngectomized patients treated at a university hospital.	Qualitative, participant observation.	The learning needs identified refer to the acquisition of information and skills related to: the function of the larynx, the disease, the objectives and consequences of surgery and treatments; the possibility of carrying out professional, leisure and sexual activities; the possibility of training the esophageal voice; altered body image; and the development of skills for self-care with the tracheostomy.
[E5] Tracheostomy care education and its effect on knowledge and burden of caregivers of elderly patients: a quasi-experimental study(¹⁴14. Karaca T, Altinbas Y, 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: http://doi.org/10.1111/scs.12684. PubMed PMID: 30883869. https://doi.org/10.1111/scs.12684... ).	2019, Türkiye.	To investigate the effect of tracheostomy management training for caregivers of elderly patients on caregivers’ levels of burden and knowledge.	Quasi-experimental.	Training increased the caregiver’s level of knowledge and reduced the burden of care. Attitudes and skills to be acquired should be explained in a language understandable to patients and caregivers and taught by demonstration methods during the hospitalization period.
[E6] Developing the tracheostomy care anxiety relief through education and support (T-CARES) program(¹⁵15. Loerzel VW, Crosby WW, Reising E, Sole ML. Developing the tracheostomy care anxiety relief through education and support (T-CARES) program. Clin J Oncol Nurs. 2014;18(5):522–7. doi: http://doi.org/10.1188/14.CJON.522-527. PubMed PMID: 25253106. https://doi.org/10.1188/14.CJON.522-527... ).	2014, United States.	To describe the development and results of the T-CARES program, developed in response to the high readmission rates of head and neck cancer patients discharged with a tracheostomy.	Quasi-experimental.	The T-CARES program shows promise in reducing anxiety and increasing aspiration competence in home caregivers of a family member with a new tracheostomy.
[E7] Gaining experience over time: The family caregivers’ perception of patients with a tracheostomy in home care(¹⁶16. Hasanvand S, Daraie S, Goudarzi F, Rassouli M. Gaining experience over time: the family caregivers’ perception of patients with a tracheostomy in home care. Iran J Nurs Midwifery Res. 2021;26(2):137–43. doi: http://doi.org/10.4103/ijnmr.IJNMR_173_20. PubMed PMID: 34036061. https://doi.org/10.4103/ijnmr.IJNMR_173_... ).	2021, Iran.	To explain the experiences of caregivers and family members of patients with tracheostomies about caring for the patient at home.	Qualitative, content analysis.	The categories of experiences identified in the study include: need for training; need to receive care support; care challenges; burden; experience, hope and inner satisfaction.
[E8] Is disinfection of mechanical ventilation tubing needed at home(¹⁷17. Toussaint M, Steens M, Van Zeebroeck A, Soudon P. Is disinfection of mechanical ventilation tubing needed at home? Int J Hyg Environ Health. 2006;209(2):183–90. doi: http://doi.org/10.1016/j.ijheh.2005.09.009. PubMed PMID: 16376145. https://doi.org/10.1016/j.ijheh.2005.09.... )?	2006, Belgium.	To determine the level of cleanliness and sterility of the home ventilation circuit (HVC) in patients on home ventilation and the efficiency of the recommended HVC cleaning protocol.	Experimental.	Recommendations such as using a dishwasher twice a month to wash all parts of the tubes, circuits and ventilation masks, and cleaning tracheostomy tubes with hydrogen peroxide or through a hot bath with a brush and detergent were presented. Decontamination is only indicated when the tube is visually dirty and/or when tracheostomized patients are susceptible to respiratory tract infections.
[E9] Caring for patients with a tracheostomy at home: a descriptive, cross-sectional study to evaluate health care practices and caregiver burden(¹⁸18. Karaca T, Altinbas Y, 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):22-9. doi: http://doi.org/10.25270/wmp.2019.3.2229. PubMed PMID: 30986200. https://doi.org/10.25270/wmp.2019.3.2229... ).	2019, Türkiye.	To determine the health care practices and burden of family caregivers of tracheostomy patients living at home.	Descriptive, cross-sectional.	The care behavior of caregivers was assessed in the following categories: knowledge of emergency care, number of instruments for care, frequency of home visits, experience in emergency situations in the last six months and the patient’s activities of daily living.
[E10] Home care nursing advice for patients with head and neck cancer in India(¹⁹19. Murali S, Leng M, Rosemund S. Home care nursing advice for patients with head and neck cancer in India. Indian J Palliat Care. 2006;12(12):77. doi: http://doi.org/10.4103/0973-1075.30250. https://doi.org/10.4103/0973-1075.30250... ).	2006, India.	Instructing patients, family members and caregivers on the procedures and care required for the mouth, tracheostomy and nasogastric tube.	Clinical opinion.	Tracheostomy care includes changing and cleaning the inner tube; cleaning around the tracheostomy site and changing dressings daily; looking for signs of infection in the mouth and stoma area; as well as preparing solutions to sanitize the structures involved in the device.
[E11] Long-term care of the patient with a tracheostomy(²⁰20. Lewarski JS. Long-term care of the patient with a tracheostomy. Respir Care. 2005;50(4):534–7. PubMed PMID: 15807917.).	2005, United States.	To discuss the components of a long-term tracheostomy treatment program.	Clinical opinion.	Patient education should begin before tracheostomy insertion and include: basic airway anatomy; justification for tracheostomy use; description of tube operation; signs and symptoms of respiratory distress; suctioning technique; tube cleaning and maintenance; stoma site assessment and cleaning; cardiopulmonary resuscitation; emergency decannulation and reinsertion procedures; tube change procedure; use of equipment and supplies.
[E12] Tracheostomy selfcare: The Nottingham System(²¹21. Mason J, Murty GE, Foster H, Bradley PJ. Tracheostomy selfcare: the Nottingham System. J Laryngol Otol. 1992;106(8):723–4. doi: http://doi.org/10.1017/S0022215100120699. PubMed PMID: 1402367. https://doi.org/10.1017/S002221510012069... ).	1992, England.	To describe the Nottingham System, which aims to teach tracheostomy self-care in a step-by-step manner.	Descriptive.	Care is described as: recognizing the need to clean and change the tube; removing, cleaning and inserting the inner tube; preparing the equipment for changing the outer tube; applying tapes; removing, cleaning and inserting the outer tube; skin care.
[E13] Effect of videotape for home instruction on the quality of life of tracheostomy patients: a randomized clinical trial(²²22. Mohammadi N, Farahani M, Vatandost S. Effect of videotape for home instruction on the quality of life of tracheostomy patients: a randomized clinical trial. J Med Life. 2015;8(4):287–94.).	2015, Iran.	Verifying the effect of instructional videos on the quality of life of people with tracheostomies.	Quasi-experimental.	The daily care presented was: bathing, shaving, suctioning, dressing the peristomal skin, cleaning the tracheostomy tube, knowing how to identify symptoms of infection at the tracheostomy site, knowing how to communicate with other people and how to present in public.
[E14] Helping a laryngectomy patient go home(²³23. Patry-lahey R. Helping a laryngectomy patient go home. Nursing. 1985;15(3):63–5. doi: http://doi.org/10.1097/00152193-198503000-00016. PubMed PMID: 3844649. https://doi.org/10.1097/00152193-1985030... ).	1985, United States.	To describe care for laryngectomized patients, ranging from communication to teaching self-care.	Clinical opinion.	Care aimed at helping patients regain independence and autonomy was described, such as communication training, daily cannula removal and cleaning, nutritional counseling and other self-care procedures.

BHN	Tracheostomy care in the home environment
BHN	Care	Recommendations on how to carry out care
Psychobiologic	Aspiration of secretions(¹1. Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. Patient. 2018;11(2):175–91. doi: http://doi.org/10.1007/s40271-017-0277-1. PubMed PMID: 28914429. https://doi.org/10.1007/s40271-017-0277-... ,¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... ,¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ,¹⁴14. Karaca T, Altinbas Y, 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: http://doi.org/10.1111/scs.12684. PubMed PMID: 30883869. https://doi.org/10.1111/scs.12684... ,¹⁵15. Loerzel VW, Crosby WW, Reising E, Sole ML. Developing the tracheostomy care anxiety relief through education and support (T-CARES) program. Clin J Oncol Nurs. 2014;18(5):522–7. doi: http://doi.org/10.1188/14.CJON.522-527. PubMed PMID: 25253106. https://doi.org/10.1188/14.CJON.522-527... ,¹⁸18. Karaca T, Altinbas Y, 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):22-9. doi: http://doi.org/10.25270/wmp.2019.3.2229. PubMed PMID: 30986200. https://doi.org/10.25270/wmp.2019.3.2229... ,²⁰20. Lewarski JS. Long-term care of the patient with a tracheostomy. Respir Care. 2005;50(4):534–7. PubMed PMID: 15807917.,²²22. Mohammadi N, Farahani M, Vatandost S. Effect of videotape for home instruction on the quality of life of tracheostomy patients: a randomized clinical trial. J Med Life. 2015;8(4):287–94.,²³23. Patry-lahey R. Helping a laryngectomy patient go home. Nursing. 1985;15(3):63–5. doi: http://doi.org/10.1097/00152193-198503000-00016. PubMed PMID: 3844649. https://doi.org/10.1097/00152193-1985030... ).	– Use aseptic technique(¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... ). – Pre-oxygenate the patient(¹⁸18. Karaca T, Altinbas Y, 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):22-9. doi: http://doi.org/10.25270/wmp.2019.3.2229. PubMed PMID: 30986200. https://doi.org/10.25270/wmp.2019.3.2229... ). – Use vacuum pressure between 100 and 150 mmHg(¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... ,¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ). – Perform the procedure within 10 to 15 seconds(¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... ,¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ,²³23. Patry-lahey R. Helping a laryngectomy patient go home. Nursing. 1985;15(3):63–5. doi: http://doi.org/10.1097/00152193-198503000-00016. PubMed PMID: 3844649. https://doi.org/10.1097/00152193-1985030... ). – Instill saline solution(²³23. Patry-lahey R. Helping a laryngectomy patient go home. Nursing. 1985;15(3):63–5. doi: http://doi.org/10.1097/00152193-198503000-00016. PubMed PMID: 3844649. https://doi.org/10.1097/00152193-1985030... ). – Use a portable aspirator(¹1. Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. Patient. 2018;11(2):175–91. doi: http://doi.org/10.1007/s40271-017-0277-1. PubMed PMID: 28914429. https://doi.org/10.1007/s40271-017-0277-... ). – Perform the procedure daily, 1 to 5 times a day(¹⁸18. Karaca T, Altinbas Y, 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):22-9. doi: http://doi.org/10.25270/wmp.2019.3.2229. PubMed PMID: 30986200. https://doi.org/10.25270/wmp.2019.3.2229... ).
	Stoma care: cleaning and changing dressings(¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... 12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... 13. Zago MMF, Casagrande LDR. As necessidades de aprendizagem dos pacientes laringectomizados. Rev Gaúcha Enferm. 1992;13(2):17–7. PubMed PMID: 1297160. 14. Karaca T, Altinbas Y, 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: http://doi.org/10.1111/scs.12684. PubMed PMID: 30883869. https://doi.org/10.1111/scs.12684... 15. Loerzel VW, Crosby WW, Reising E, Sole ML. Developing the tracheostomy care anxiety relief through education and support (T-CARES) program. Clin J Oncol Nurs. 2014;18(5):522–7. doi: http://doi.org/10.1188/14.CJON.522-527. PubMed PMID: 25253106. https://doi.org/10.1188/14.CJON.522-527... -¹⁶16. Hasanvand S, Daraie S, Goudarzi F, Rassouli M. Gaining experience over time: the family caregivers’ perception of patients with a tracheostomy in home care. Iran J Nurs Midwifery Res. 2021;26(2):137–43. doi: http://doi.org/10.4103/ijnmr.IJNMR_173_20. PubMed PMID: 34036061. https://doi.org/10.4103/ijnmr.IJNMR_173_... ,¹⁸18. Karaca T, Altinbas Y, 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):22-9. doi: http://doi.org/10.25270/wmp.2019.3.2229. PubMed PMID: 30986200. https://doi.org/10.25270/wmp.2019.3.2229... 19. Murali S, Leng M, Rosemund S. Home care nursing advice for patients with head and neck cancer in India. Indian J Palliat Care. 2006;12(12):77. doi: http://doi.org/10.4103/0973-1075.30250. https://doi.org/10.4103/0973-1075.30250... 20. Lewarski JS. Long-term care of the patient with a tracheostomy. Respir Care. 2005;50(4):534–7. PubMed PMID: 15807917. 21. Mason J, Murty GE, Foster H, Bradley PJ. Tracheostomy selfcare: the Nottingham System. J Laryngol Otol. 1992;106(8):723–4. doi: http://doi.org/10.1017/S0022215100120699. PubMed PMID: 1402367. https://doi.org/10.1017/S002221510012069... 22. Mohammadi N, Farahani M, Vatandost S. Effect of videotape for home instruction on the quality of life of tracheostomy patients: a randomized clinical trial. J Med Life. 2015;8(4):287–94.-²³23. Patry-lahey R. Helping a laryngectomy patient go home. Nursing. 1985;15(3):63–5. doi: http://doi.org/10.1097/00152193-198503000-00016. PubMed PMID: 3844649. https://doi.org/10.1097/00152193-1985030... ).	– Change the dressing twice a day or as necessary given the amount of secretions(¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... ). – Change the dressing daily(¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ,¹⁹19. Murali S, Leng M, Rosemund S. Home care nursing advice for patients with head and neck cancer in India. Indian J Palliat Care. 2006;12(12):77. doi: http://doi.org/10.4103/0973-1075.30250. https://doi.org/10.4103/0973-1075.30250... ). – Sanitize the peristomal skin with saline solution(¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ,¹⁹19. Murali S, Leng M, Rosemund S. Home care nursing advice for patients with head and neck cancer in India. Indian J Palliat Care. 2006;12(12):77. doi: http://doi.org/10.4103/0973-1075.30250. https://doi.org/10.4103/0973-1075.30250... ). – Sanitize the peristomal skin with 3% hydrogen peroxide, soap and water, absorbent cotton, cotton buds, clean cloths and gauze(¹⁵15. Loerzel VW, Crosby WW, Reising E, Sole ML. Developing the tracheostomy care anxiety relief through education and support (T-CARES) program. Clin J Oncol Nurs. 2014;18(5):522–7. doi: http://doi.org/10.1188/14.CJON.522-527. PubMed PMID: 25253106. https://doi.org/10.1188/14.CJON.522-527... ,²⁰20. Lewarski JS. Long-term care of the patient with a tracheostomy. Respir Care. 2005;50(4):534–7. PubMed PMID: 15807917.). – Identify signs of infection in the stoma(²²22. Mohammadi N, Farahani M, Vatandost S. Effect of videotape for home instruction on the quality of life of tracheostomy patients: a randomized clinical trial. J Med Life. 2015;8(4):287–94.). – Use sterile water (obtained after boiling water for 20 minutes), a mirror to guide cleaning and gauze(²³23. Patry-lahey R. Helping a laryngectomy patient go home. Nursing. 1985;15(3):63–5. doi: http://doi.org/10.1097/00152193-198503000-00016. PubMed PMID: 3844649. https://doi.org/10.1097/00152193-1985030... ).
	Hygienization of the endocannula(¹1. Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. Patient. 2018;11(2):175–91. doi: http://doi.org/10.1007/s40271-017-0277-1. PubMed PMID: 28914429. https://doi.org/10.1007/s40271-017-0277-... ,¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... 12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... 13. Zago MMF, Casagrande LDR. As necessidades de aprendizagem dos pacientes laringectomizados. Rev Gaúcha Enferm. 1992;13(2):17–7. PubMed PMID: 1297160. 14. Karaca T, Altinbas Y, 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: http://doi.org/10.1111/scs.12684. PubMed PMID: 30883869. https://doi.org/10.1111/scs.12684... 15. Loerzel VW, Crosby WW, Reising E, Sole ML. Developing the tracheostomy care anxiety relief through education and support (T-CARES) program. Clin J Oncol Nurs. 2014;18(5):522–7. doi: http://doi.org/10.1188/14.CJON.522-527. PubMed PMID: 25253106. https://doi.org/10.1188/14.CJON.522-527... 16. Hasanvand S, Daraie S, Goudarzi F, Rassouli M. Gaining experience over time: the family caregivers’ perception of patients with a tracheostomy in home care. Iran J Nurs Midwifery Res. 2021;26(2):137–43. doi: http://doi.org/10.4103/ijnmr.IJNMR_173_20. PubMed PMID: 34036061. https://doi.org/10.4103/ijnmr.IJNMR_173_... 17. Toussaint M, Steens M, Van Zeebroeck A, Soudon P. Is disinfection of mechanical ventilation tubing needed at home? Int J Hyg Environ Health. 2006;209(2):183–90. doi: http://doi.org/10.1016/j.ijheh.2005.09.009. PubMed PMID: 16376145. https://doi.org/10.1016/j.ijheh.2005.09.... 18. Karaca T, Altinbas Y, 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):22-9. doi: http://doi.org/10.25270/wmp.2019.3.2229. PubMed PMID: 30986200. https://doi.org/10.25270/wmp.2019.3.2229... 19. Murali S, Leng M, Rosemund S. Home care nursing advice for patients with head and neck cancer in India. Indian J Palliat Care. 2006;12(12):77. doi: http://doi.org/10.4103/0973-1075.30250. https://doi.org/10.4103/0973-1075.30250... 20. Lewarski JS. Long-term care of the patient with a tracheostomy. Respir Care. 2005;50(4):534–7. PubMed PMID: 15807917. 21. Mason J, Murty GE, Foster H, Bradley PJ. Tracheostomy selfcare: the Nottingham System. J Laryngol Otol. 1992;106(8):723–4. doi: http://doi.org/10.1017/S0022215100120699. PubMed PMID: 1402367. https://doi.org/10.1017/S002221510012069... 22. Mohammadi N, Farahani M, Vatandost S. Effect of videotape for home instruction on the quality of life of tracheostomy patients: a randomized clinical trial. J Med Life. 2015;8(4):287–94.-²³23. Patry-lahey R. Helping a laryngectomy patient go home. Nursing. 1985;15(3):63–5. doi: http://doi.org/10.1097/00152193-198503000-00016. PubMed PMID: 3844649. https://doi.org/10.1097/00152193-1985030... ).	– Perform mechanical cleaning with sterile water or sterile saline solution(¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... ,²³23. Patry-lahey R. Helping a laryngectomy patient go home. Nursing. 1985;15(3):63–5. doi: http://doi.org/10.1097/00152193-198503000-00016. PubMed PMID: 3844649. https://doi.org/10.1097/00152193-1985030... ). – Clean with hydrogen peroxide(¹⁷17. Toussaint M, Steens M, Van Zeebroeck A, Soudon P. Is disinfection of mechanical ventilation tubing needed at home? Int J Hyg Environ Health. 2006;209(2):183–90. doi: http://doi.org/10.1016/j.ijheh.2005.09.009. PubMed PMID: 16376145. https://doi.org/10.1016/j.ijheh.2005.09.... ,²³23. Patry-lahey R. Helping a laryngectomy patient go home. Nursing. 1985;15(3):63–5. doi: http://doi.org/10.1097/00152193-198503000-00016. PubMed PMID: 3844649. https://doi.org/10.1097/00152193-1985030... ). – Clean the endocannula daily(¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ,¹³13. Zago MMF, Casagrande LDR. As necessidades de aprendizagem dos pacientes laringectomizados. Rev Gaúcha Enferm. 1992;13(2):17–7. PubMed PMID: 1297160.,²³23. Patry-lahey R. Helping a laryngectomy patient go home. Nursing. 1985;15(3):63–5. doi: http://doi.org/10.1097/00152193-198503000-00016. PubMed PMID: 3844649. https://doi.org/10.1097/00152193-1985030... ). – Use lukewarm water and neutral detergent (with the exception of silicone cannula, where only saline solution is recommended)(¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ). – Use brushes(¹1. Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. Patient. 2018;11(2):175–91. doi: http://doi.org/10.1007/s40271-017-0277-1. PubMed PMID: 28914429. https://doi.org/10.1007/s40271-017-0277-... ,¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... ,¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ) or gauze(¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... ). – Use a dishwasher for 90 minutes at 70ºC or use hot water, brushes and detergent, followed by complete drying(¹⁷17. Toussaint M, Steens M, Van Zeebroeck A, Soudon P. Is disinfection of mechanical ventilation tubing needed at home? Int J Hyg Environ Health. 2006;209(2):183–90. doi: http://doi.org/10.1016/j.ijheh.2005.09.009. PubMed PMID: 16376145. https://doi.org/10.1016/j.ijheh.2005.09.... ). – Clean with sodium bicarbonate solution, cloth or gauze and running water, boil the endocannula for 10 minutes and dry with a clean cloth after cooling(¹⁹19. Murali S, Leng M, Rosemund S. Home care nursing advice for patients with head and neck cancer in India. Indian J Palliat Care. 2006;12(12):77. doi: http://doi.org/10.4103/0973-1075.30250. https://doi.org/10.4103/0973-1075.30250... ).
	Tracheostomy fixation(¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... ,¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ,¹⁴14. Karaca T, Altinbas Y, 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: http://doi.org/10.1111/scs.12684. PubMed PMID: 30883869. https://doi.org/10.1111/scs.12684... ,¹⁵15. Loerzel VW, Crosby WW, Reising E, Sole ML. Developing the tracheostomy care anxiety relief through education and support (T-CARES) program. Clin J Oncol Nurs. 2014;18(5):522–7. doi: http://doi.org/10.1188/14.CJON.522-527. PubMed PMID: 25253106. https://doi.org/10.1188/14.CJON.522-527... ,²¹21. Mason J, Murty GE, Foster H, Bradley PJ. Tracheostomy selfcare: the Nottingham System. J Laryngol Otol. 1992;106(8):723–4. doi: http://doi.org/10.1017/S0022215100120699. PubMed PMID: 1402367. https://doi.org/10.1017/S002221510012069... ).	– Change the fixation with four hands (two people)(¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... ). – Change the fixation every day, keeping a gap of two fingers so as not to suffocate the patient(¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ). – Change the fixation every day, keeping a gap of one finger between the fixator and the patient’s neck(¹⁵15. Loerzel VW, Crosby WW, Reising E, Sole ML. Developing the tracheostomy care anxiety relief through education and support (T-CARES) program. Clin J Oncol Nurs. 2014;18(5):522–7. doi: http://doi.org/10.1188/14.CJON.522-527. PubMed PMID: 25253106. https://doi.org/10.1188/14.CJON.522-527... ).
	Airway humidification(¹¹11. Freire-Figueroa F, Poblete-Figueroa C, Villarroel-Sgorbini C, Marín-Navarro V, González-Cuesta F, Muñoz-Sotelo C, et al. Descripción y manejo del paciente traqueostomizado en Hospitalización Domiciliaria: experiencia en el Complejo Asistencial Doctor Sótero del Río. Hosp. Domic. 2022;6(2):67–78. doi: http://doi.org/10.22585/hospdomic.v6i2.154. https://doi.org/10.22585/hospdomic.v6i2.... ,¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ,¹⁴14. Karaca T, Altinbas Y, 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: http://doi.org/10.1111/scs.12684. PubMed PMID: 30883869. https://doi.org/10.1111/scs.12684... ,¹⁸18. Karaca T, Altinbas Y, 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):22-9. doi: http://doi.org/10.25270/wmp.2019.3.2229. PubMed PMID: 30986200. https://doi.org/10.25270/wmp.2019.3.2229... ,²⁰20. Lewarski JS. Long-term care of the patient with a tracheostomy. Respir Care. 2005;50(4):534–7. PubMed PMID: 15807917.).	– Perform airway nebulization daily, 1 to 5 times a day(¹⁸18. Karaca T, Altinbas Y, 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):22-9. doi: http://doi.org/10.25270/wmp.2019.3.2229. PubMed PMID: 30986200. https://doi.org/10.25270/wmp.2019.3.2229... ).
	Emergency care(¹²12. da Costa ECL, Rodrigues CF, Matias JG, Bezerra SMG, Rocha DM, Machado RS, et al. Cuidados para a prevenção de complicações em pacientes traqueostomizados. Rev Enferm UFPE. 2019;13(1):169–78. doi: http://doi.org/10.5205/1981-8963-v13i1a238545p169-178-2019. https://doi.org/10.5205/1981-8963-v13i1a... ,¹⁵15. Loerzel VW, Crosby WW, Reising E, Sole ML. Developing the tracheostomy care anxiety relief through education and support (T-CARES) program. Clin J Oncol Nurs. 2014;18(5):522–7. doi: http://doi.org/10.1188/14.CJON.522-527. PubMed PMID: 25253106. https://doi.org/10.1188/14.CJON.522-527... ,¹⁶16. Hasanvand S, Daraie S, Goudarzi F, Rassouli M. Gaining experience over time: the family caregivers’ perception of patients with a tracheostomy in home care. Iran J Nurs Midwifery Res. 2021;26(2):137–43. doi: http://doi.org/10.4103/ijnmr.IJNMR_173_20. PubMed PMID: 34036061. https://doi.org/10.4103/ijnmr.IJNMR_173_... ).	– Reinsert the cannula (in case of decannulation)(¹⁵15. Loerzel VW, Crosby WW, Reising E, Sole ML. Developing the tracheostomy care anxiety relief through education and support (T-CARES) program. Clin J Oncol Nurs. 2014;18(5):522–7. doi: http://doi.org/10.1188/14.CJON.522-527. PubMed PMID: 25253106. https://doi.org/10.1188/14.CJON.522-527... ). – Remove the endocannula (in the event of a mucous plug), assess breathing, aspirate secretions and, if the patient does not improve, call the emergency services(¹⁵15. Loerzel VW, Crosby WW, Reising E, Sole ML. Developing the tracheostomy care anxiety relief through education and support (T-CARES) program. Clin J Oncol Nurs. 2014;18(5):522–7. doi: http://doi.org/10.1188/14.CJON.522-527. PubMed PMID: 25253106. https://doi.org/10.1188/14.CJON.522-527... ). – Avoid removing the tracheostomy tube(¹⁶16. Hasanvand S, Daraie S, Goudarzi F, Rassouli M. Gaining experience over time: the family caregivers’ perception of patients with a tracheostomy in home care. Iran J Nurs Midwifery Res. 2021;26(2):137–43. doi: http://doi.org/10.4103/ijnmr.IJNMR_173_20. PubMed PMID: 34036061. https://doi.org/10.4103/ijnmr.IJNMR_173_... ).
	Stoma protection(¹³13. Zago MMF, Casagrande LDR. As necessidades de aprendizagem dos pacientes laringectomizados. Rev Gaúcha Enferm. 1992;13(2):17–7. PubMed PMID: 1297160.).	– Protect the stoma with elements that prevent the entry of foreign bodies(¹³13. Zago MMF, Casagrande LDR. As necessidades de aprendizagem dos pacientes laringectomizados. Rev Gaúcha Enferm. 1992;13(2):17–7. PubMed PMID: 1297160.).
	Nutrition(¹⁴14. Karaca T, Altinbas Y, 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: http://doi.org/10.1111/scs.12684. PubMed PMID: 30883869. https://doi.org/10.1111/scs.12684... ,¹⁸18. Karaca T, Altinbas Y, 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):22-9. doi: http://doi.org/10.25270/wmp.2019.3.2229. PubMed PMID: 30986200. https://doi.org/10.25270/wmp.2019.3.2229... ).	– Offering a balanced diet(¹⁸18. Karaca T, Altinbas Y, 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):22-9. doi: http://doi.org/10.25270/wmp.2019.3.2229. PubMed PMID: 30986200. https://doi.org/10.25270/wmp.2019.3.2229... ).
	Management of cuff(¹⁴14. Karaca T, Altinbas Y, 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: http://doi.org/10.1111/scs.12684. PubMed PMID: 30883869. https://doi.org/10.1111/scs.12684... ,¹⁸18. Karaca T, Altinbas Y, 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):22-9. doi: http://doi.org/10.25270/wmp.2019.3.2229. PubMed PMID: 30986200. https://doi.org/10.25270/wmp.2019.3.2229... ).	No recommendations / adaptations.
	Hand hygiene before handling the tracheostomy(¹⁴14. Karaca T, Altinbas Y, 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: http://doi.org/10.1111/scs.12684. PubMed PMID: 30883869. https://doi.org/10.1111/scs.12684... ,¹⁶16. Hasanvand S, Daraie S, Goudarzi F, Rassouli M. Gaining experience over time: the family caregivers’ perception of patients with a tracheostomy in home care. Iran J Nurs Midwifery Res. 2021;26(2):137–43. doi: http://doi.org/10.4103/ijnmr.IJNMR_173_20. PubMed PMID: 34036061. https://doi.org/10.4103/ijnmr.IJNMR_173_... ).	No recommendations / adaptations.
Psychosocial	Re-establishing the ability to communicate(¹1. Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. Patient. 2018;11(2):175–91. doi: http://doi.org/10.1007/s40271-017-0277-1. PubMed PMID: 28914429. https://doi.org/10.1007/s40271-017-0277-... ,¹³13. Zago MMF, Casagrande LDR. As necessidades de aprendizagem dos pacientes laringectomizados. Rev Gaúcha Enferm. 1992;13(2):17–7. PubMed PMID: 1297160.,¹⁴14. Karaca T, Altinbas Y, 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: http://doi.org/10.1111/scs.12684. PubMed PMID: 30883869. https://doi.org/10.1111/scs.12684... ,¹⁸18. Karaca T, Altinbas Y, 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):22-9. doi: http://doi.org/10.25270/wmp.2019.3.2229. PubMed PMID: 30986200. https://doi.org/10.25270/wmp.2019.3.2229... ,²⁰20. Lewarski JS. Long-term care of the patient with a tracheostomy. Respir Care. 2005;50(4):534–7. PubMed PMID: 15807917.,²²22. Mohammadi N, Farahani M, Vatandost S. Effect of videotape for home instruction on the quality of life of tracheostomy patients: a randomized clinical trial. J Med Life. 2015;8(4):287–94.,²³23. Patry-lahey R. Helping a laryngectomy patient go home. Nursing. 1985;15(3):63–5. doi: http://doi.org/10.1097/00152193-198503000-00016. PubMed PMID: 3844649. https://doi.org/10.1097/00152193-1985030... ).	– Instruct the patient about the esophageal voice(¹1. Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. Patient. 2018;11(2):175–91. doi: http://doi.org/10.1007/s40271-017-0277-1. PubMed PMID: 28914429. https://doi.org/10.1007/s40271-017-0277-... ,¹³13. Zago MMF, Casagrande LDR. As necessidades de aprendizagem dos pacientes laringectomizados. Rev Gaúcha Enferm. 1992;13(2):17–7. PubMed PMID: 1297160.) and communication aids(¹1. Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. Patient. 2018;11(2):175–91. doi: http://doi.org/10.1007/s40271-017-0277-1. PubMed PMID: 28914429. https://doi.org/10.1007/s40271-017-0277-... ).
Psychosocial	Social reintegration of the patient(¹1. Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. Patient. 2018;11(2):175–91. doi: http://doi.org/10.1007/s40271-017-0277-1. PubMed PMID: 28914429. https://doi.org/10.1007/s40271-017-0277-... ,²²22. Mohammadi N, Farahani M, Vatandost S. Effect of videotape for home instruction on the quality of life of tracheostomy patients: a randomized clinical trial. J Med Life. 2015;8(4):287–94.).	– Ensure family support by developing strategies(¹1. Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. Patient. 2018;11(2):175–91. doi: http://doi.org/10.1007/s40271-017-0277-1. PubMed PMID: 28914429. https://doi.org/10.1007/s40271-017-0277-... ). – Encourage the occupation of spaces and the adoption of common routines(¹1. Nakarada-Kordic I, Patterson N, Wrapson J, Reay SD. A systematic review of patient and caregiver experiences with a tracheostomy. Patient. 2018;11(2):175–91. doi: http://doi.org/10.1007/s40271-017-0277-1. PubMed PMID: 28914429. https://doi.org/10.1007/s40271-017-0277-... ).

[1] Corresponding author: Aldenora Laísa Paiva de Carvalho Cordeiro, Rua Cassiano Campolina, 437, apto. 301, Bairro Dona Clara, 31260-210 – Belo Horizonte, MG, Brazil, alaisapc@hotmail.com

Brasil

Brasil

Cuidados de traqueostomía para adultos y ancianos en el entorno domiciliario: una revisión de alcance

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