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Rumbach A, Aiken P, Novakovic D. Treatment Outcome Measures for Spasmodic Dysphonia: A Systematic Review. J Voice 2024; 38:540.e13-540.e43. [PMID: 35513935 DOI: 10.1016/j.jvoice.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/03/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE This systematic review aims to identify instruments used to evaluate treatment outcomes for people with spasmodic dysphonia. METHODS Electronic database (PubMed, Cochrane Library, Embase, and CINAHL) searches and hand-searching identified studies that evaluated treatment approaches for spasmodic dysphonia which included pre and post outcome data. RESULTS A total of 4714 articles were retrieved from searching databases; 1165 were duplicates. Titles and abstracts of 3549 were screened, with 171 being selected for full-text review. During full-text review, 101 articles were deemed suitable for inclusion. An additional 24 articles were identified as suitable for inclusion through hand-searching of reference lists. Data was extracted from 125 studies, identifying 220 outcome measures. As per the World Health Organization's International Classification of Functioning (ICF), the majority measured body functions (n = 212, 96%). Outcomes that explored communication and participation in everyday life and attitudes towards communication (ie, activity and participation domains) were infrequent (n = 8; 4%). Quality of life, a paradigm outside of the scope of the ICF, was also captured by four outcome measures. No instruments evaluating communication partners' perspectives were identified. CONCLUSIONS Currently there is no unified approach to the measurement of outcomes in SD treatment research. Development and implementation of a core outcome set is recommended to facilitate improved understanding of the efficacy of current and new treatment options.
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Affiliation(s)
- Anna Rumbach
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.
| | - Patrick Aiken
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Daniel Novakovic
- Dr Liang Voice Program - Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Ter Wal N, van Ewijk L, Visser-Meily JMA, Volkmer A, Gerrits E, Terwee CB. Further development in measuring communicative participation: identifying items to extend the applicability of the communicative participation item bank. J Patient Rep Outcomes 2023; 7:49. [PMID: 37237158 DOI: 10.1186/s41687-023-00586-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The ability to communicate is a prerequisite for participation in today's society. To measure participation in adults with communication disorders, the Communicative Participation Item Bank (CPIB) was developed in 2006. Since then, several new PROMs have been developed to measure communication and the impact of communication disorders on participation. Moreover, the CPIB items do not all appear to be relevant to certain populations with communication problems and context of communicative participation is changing rapidly, given the increased use of digital communication forms. The purpose of this study was to identify new PROMs developed since 2006 that aim to measure (aspects of) communication, in order to select items that are suitable for expanding the Communicative Participation Item Bank to make the item bank more widely applicable (e.g., to the hearing-impaired population) and tailored to the current societal context. METHODS Medline and Embase were used to search for PROMs that aim to measure (aspects of) communication. Each new PROM as well as the CPIB, was evaluated to determine to what extent it contains items that measure communicative participation and to what extent these items capture all communicative participation domains by linking each item to the ICF Activities and Participation domains. RESULTS This study identified 31 new PROMs, containing 391 items that were labelled as measuring communicative participation. The majority of the 391 items measure aspects of ICF Activities and Participation domain 'communication', followed by the domain 'interpersonal interactions and relationships'. The other ICF Activity and Participation domains were less often addressed. Analysis of the CPIB showed that items do not cover all domains of participation as defined in the ICF, such as the 'major life areas' domain. CONCLUSIONS We found a potential pool of 391 items measuring communicative participation that could be considered for extending the CPIB. We found items in domains that are already present in the CPIB, but also items that relate to new domains, such as an item on talking with customers or clients for the 'major life areas' domain. Inclusion of new items in other domains would benefit the comprehensiveness of the item bank.
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Affiliation(s)
- Nicole Ter Wal
- Research Centre Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, P.O. box 12011, Utrecht, 3501 AA, The Netherlands.
- Department of Languages, Literature and Communication, Utrecht Institute of Linguistics OTS, Utrecht University, Utrecht, The Netherlands.
| | - Lizet van Ewijk
- Research Centre Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, P.O. box 12011, Utrecht, 3501 AA, The Netherlands
| | - Johanna M A Visser-Meily
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, De Hoogstraat Rehabilitation, University Medical Centre Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Anna Volkmer
- Department of Language and Cognition, University College London, London, UK
| | - Ellen Gerrits
- Research Centre Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, P.O. box 12011, Utrecht, 3501 AA, The Netherlands
- Department of Languages, Literature and Communication, Utrecht Institute of Linguistics OTS, Utrecht University, Utrecht, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Dwyer CD, Gochman GE, Rosen CA, Young VN, Schneider SL. Comparison of Outcome Measures (Subjective, Objective, and Patient-Based) in Laryngeal Dystonia Treatment With Botulinum Toxin A Injection. J Voice 2023:S0892-1997(23)00122-4. [PMID: 37121839 DOI: 10.1016/j.jvoice.2023.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND Outcome assessment in laryngeal dystonia is hindered by lack of consensus on a core set of outcome measures to quantify treatment effect and disease severity on quality of life. Potential outcome measure domains include objective voice, clinician reported, and patient reported outcome measures (PROMs) for determining treatment success and longitudinal disease tracking. We aim to determine correlations between a selections of outcome measure tools following Botulinum toxin injection. METHODS A selection of instruments were administered to assess adductor laryngeal dystonia patient outcomes before and after Botulinum toxin injection. Voice samples recorded using a cellular telephone application were used for objective acoustic measures (CPPS, acoustic voice quality index) and speech language pathologist perceptual analysis (CAPE-V). Additionally, patients completed a PROMs battery consisting of the Voice Handicap Index-10, Communicative Participation Item Bank-10, OMNI-Vocal Effort Scale, 3 visual analog scale (VAS) questions. Changes in these outcome measures pre-post treatment were compared between each other and with a global rating of change questionnaire (GRCQ) using Spearman's rank correlation coefficients. RESULTS Twenty six patients (20 female, mean age 57.7 years) participated. Using an anchor based GRCQ, patients reported Botox efficacy was the only outcome measure found to have significant correlation (r = 0.54, P = 0.022); all other outcome measures did not meet statistically significant correlation. Amongst the selected outcome tools, several moderate-strong correlations were identified, largely for outcome measures within the same domain. Most notable were correlations between the patient reported OMNI-VES and VAS questions (r > 0.68, P < 0.05), clinician CAPE-V strain and overall severity (r = 0.900, P < 0.001), and acoustic voice quality index with sustained vowel CPPs (r = -0.797, P = 0.002). CONCLUSION Correlation between outcome measures instruments used for patients with adductor laryngeal dystonia requires further attention. Weak correlations with an anchor based GRCQ were found for this study's selected outcome instruments. A select number of correlations were found between outcome instruments within each of the individual outcome measure domains (patient perception, clinical perception, objective acoustics), but there was largely a lack of correlation found for instruments between these three separate domains.
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Affiliation(s)
- Christopher D Dwyer
- Division of Otolaryngology, Department of Surgery, Harvard University, Brigham & Women's Hospital, Boston, Massachusetts.
| | - Grant E Gochman
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California
| | - Clark A Rosen
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California
| | - VyVy N Young
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California
| | - Sarah L Schneider
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, California
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Ter Wal N, van Ewijk L, Dijkhuis L, Visser-Meily JMA, Terwee CB, Gerrits E. Everyday Barriers in Communicative Participation According to People With Communication Problems. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1033-1050. [PMID: 36787154 DOI: 10.1044/2022_jslhr-22-00405] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE The purpose of this study was to gain a comprehensive understanding of participation situations that are challenging for people with communication problems, to provide input for the further development of potential items for the Communicative Participation Item Bank (CPIB). METHOD A purposive sampling strategy was used to include a diverse group of people with communication problems. Diaries were used as a sensitizing exercise for inductive in-depth interviews. In these interviews, elements of communicative participation situations (concepts) were elicited that participants themselves experienced as difficult because of their communication problem. A thematic content analysis was used to identify overarching themes. In addition, new items were formulated based on the raw codes of the transcripts and linked to the International Classification of Functioning, Disability and Health Activity and Participation domains to examine the distribution of items across the breadth of the construct of communicative participation. RESULTS Eighteen interviews yielded 44 different concepts. They were clustered in six themes, which capture the person, location, topic, mode, moment, and pace of communication. In total, 103 new items measuring communicative participation were formulated. Most of these items relate to International Classification of Functioning, Disability and Health Activity and Participation domains "interpersonal interactions and relationships," "major life areas," and "community, social, and civic life." CONCLUSIONS This study resulted in an overview of self-reported barriers in daily communicative participation experienced by people with communication problems. These communicative participation situations can be captured within 44 concepts, which are covered by six themes. Future work should investigate if the newly written items can be added to the CPIB. The concepts and the themes can be used in designing and delivering a participation-focused intervention for this population.
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Affiliation(s)
- Nicole Ter Wal
- Research Centre Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences (ILS), Utrecht University, the Netherlands
| | - Lizet van Ewijk
- Research Centre Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
| | - Lotti Dijkhuis
- Research Centre Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
| | - Johanna M A Visser-Meily
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Centre, University Medical Centre Utrecht, the Netherlands
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht and Utrecht University, and De Hoogstraat Rehabilitation, the Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, UMC, Vrije Universiteit Amsterdam, the Netherlands
| | - Ellen Gerrits
- Research Centre Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences (ILS), Utrecht University, the Netherlands
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Palacios-Ceña D, Ordás-Bandera C, Casas-Limón J, Pérez-Corrales J, Güeita-Rodríguez J, Arias-Navalón JA, Cuadrado ML. Real-world experience of OnabotulinumtoxinA treatment in female patients with chronic migraine: a qualitative study using in-depth interviews. Ann Med 2023; 55:2255215. [PMID: 37708876 PMCID: PMC10936648 DOI: 10.1080/07853890.2023.2255215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Chronic migraine (CM) causes great disability and affects an individual's quality of life. OnabotulinumtoxinA (OBT-A, Botox®) was the first prophylactic treatment specifically indicated for CM. The aim of this study was to describe the experiences of women with CM treated with OBT-A. MATERIALS AND METHODS The study design is a qualitative descriptive study. A purposeful sampling of 30 women (mean age, 42.7; standard deviation, 10.6) who had received at least two administrations of OBT-A for CM (PREEMPT protocol) was performed. Data collection included in-depth interviews and researchers' field notes. A thematic analysis was carried out according to qualitative research guidelines. RESULTS Five themes were identified: (a) A long way to go before Botox®, (b) First time hearing about the treatment and its expectations, (c) The administration of Botox®, (d) Treatment effects, and (e) Follow-up. Patients described a long history of treatment failures prior to the start of OBT-A treatment. Information about this migraine treatment came from the neurologist; following the information, patients had high expectations, including unrealistic expectations regarding the onset and duration of effect. They acknowledged fear of the injections and some discomfort due to the procedure. With treatment, participants reported better migraine control and an improvement in their quality of life. Follow-up had some barriers, such as delayed appointments for subsequent doses, but also strengths, such as effectiveness and few side effects. CONCLUSIONS Qualitative research offers insight into how patients with CM experience treatment with OBT-A. Our results highlight some relevant aspects that should be considered when providing OBT-A treatment.
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Affiliation(s)
- Domingo Palacios-Ceña
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Carlos Ordás-Bandera
- Department of Neurology, Hospital Universitario Rey Juan Carlos, Móstoles, Spain
| | - Javier Casas-Limón
- Department of Neurology, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
| | - Jorge Pérez-Corrales
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Javier Güeita-Rodríguez
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
| | | | - María-Luz Cuadrado
- Department of Neurology, Hospital Clínico San Carlos, Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain
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Yorkston K, Baylor CR, Eadie T, Kapsner-Smith M. Perceptions regarding communicative participation in individuals receiving botulinum toxin injections for laryngeal dystonia. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:1296-1315. [PMID: 34453393 DOI: 10.1111/1460-6984.12668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/26/2021] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Laryngeal dystonia (LD), or spasmodic dysphonia (SD), is a neurological disorder characterized by focal dystonia or involuntary spasms of the laryngeal muscles and associated voice symptoms. It is typically treated with injection of botulinum toxin (BoNT) that weakens the affected muscles. AIMS The primary purpose of this qualitative study was to explore participants' experience of living with LD and BoNT treatment. The secondary purpose was to examine those experiences as a function of participants' scores on the Communicative Participation Item Bank (CPIB). Results will enhance our understanding of restrictions in communicative participation, assist in planning intervention targeting these restrictions and aid in clinical interpretation of CPIB scores. METHODS & PROCEDURES Semi-structured interviews using a phenomenological tradition and focusing on BoNT treatment and communicative participation were conducted with 26 people with LD who are on established BoNT treatment regimens. Interviews were recorded, transcribed, coded and analysed inductively. Participants were categorized by CPIB scores into groups ranging from none to extensive participation restrictions. Both self- and expert ratings of voice were obtained. OUTCOMES & RESULTS Participants with different levels of CPIB scores had different experiences related to communicative participation in the context of BoNT treatment. These differences were organized into the following topics: BoNT and voice; attitudes toward participation; coping strategies; and advice. For all participants except those in the least restricted and most restricted groups, expert ratings of voice did not relate to CPIB scores. CONCLUSIONS & IMPLICATIONS Although most participants report improved voice with BoNT treatment, many participants experienced lingering restrictions in communicative participation, some to a severe extent. Participants reported coping with these restrictions in many ways; some of these strategies were more successful than others. Those with restricted participation recommended more support for daily life and the emotional toll of LD, as well as support for family members. This support might be offered by speech-language pathologists. WHAT THIS PAPER ADDS What is already known on the subject Participants with different levels of CPIB scores had different experiences related to communicative participation in the context of BoNT treatment. What this study adds to the existing knowledge Although most participants report improved voice with BoNT treatment, many participants experienced lingering restrictions in communicative participation, some to a severe extent. What are the potential or actual clinical implications of this work? SLP services that take a participation-focused approach to intervention and use multi-factorial approaches to help clients maximize their life participation in the context of LD are well within the SLP scope of practice. SLPs can help clients find and use their optimal voices within the constraints of the dystonia and BoNT effects.
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Affiliation(s)
- Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Carolyn R Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Tanya Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Mara Kapsner-Smith
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
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Baylor C, Eadie T, Yorkston K. The Communicative Participation Item Bank: Evaluating, and Reevaluating, Its Use across Communication Disorders in Adults. Semin Speech Lang 2021; 42:225-239. [PMID: 34261165 DOI: 10.1055/s-0041-1729947] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Patient-reported outcomes (PROs) are essential in patient-centered, evidence-based practice in speech-language pathology. PROs respect individuals who live with communication disorders as key stakeholders providing a critically unique perspective on consequences of communication disorders, and whether interventions bring about meaningful changes. Some PROs focus on specific communication symptoms such as voice or language symptom severity, while others focus on broader constructs such as quality of life. Many PROs target specific diagnostic groups. This article presents the Communicative Participation Item Bank (CPIB), a PRO that measures communicative participation restrictions. The CPIB was based on the concept of participation, or engagement in life situations, as defined in the World Health Organization's International Classification of Functioning, Disability, and Health. It was designed to be relevant for adults across different communication disorders to facilitate clinical and research activities that may involve either comparing or aggregating data across communication disorders. The CPIB follows current PRO development protocols including systematic guidance from stakeholders through cognitive interviews, and the measurement methods of Item Response Theory that allow precise and adaptive assessment. This article reviews use of the CPIB across different diagnostic groups, and identifies needs for future efforts to expand the relevance of the CPIB further.
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Affiliation(s)
- Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Tanya Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
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Page AD, Elhayek N, Baylor C, Adams S, Jog M, Yorkston K. Exploring the Psychosocial Impact of Botulinum Toxin Type A Injections for Individuals With Oromandibular Dystonia: A Qualitative Study of Patients' Experiences. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1314-1328. [PMID: 33647215 DOI: 10.1044/2020_ajslp-20-00124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The purpose of this study was to explore the psychosocial impact of botulinum toxin (BoNT) injections for oromandibular dystonia (OMD) and to gain a better understanding of how participants judge the success of this treatment. Method Eight individuals with OMD and dysarthria participated in one face-to-face, semistructured interview. Interviews were audio-recorded and transcribed verbatim. Qualitative, phenomenological methods of coding, immersion, and emergence were used in the analysis of interview data. Results Two major themes and six subthemes emerged from the analysis of interview data. The first theme, Botox has changed me and my experiences, explored the participants' perspective of receiving BoNT injections and its psychosocial impact. The second theme, What communication is like for me, explored the psychosocial impact of BoNT on speech production and participation. Conclusions Our results suggest that BoNT has a variable impact on domains related to quality of life, satisfaction with treatment, speech production, and communicative participation. This study adds novel information related to the psychosocial consequences of BoNT treatment in the management of OMD and builds on a literature that studies the consequences and experiences of living with OMD.
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Affiliation(s)
- Allyson D Page
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
| | - Nada Elhayek
- Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Scott Adams
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
| | - Mandar Jog
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle
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Isetti D. Disclosure of a communication disorder during a job interview: A theoretical model. JOURNAL OF COMMUNICATION DISORDERS 2020; 87:106038. [PMID: 32835898 DOI: 10.1016/j.jcomdis.2020.106038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/28/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
With the passage of the Americans with Disabilities Act Amendments Act of 2008 (ADAAA), the definition of disability was expanded and the terms "speaking, hearing, and communicating" were given status as major life activities. Therefore, any communication disorder which substantially limits these major life activities in the workplace can qualify as a disability under the law. This legal protection means that no employer can ever ask about the presence of a communication disorder, and a job applicant is never required to disclose their communication disorder during the hiring process. However, this right to refrain from disclosure potentially places job applicants in a difficult situation. Applicants can choose to remain silent about their disorder and hopefully avoid hiring discrimination, yet the only way that workplace accommodations can be legally requested is if disclosure of the disability takes place. This disclosure decision-making process is likely complex and dependent upon multiple factors. Aspects such as workplace culture, job duties, severity of symptoms, individual motivations, and characteristics of the communication disorder likely all play a role when weighing the decision to disclose. This article proposes a theoretical model which outlines the factors that might influence the disclosure decision-making process for those with communication disorders before a job interview. Each major component of this decision-making process is highlighted, focusing on which factors might inhibit or foster disclosure within a hiring context. Clinical implications are discussed which can allow speech-language pathologists to assist those who are struggling with this important decision. The article also identifies areas in need of future research.
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Affiliation(s)
- Derek Isetti
- Department of Speech-Language Pathology, University of the Pacific, 3601 Pacific Ave., Stockton, CA, 95211, United States.
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Baylor C, Darling-White M. Achieving Participation-Focused Intervention Through Shared Decision Making: Proposal of an Age- and Disorder-Generic Framework. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:1335-1360. [PMID: 32463702 PMCID: PMC7893522 DOI: 10.1044/2020_ajslp-19-00043] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/20/2019] [Accepted: 02/10/2020] [Indexed: 05/08/2023]
Abstract
Introduction The World Health Organization's International Classification of Functioning, Disability and Health calls on speech-language pathologists (SLPs) to provide care that impacts all aspects of an individual's experience with a communication disorder, including their participation in valued life situations. However, SLPs often report feeling unprepared to implement and document interventions that target life participation. The purpose of this article is to propose a framework to guide participation-focused intervention practices. This age- and disorder-generic framework is designed to be applicable with clients across the variety of settings in which SLPs work. Method In this clinical focus article, we draw on past research and clinical experience to propose a restructuring of World Health Organization's International Classification of Functioning, Disability and Health components such that participation is the primary focus and outcomes indicator for intervention. In this framework, a specific communicative participation situation is identified and assessed quantitatively, and a corresponding participation-focused goal is established through shared decision making. Following that, assessments are conducted and goals are established in the areas of communication skills, physical and social environments, and personal perspectives. Results The proposed framework provides a concrete organizational structure as well as assessment, goal-writing, and intervention examples to assist SLPs in translating theoretical biopsychosocial frameworks into clinical practices. Conclusions SLPs can and do provide holistic communication services to clients to help them achieve their life participation goals. This article provides an example as to how we can document the need for, as well as the value and impact of our important work, meeting the diverse life participation needs of clients. Supplemental Material https://doi.org/10.23641/asha.12360758.
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Affiliation(s)
- Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Meghan Darling-White
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
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Yiu Y, Baylor CR, Bamer AM, Shelly S, Klein AM, Garrett CG, Pitman MJ. Validation of the Communicative Participation Item Bank as an Outcome Measure for Spasmodic Dysphonia. Laryngoscope 2020; 131:859-864. [PMID: 32710809 DOI: 10.1002/lary.28897] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/11/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Current patient-reported outcome measures do not adequately capture the impact of spasmodic dysphonia (SD) on communication in daily life situations. The aim of this study was to validate the Communicative Participation Item Bank (CPIB), which specifically measures a disease's impact on daily conversational situations, as an outcome measure for SD. STUDY DESIGN Multi-institutional prospective cohort study. METHODS A prospective study was conducted with administration of the 46-question CPIB and the Voice Handicap Index-10 (VHI-10) to 190 participants with SD before (time 1) and 6 weeks after (time 2) botulinum toxin injection. Differential item function (DIF) analyses were performed to examine potential item bias. Paired t-tests were used to assess change in each of the CPIB and VHI-10 scores after treatment. Pearson correlations were calculated between the CPIB and VHI-10. RESULTS DIF analyses revealed no clinically meaningful difference between the item parameters generated for this SD sample and the original CPIB calibration sample. There were statistically significant changes between the pre-treatment and post-treatment time points for both the CPIB and VHI-10. Correlations between the CPIB and VHI were moderate-high. CONCLUSIONS The CPIB item bank, General Short Form, and scoring parameters can be used with people with SD for valid and reliable measurement of the impact of communication disorders on communication in everyday life. The CPIB is sensitive to changes with intervention, proving useful for clinical and research purposes to assess the efficacy and effectiveness of interventions. LEVEL OF EVIDENCE Level 2, prospective observational research with an experimental design (ie, cohort study). Laryngoscope, 131:859-864, 2021.
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Affiliation(s)
- Yin Yiu
- Texas Voice Center, Department of Otolaryngology - Head & Neck Surgery, Houston Methodist Hospital, Houston, Texas, U.S.A
| | - Carolyn R Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, U.S.A
| | - Alyssa M Bamer
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, U.S.A
| | - Sandeep Shelly
- Emory Voice Center, Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - Adam M Klein
- Emory Voice Center, Department of Otolaryngology - Head & Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - C Gaelyn Garrett
- Vanderbilt Voice Center, Department of Otolaryngology - Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A
| | - Michael J Pitman
- The Center for Voice and Swallowing, Department of Otolaryngology - Head & Neck Surgery, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, New York, U.S.A
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Engelhoven AER, Zraick RI, Bursac Z, Tulunay-Ugur O, Hadden K. The Effects of Self-Esteem, Coping, and Voice-Related Quality of Life on Communicative Participation Before and After BOTOX® Treatment for Spasmodic Dysphonia. J Voice 2020; 36:146.e5-146.e16. [PMID: 32451253 DOI: 10.1016/j.jvoice.2020.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/07/2020] [Accepted: 03/23/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES/HYPOTHESIS The purpose of this study was to (1) investigate the percent change in communicative participation in individuals with spasmodic dysphonia (SD) pre- and post-BOTOX® treatment; and (2) to investigate if percent change in communicative participation is predicted by change in self-esteem, coping, and/or Voice-Related Quality of Life (V-RQOL) pre- and post-BOTOX® treatment. STUDY DESIGN/METHODS A cross-sectional study of 49 patients was conducted across three clinics, with each participant completing the Rosenberg Self-Esteem Scale, the Voice Disability Coping Questionnaire (VDCQ), the V-RQOL instrument, and the Communication Participation Item Bank (CPIB) before BOTOX® treatment and 10-14 days following BOTOX® treatment. DATA ANALYSIS For Research Question 1, a paired t test was applied to test the equality of means for CPIB and to test the pre-post changes among other composite measurements before and after the BOTOX® treatment. For Research Question 2, a multivariable linear regression model was applied with percent change in CPIB as a main outcome, and change in Rosenberg Self-Esteem Scale, VDCQ, and the V-RQOL as independent variables (or covariates) in order to test the associations. RESULTS The results indicated that pre- and post-BOTOX® measures of communicative participation are not statistically significantly different among the participants with SD. There was a strong positive correlation between change in coping and voice-related QOL. CONCLUSIONS A better understanding of the relationship between communicative participation and voice-related QOL is warranted. Item analysis of the V-RQOL and the VDCQ may illustrate coping strategies and functional impairments and provide further information regarding highly variable communicative participation among individuals with SD.
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Affiliation(s)
- Amy E R Engelhoven
- University of Central Florida, School of Communication Sciences and Disorders, Orlando, Florida.
| | - Richard I Zraick
- University of Central Florida, School of Communication Sciences and Disorders, Orlando, Florida
| | - Zoran Bursac
- Robert Stempel College of Public Health, Florida International University, Miami, Florida
| | - Ozlem Tulunay-Ugur
- University of Arkansas for Medical Sciences, Department of Otolaryngology, Little Rock, Arkansas
| | - Kristie Hadden
- University of Arkansas for Medical Sciences, Center for Health Literacy, Little Rock, Arkansas
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Arai S, Fukase Y, Okii A, Suzukamo Y, Suga T. Selection process for botulinum toxin injections in patients with chronic-stage hemiplegic stroke: a qualitative study. BMC Med Inform Decis Mak 2019; 19:280. [PMID: 31856809 PMCID: PMC6923967 DOI: 10.1186/s12911-019-1003-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 12/11/2019] [Indexed: 11/10/2022] Open
Abstract
Background Botulinum toxin (BT) injection is a new treatment for spasticity with hemiplegia after stroke. How a patient decides to receive BT injections after becoming aware of the treatment remains unclear. In this exploratory qualitative study, we aimed to investigate patients’ decision-making about treatment strategies in collaboration with family and health professionals and to identify conflicts in patients’ feelings about BT treatment. Methods The study included six patients with stroke sequelae. Data were collected using comprehensive interviews and were analyzed using the grounded theory approach and trajectory equifinality modeling. Results After patients learned about BT treatment, they clearly exhibited the following two concurrent perceptions: “the restriction of one’s life due to disabilities” and “the ability to do certain things despite one’s disabilities.” Some patients reported a “fear of not being able to maintain the status quo owing to the side effects of BT.” To alleviate this fear, timely support from family members was offered, and patients overcame anxiety through creative thinking. However, there were also expressions that revealed patients’ difficulties dealing with negative events. These factors influenced the patients’ development of “expectations of BT” or “hesitations about BT.” Conclusions To establish treatment strategies in collaboration with patients, healthcare professionals should show supportive attitudes and have discussions with patients and their family members to help patients resolve their conflicts and should establish treatment strategies that maintain the positive aspects of patients’ lives.
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Affiliation(s)
- Sawako Arai
- Department of Clinical Psychology, Kawasaki University of Medical Welfare, 288, Matsushima, Kurashiki, Okayama, Japan.
| | - Yuko Fukase
- Department of Health Science, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Akira Okii
- Physical Medicine and Rehabilitation Okii Clinic, Iwakuni, Yamaguchi, Japan
| | - Yoshimi Suzukamo
- Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Toshimitsu Suga
- Kansai Medical University Medical Center, Moriguchi, Osaka, Japan
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Faham M, Ahmadi A, Silverman E, Harouni GG, Dabirmoghaddam P. Quality of Life After Botulinum Toxin Injection in Patients With Adductor Spasmodic Dysphonia; a Systematic Review and Meta-analysis. J Voice 2019; 35:271-283. [PMID: 31477348 DOI: 10.1016/j.jvoice.2019.07.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Adductor spasmodic dysphonia is an extremely disabling voice disorder that negatively impacts a patient's quality of life (QOL). We performed a systematic review to determine if Botulinum Toxin (BT) injections improved voice related QOL in patients with this disorder. METHODS PubMed, EMBASE, Web of Science, Cochrane Library, ProQuest, and Scopus from 2000, to and including November 1st, 2018, were searched. We identified randomized controlled trials, controlled trials, and observational studies of the effects of BT injections on the QOL in patients with adductor spasmodic dysphonia. The two authors, separately and individually chose the studies based on inclusion criteria, assessed study quality, and relevant extracted data. RESULTS Nine studies used the Voice Handicap Index (VHI). The results showed significant changes pre- to post-BT injection (SMD = -0.357; 95% CI: -0.579, -0.136; z = 3.16; P = 0.002; I-squared = 0.000%). Five studies used the Voice-Related QOL; their results also showed a significant improvement pre- to postinjection (SMD = -2.99; 95% CI: -3.27, -1.32; z = 4.61; P < 0.001; I-squared = 87%). Three other studies used other, shortened versions of the VHI, VHI-10. They also showed significant results (SMD = -0.145; 95% CI: -0.349, 0.06; z = 1.38; P = 0.17; I-squared = 0.000). CONCLUSION BT injections positively affect patients' QOL. However, patients' QOL scores may never be normalized, in line with perceptual voice quality and acoustic parameters.
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Affiliation(s)
- Maryam Faham
- Department of Speech and Language Pathology, Shiraz University of Medical Sciences, Shiraz, Iran; Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Akram Ahmadi
- Department of Speech Therapy, School of Rehabilitation, Babol University of Medical Sciences, Babol, IR Iran
| | - Erin Silverman
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida
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Palmer AD, Carder PC, White DL, Saunders G, Woo H, Graville DJ, Newsom JT. The Impact of Communication Impairments on the Social Relationships of Older Adults: Pathways to Psychological Well-Being. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:1-21. [PMID: 30950760 DOI: 10.1044/2018_jslhr-s-17-0495] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose Social contact is known to be vital for older adults' mental and physical health but, because communication impairments often co-occur with other types of disability, it is difficult to generalize about the relative impact of a communication impairment on the social relationships of older adults. Specific aims of the study were to examine whether the severity of a communication impairment was associated with a range of social measures and to examine the association between these characteristics and psychological well-being. Method Community-dwelling older adults ranging in age from 65 to 94 were recruited for the study of Communication, Health, Aging, Relationship Types and Support. The sample included 240 participants with communication disorders arising from a variety of etiologies including hearing impairment, voice disorders, head and neck cancer, and neurologic disease, as well as older adults without a communication disorder. Results Communication impairment was a significant independent predictor for key characteristics of social relationships, including the number of friends in the social network, two types of social support, the frequency of social participation, and social self-efficacy. Communication impairment was also a significant predictor for higher levels of loneliness and depression. In addition, two distinct pathways between communication impairment and psychological well-being were identified, with social self-efficacy and reassurance of worth as mediators. Conclusions Even after controlling for age, gender, health, and disability, communication impairment is a significant independent predictor for key aspects of the social function of older adults and demonstrates two distinct pathways to loneliness and depression. Supplemental Material https://doi.org/10.23641/asha.7250282.
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Affiliation(s)
- Andrew D Palmer
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Paula C Carder
- Institute on Aging, College of Urban and Public Affairs, Portland State University, OR
| | - Diana L White
- Institute on Aging, College of Urban and Public Affairs, Portland State University, OR
| | - Gabrielle Saunders
- National Center for Rehabilitative Auditory Research, Portland VA Medical Center, OR
| | - Hyeyoung Woo
- Department of Sociology, Portland State University, OR
| | - Donna J Graville
- NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
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Shoffel-Havakuk H, Marks KL, Morton M, Johns MM, Hapner ER. Validation of the OMNI vocal effort scale in the treatment of adductor spasmodic dysphonia. Laryngoscope 2018; 129:448-453. [PMID: 30315575 DOI: 10.1002/lary.27430] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/02/2018] [Accepted: 06/18/2018] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To establish the validity of the OMNI Vocal Effort Scale (OMNI-VES) for resistance exercise, a single-question pictorial scale, in voice-related perceived exertion. Additionally, the study aimed to assess the role of the OMNI-VES as an outcome measurement in the treatment of adductor spasmodic dysphonia (ADSD). METHODS A prospective validation study was conducted on 226 participants. The case group was comprised of 178 patients receiving botulinum toxin (BTX) injections for ADSD and 48 controls without a voice disorder. Prior to a planned injection, the participants were asked to complete the OMNI-VES and the Voice-Related Quality-of-Life (V-RQOL) questionnaires, and the clinician completed the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). A subgroup of 17 patients were administered a repeat assessment 1 month after injection. RESULTS There was a weak correlation between the OMNI-VES and the V-RQOL score (Tau-b = -0.252, P < 0.001), and no significant correlation with the CAPE-V. Participants with ADSD had significantly higher OMNI-VES scores compared with normal controls, 5.07 ± 2.18 and 1.47 ± 2.28, respectively (P value < 0.0001). The average OMNI-VES score significantly improved 1 month following a BTX injection, from 6 ± 2.4 to 3.4 ± 2.8 (P value = 0.0003). Eighty-eight percent of the patients demonstrated a decrease in the OMNI-VES score following injection, whereas only 47% demonstrated an improvement in the V-RQOL score. CONCLUSION The OMNI-VES is a validated tool for rating perceived voice-related exertion in people with ADSD and can be used for evaluating response to BTX injection treatment. LEVEL OF EVIDENCE 2b Laryngoscope, 129:448-453, 2019.
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Affiliation(s)
- Hagit Shoffel-Havakuk
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petach Tikva; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Katherine L Marks
- Center for Laryngeal Surgery and Voice Rehabilitation, Massachusetts General Hospital, Boston, Massachusetts
| | - Mariah Morton
- Division of Communication Sciences and Disorders, College of Health Sciences, University of Kentucky, Lexington, Kentucky
| | - Michael M Johns
- USC Voice Center, Department of Otolaryngology Head and Neck Surgery, University of Southern California, Los Angeles, California, U.S.A
| | - Edie R Hapner
- USC Voice Center, Department of Otolaryngology Head and Neck Surgery, University of Southern California, Los Angeles, California, U.S.A
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Sav A, Salehi A, Mair FS, McMillan SS. Measuring the burden of treatment for chronic disease: implications of a scoping review of the literature. BMC Med Res Methodol 2017; 17:140. [PMID: 28899342 PMCID: PMC5596495 DOI: 10.1186/s12874-017-0411-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 08/31/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Although there has been growing research on the burden of treatment, the current state of evidence on measuring this concept is unknown. This scoping review aimed to provide an overview of the current state of knowledge as well as clear recommendations for future research, within the context of chronic disease. METHODS Four health-based databases, Scopus, CINAHL, Medline, and PsychInfo, were comprehensively searched for peer-reviewed articles published between the periods of 2000-2016. Titles and abstracts were independently read by two authors. All discrepancies between the authors were resolved by a third author. Data was extracted using a standardized proforma and a comparison analysis was used in order to explore the key treatment burden measures and categorize them into three groups. RESULTS Database searching identified 1458 potential papers. After removal of duplications, and irrelevant articles by title, 1102 abstracts remained. An additional 22 papers were added via snowball searching. In the end, 101 full papers were included in the review. A large number of the studies involved quantitative measures and conceptualizations of treatment burden (n = 64; 63.4%), and were conducted in North America (n = 49; 48.5%). There was significant variation in how the treatment burden experienced by those with chronic disease was operationalized and measured. CONCLUSION Despite significant work, there is still much ground to cover to comprehensively measure treatment burden for chronic disease. Greater qualitative focus, more research with cultural and minority populations, a larger emphasis on longitudinal studies and the consideration of the potential effects of "identity" on treatment burden, should be considered.
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Affiliation(s)
- Adem Sav
- School of Allied Health, Australian Catholic University, Banyo, Queensland, Australia. .,, PO Box 456, Virginia, 4014, Australia.
| | - Asiyeh Salehi
- Menzies Health Institute Queensland, Griffith University, University Drive, Meadowbrook, QLD, Australia
| | - Frances S Mair
- General Practice and Primary Care, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - Sara S McMillan
- Menzies Health Institute Queensland, Griffith University, University Drive, Meadowbrook, QLD, Australia
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Isetti DD, Baylor CR, Burns MI, Eadie TL. Employer Reactions to Adductor Spasmodic Dysphonia: Exploring the Influence of Symptom Severity and Disclosure of Diagnosis During a Simulated Telephone Interview. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:469-482. [PMID: 28492935 DOI: 10.1044/2016_ajslp-16-0040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 12/05/2016] [Indexed: 06/07/2023]
Abstract
PURPOSE The purpose of this study was to determine the influence of symptom severity and disclosure of adductor spasmodic dysphonia (ADSD) on the perceptions of human resource personnel members (HRPs) during a simulated phone interview. METHOD One female speaker with ADSD was recorded reading an interview script at two time points: (a) pre-BOTOX injection (severe), and (b) post-BOTOX injection (mild). Thirty-two HRPs evaluated the recording in one of the two conditions via a qualitative structured interview. HRPs gave their recommendations regarding when and how to disclose ADSD. RESULTS In the mild condition, no HRP perceived that the applicant had a voice disorder. Disclosure was not recommended as often, as an impairment was not initially noticed. However, 15/16 HRPs commented on the applicant's voice in the severe condition, with most suspecting she was a smoker or had lung/throat cancer. Disclosure in the severe condition was recommended more often, as it clarified symptoms that were noted at the outset. CONCLUSIONS Symptom severity in ADSD influences employer perceptions during the phone interview process. Incorrect assumptions may be made about applicants with severe symptoms, and apparentness of symptoms influences whether or not disclosure is recommended. Results have implications for counseling individuals with ADSD who are navigating the job interview process.
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Affiliation(s)
- Derek D Isetti
- Department of Speech Language Pathology and Audiology, University of the Pacific, Stockton, CA
| | - Carolyn R Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Michael I Burns
- Speech and Hearing Sciences, University of Washington, Seattle
| | - Tanya L Eadie
- Speech and Hearing Sciences, University of Washington, Seattle
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Gonçalves ACV, Jácome CIO, Demain SH, Hunt KJ, Marques ASPDD. Burden of treatment in the light of the international classification of functioning, disability and health: a "best fit" framework synthesis. Disabil Rehabil 2016; 39:1253-1261. [PMID: 27374769 DOI: 10.1080/09638288.2016.1194898] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE This systematic literature review aimed to (1) summarize and explain the concept of Burden of Treatment (BoT) using the International Classification of Functioning, Disability and Health (ICF) terminology, and (2) inform the development of a future Comprehensive ICF Core Set for BoT. METHOD Searches on EMbase, Medline, CINAHL and PsycINFO were conducted. Only qualitative studies were considered for inclusion. The screening and data extraction stages were followed by a "Best-fit" framework synthesis and content analysis, using the established ICF linking rules. Screening, data extraction, quality appraisal and data analysis were performed by two independent researchers. RESULTS Seventeen studies were included in this review. The "Best-fit" framework synthesis generated 179 subthemes which identified that BoT impacts negatively on body functions and structures, restricts valued activities and participation and influences contextual factors through life roles, self-identify and relationships. The identified subthemes were linked to 77 ICF categories. CONCLUSIONS This study is part of the preparatory phase of a Comprehensive ICF Core Set for BoT and our findings will inform the further needed studies on this phase. The use of ICF terminology to describe BoT provides an accessible route for understanding this complex concept, which is pivotal for rethinking clinical practice. Implications for rehabilitation Health professionals applying the ICF should consider the negative impact of interventions on patient's life roles and self-identity, body functions and structures and on valued activities and participation. Health professionals who may be concerned about the treatment burden being experienced by their patients can now use the ICF terminology to discuss this with the multidisciplinary team. Poor adherence to rehabilitation programs may be explained by an increased BoT. This phenomenon can now be mapped to the ICF, and coded using a framework well known by multidisciplinary teams.
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Affiliation(s)
| | | | - Sara Holtum Demain
- a Faculty of Health Sciences , University of Southampton , Southampton , UK
| | - Katherine J Hunt
- a Faculty of Health Sciences , University of Southampton , Southampton , UK
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Isetti D, Eadie T. The Americans With Disabilities Act and Voice Disorders: Practical Guidelines for Voice Clinicians. J Voice 2016; 30:293-300. [DOI: 10.1016/j.jvoice.2015.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 04/10/2015] [Indexed: 11/26/2022]
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22
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Shiba TL, Chhetri DK. Dynamics of phonatory posturing at phonation onset. Laryngoscope 2015; 126:1837-43. [PMID: 26690882 DOI: 10.1002/lary.25816] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 10/29/2015] [Accepted: 11/13/2015] [Indexed: 11/08/2022]
Abstract
INTRODUCTION In speech and singing, the intrinsic laryngeal muscles set the prephonatory posture prior to the onset of phonation. The timing and shape of the prephonatory glottal posture can directly affect the resulting phonation type. We investigated the dynamics of human laryngeal phonatory posturing. METHODS Onset of vocal fold adduction to phonation was observed in 27 normal subjects using high-speed video recording. Subjects were asked to utter a variety of phonation types (modal, breathy, pressed, /i/ following sniff). Digital videokymography with concurrent acoustic signal was analyzed to assess the timing of the following: onset of adduction to final phonatory posture (FPT), phonation onset time (POT), and phonatory posture time (PPT). Final phonatory posture time was determined as the moment at which the laryngeal configuration used in phonation was first achieved. RESULTS Thirty-three audiovisual recordings met inclusion criteria. Average FPT, PPT, and POT were as follows: 303, 106, and 409 ms for modal; 430, 104, and 534 ms for breathy; 483, 213, and 696 ms for pressed; and 278, 98, and 376 ms for sniff-/i/. The following posturing features were observed: 1) pressed phonation: increased speed of closure just prior to final posture, complete glottal closure, and increased supraglottic hyperactivity; and 2) breathy phonation: decreased speed of closure prior to final posture, increased posterior glottal gap, and increased midmembranous gap. CONCLUSIONS Phonation onset latency was shortest for modal and longest for pressed voice. These findings are likely explained by glottal resistance and subglottal pressure requirements. LEVEL OF EVIDENCE NA. Laryngoscope, 126:1837-1843, 2016.
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Affiliation(s)
- Travis L Shiba
- Laryngeal Physiology Laboratory, CHS 62-132, Department of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, California, U.S.A
| | - Dinesh K Chhetri
- Laryngeal Physiology Laboratory, CHS 62-132, Department of Head and Neck Surgery, UCLA School of Medicine, Los Angeles, California, U.S.A
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Demain S, Gonçalves AC, Areia C, Oliveira R, Marcos AJ, Marques A, Parmar R, Hunt K. Living with, managing and minimising treatment burden in long term conditions: a systematic review of qualitative research. PLoS One 2015; 10:e0125457. [PMID: 26024379 PMCID: PMC4449201 DOI: 10.1371/journal.pone.0125457] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 03/16/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND 'Treatment burden', defined as both the workload and impact of treatment regimens on function and well-being, has been associated with poor adherence and unfavourable outcomes. Previous research focused on treatment workload but our understanding of treatment impact is limited. This research aimed to systematically review qualitative research to identify: 1) what are the treatment generated disruptions experienced by patients across all chronic conditions and treatments? 2) what strategies do patients employ to minimise these treatment generated disruptions? METHODS AND FINDINGS The search strategy centred on: treatment burden and qualitative methods. Medline, CINAHL, Embase, and PsychINFO were searched electronically from inception to Dec 2013. No language limitations were set. Teams of two reviewers independently conducted paper screening, data extraction, and data analysis. Data were analysed using framework synthesis informed by Cumulative Complexity Model. Eleven papers reporting data from 294 patients, across a range of conditions, age groups and nationalities were included. Treatment burdens were experienced as a series of disruptions: biographical disruptions involved loss of freedom and independence, restriction of meaningful activities, negative emotions and stigma; relational disruptions included strained family and social relationships and feeling isolated; and, biological disruptions involved physical side-effects. Patients employed "adaptive treatment work" and "rationalised non-adherence" to minimise treatment disruptions. Rationalised non-adherence was sanctioned by health professionals at end of life; at other times it was a "secret-act" which generated feelings of guilt and impacted on family and clinical relationships. CONCLUSIONS Treatments generate negative emotions and physical side effects, strain relationships and affect identity. Patients minimise these disruptions through additional adaptive work and/or by non-adherence. This affects physical outcomes and care relationships. There is a need for clinicians to engage with patients in honest conversations about treatment disruptions and the 'adhere-ability' of recommended regimens. Patient-centred practice requires management plans which optimise outcomes and minimise disruptions.
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Affiliation(s)
- Sara Demain
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- NIHR Wessex Collaboration for Leadership and Research in Health Care, Southampton, United Kingdom
| | - Ana-Carolina Gonçalves
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- School of Health Sciences, University of Aveiro (ESSUA), Agras do Crasto—Campus Universitário de Santiago, Edifício 30, 3810–193 Aveiro, Portugal
| | - Carlos Areia
- School of Health Sciences, University of Aveiro (ESSUA), Agras do Crasto—Campus Universitário de Santiago, Edifício 30, 3810–193 Aveiro, Portugal
| | - Rúben Oliveira
- School of Health Sciences, University of Aveiro (ESSUA), Agras do Crasto—Campus Universitário de Santiago, Edifício 30, 3810–193 Aveiro, Portugal
| | - Ana Jorge Marcos
- School of Health Sciences, University of Aveiro (ESSUA), Agras do Crasto—Campus Universitário de Santiago, Edifício 30, 3810–193 Aveiro, Portugal
| | - Alda Marques
- School of Health Sciences, University of Aveiro (ESSUA), Agras do Crasto—Campus Universitário de Santiago, Edifício 30, 3810–193 Aveiro, Portugal
- Unidade de Investigação e Formação sobre Adultos e Idosos (UNIFAI), Porto, Portugal
| | - Ranj Parmar
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - Katherine Hunt
- Faculty of Health Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
- NIHR Wessex Collaboration for Leadership and Research in Health Care, Southampton, United Kingdom
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Alcohol responsiveness in laryngeal dystonia: a survey study. J Neurol 2015; 262:1548-56. [PMID: 25929664 DOI: 10.1007/s00415-015-7751-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 04/13/2015] [Accepted: 04/13/2015] [Indexed: 10/23/2022]
Abstract
Laryngeal dystonia (LD) is a task-specific focal dystonia of unknown pathophysiology affecting speech production. We examined the demographics of anecdotally reported alcohol use and its effects on LD symptoms using an online survey based on Research Electronic Data Capture (REDCap™) and National Spasmodic Dysphonia Association's patient registry. From 641 participants, 531 were selected for data analysis, and 110 were excluded because of unconfirmed diagnosis. A total of 406 patients (76.5 %) had LD and 125 (23.5 %) had LD and voice tremor (LD/VT). The consumption of alcohol was reported by 374 LD (92.1 %) and 109 LD/VT (87.2 %) patients. Improvement of voice symptoms after alcohol ingestion was noted by 227 LD (55.9 % of all patients) and 73 LD/VT (58.4 %), which paralleled the improvement observed by patient's family and/or friends in 214 LD (57.2 %) and 69 LD/VT (63.3 %) patients. The benefits lasted 1-3 h in both groups with the maximum effect after 2 drinks in LD patients (p = 0.002), whereas LD/VT symptoms improved independent of the consumed amount (p = 0.48). Our data suggest that isolated dystonic symptoms, such as in LD, are responsive to alcohol intake and this responsiveness is not attributed to the presence of VT, which is known to have significant benefits from alcohol ingestion. Alcohol may modulate the pathophysiological mechanisms underlying abnormal neurotransmission of γ-aminobutyric acid (GABA) in dystonia and as such provide new avenues for novel therapeutic options in these patients.
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Yorkston KM, Baylor C, Amtmann D. Communicative participation restrictions in multiple sclerosis: associated variables and correlation with social functioning. JOURNAL OF COMMUNICATION DISORDERS 2014; 52:196-206. [PMID: 24947986 PMCID: PMC4718073 DOI: 10.1016/j.jcomdis.2014.05.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 05/13/2014] [Accepted: 05/15/2014] [Indexed: 05/19/2023]
Abstract
UNLABELLED Individuals with multiple sclerosis (MS) are at risk for communication problems that may restrict their ability to take participation in important life roles such as maintenance of relationships, work, or household management. The aim of this project is to examine selected demographic and symptom-related variables that may contribute to participation restrictions. This examination is intended to aid clinicians in predicting who might be at risk for such restrictions and what variables may be targeted in interventions. Community-dwelling adults with MS (n=216) completed a survey either online or using paper forms. The survey included the 46-item version of the Communicative Participation Item Bank, demographics (age, sex, living situation, employment status, education, and time since onset of diagnosis of MS), and self-reported symptom-related variables (physical activity, emotional problems, fatigue, pain, speech severity, and cognitive/communication skills). In order to identify predictors of restrictions in communicative participation, these variables were entered into a backwards stepwise multiple linear regression analysis. Five variables (cognitive/communication skills, speech severity, speech usage, physical activity, and education) were statistically significant predictors of communication participation. In order to examine the relationship of communicative participation and social role variables, bivariate Spearman correlations were conducted. Results suggest only a fair to moderate relationship between communicative participation and measures of social roles. Communicative participation is a complex construct associated with a number of self-reported variables. Clinicians should be alert to risk factors for reduced communicative participation including reduced cognitive and speech skills, lower levels of speech usage, limitations in physical activities and higher levels of education. LEARNING OUTCOMES The reader will be able to: (a) describe the factors that may restrict participation in individuals with multiple sclerosis; (b) list measures of social functioning that may be pertinent in adults with multiple sclerosis; (c) discuss factors that can be used to predict communicative participation in multiple sclerosis.
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Affiliation(s)
- Kathryn M Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
| | - Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Dagmar Amtmann
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Isetti D, Xuereb L, Eadie TL. Inferring speaker attributes in adductor spasmodic dysphonia: ratings from unfamiliar listeners. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 23:134-45. [PMID: 24686338 DOI: 10.1044/2013_ajslp-13-0010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
PURPOSE To determine whether unfamiliar listeners' perceptions of speakers with adductor spasmodic dysphonia (ADSD) differ from control speakers on the parameters of relative age, confidence, tearfulness, and vocal effort and are related to speaker-rated vocal effort or voice-specific quality of life. METHOD Twenty speakers with ADSD (including 6 speakers with ADSD plus tremor) and 20 age- and sex-matched controls provided speech recordings, completed a voice-specific quality-of-life instrument (Voice Handicap Index; Jacobson et al., 1997), and rated their own vocal effort. Twenty listeners evaluated speech samples for relative age, confidence, tearfulness, and vocal effort using rating scales. RESULTS Listeners judged speakers with ADSD as sounding significantly older, less confident, more tearful, and more effortful than control speakers (p < .01). Increased vocal effort was strongly associated with decreased speaker confidence (rs = .88-.89) and sounding more tearful (rs = .83-.85). Self-rated speaker effort was moderately related (rs = .45-.52) to listener impressions. Listeners' perceptions of confidence and tearfulness were also moderately associated with higher Voice Handicap Index scores (rs = .65-.70). CONCLUSION Unfamiliar listeners judge speakers with ADSD more negatively than control speakers, with judgments extending beyond typical clinical measures. The results have implications for counseling and understanding the psychosocial effects of ADSD.
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Meyer TK, Hu A, Hillel AD. Voice disorders in the workplace: Productivity in spasmodic dysphonia and the impact of botulinum toxin. Laryngoscope 2013; 123 Suppl 6:S1-14. [DOI: 10.1002/lary.24292] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/13/2013] [Accepted: 06/13/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Tanya K. Meyer
- Department of Otolaryngology; University of Washington; Seattle Washington
| | - Amanda Hu
- Department of Otolaryngology; Drexel University; Philadelphia Pennsylvania U.S.A
| | - Allen D. Hillel
- Department of Otolaryngology; University of Washington; Seattle Washington
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What Makes a Good Voice for Radio: Perceptions of Radio Employers and Educators. J Voice 2013; 27:217-24. [DOI: 10.1016/j.jvoice.2012.08.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 08/25/2012] [Indexed: 11/18/2022]
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Abstract
Recently research offers new insights into the pathogenesis, pathophysiology, and socioemotional implications of spasmodic dysphonia (SD). Among these advances are epidemiologic studies clarifying (1) SD onset and course, (2) SD risk factors, and (3) the relationships among SD course, treatment, and psychosocial impact. In this paper, I will provide a summary of recent epidemiologic and socioemotional research advances involving the onset, course, risk factors, and psychosocial impact of SD.
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Affiliation(s)
- Kristine Tanner
- Department of Communication Disorders, Brigham Young University Provo, Utah
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Kaptein AA, Hughes BM, Scharloo M, Hondebrink N, Langeveld TPM. Psychological aspects of adductor spasmodic dysphonia: a prospective population controlled questionnaire study. Clin Otolaryngol 2010; 35:31-8. [PMID: 20447160 DOI: 10.1111/j.1749-4486.2009.02070.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine psychosocial concomitants, illness perceptions, and treatment perceptions in patients with adductor spasmodic dysphonia. DESIGN Prospective controlled cohort study. SETTING A tertiary care facility. PARTICIPANTS Forty-nine out-patients (38 women, 11 men; average age of 52 years) with adductor spasmodic dysphonia completed a battery of reliable and validated psychometric assessment instruments. Control patients' data were derived from scores in questionnaires by samples in the formal Manuals of the questionnaires used. MAIN OUTCOME MEASURES Psychosocial functioning, illness perceptions, and treatment perceptions. RESULTS Scores on psychosocial measures were elevated in male patients especially, indicating levels of psychological morbidity significantly above those seen in the general population. Assessments of illness perceptions and treatment perceptions indicated that patients perceive that they have a very low degree of control over the disorder, and experience a high emotional impact from it. Voice Handicap Index scores illustrated substantial degrees of perceived handicap. CONCLUSIONS Adductor spasmodic dysphonia is associated with significant negative psychosocial concomitants, coupled with low perceived control over the condition. Future research should elucidate the implications of illness perceptions and treatment perceptions for the biopsychosocial care of persons with adductor spasmodic dysphonia in order to improve self-management and enhance quality of life.
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Affiliation(s)
- A A Kaptein
- Department of Medical Psychology, Leiden University Medical Centre (LUMC), 2300 RC Leiden, The Netherlands.
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Baylor CR, Yorkston KM, Eadie TL, Miller RM, Amtmann D. Developing the communicative participation item bank: Rasch analysis results from a spasmodic dysphonia sample. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2009; 52:1302-20. [PMID: 19717652 PMCID: PMC3074579 DOI: 10.1044/1092-4388(2009/07-0275)] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE The purpose of this study was to conduct the initial psychometric analyses of the Communicative Participation Item Bank-a new self-report instrument designed to measure the extent to which communication disorders interfere with communicative participation. This item bank is intended for community-dwelling adults across a range of communication disorders. METHOD A set of 141 candidate items was administered to 208 adults with spasmodic dysphonia. Participants rated the extent to which their condition interfered with participation in various speaking communication situations. Questionnaires were administered online or in a paper version per participant preference. Participants also completed the Voice Handicap Index (B. H. Jacobson et al., 1997) and a demographic questionnaire. Rasch analyses were conducted using Winsteps software (J. M. Linacre, 1991). RESULTS The results show that items functioned better when the 5-category response format was recoded to a 4-category format. After removing 8 items that did not fit the Rasch model, the remaining 133 items demonstrated strong evidence of sufficient unidimensionality, with the model accounting for 89.3% of variance. Item location values ranged from -2.73 to 2.20 logits. CONCLUSIONS Preliminary Rasch analyses of the Communicative Participation Item Bank show strong psychometric properties. Further testing in populations with other communication disorders is needed.
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Affiliation(s)
- Carolyn R Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
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Yorkston KM, Baylor CR, Dietz J, Dudgeon BJ, Eadie T, Miller RM, Amtmann D. Developing a scale of communicative participation: A cognitive interviewing study. Disabil Rehabil 2009; 30:425-33. [DOI: 10.1080/09638280701625328] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bibliography. Current world literature. Laryngology and bronchoesophagology. Curr Opin Otolaryngol Head Neck Surg 2007; 15:417-24. [PMID: 17986882 DOI: 10.1097/moo.0b013e3282f3532f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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