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Kervin SR, Harris KJ, Urbano M, Curtis JA. The Relationship Between Speech-Language Pathologists' Perceptions of Clinical Terminology and Its Use in Voice Therapy with Adults. J Voice 2024:S0892-1997(24)00241-8. [PMID: 39214773 DOI: 10.1016/j.jvoice.2024.07.030] [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: 06/25/2024] [Revised: 07/28/2024] [Accepted: 07/29/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES The terminology used by speech-language pathologists (SLPs) during voice therapy is important for treatment outcomes because it can impact both patient self-efficacy and adherence. However, little is known about what factors influence the terminology that SLPs choose to use. Understanding this gap is important to ultimately optimize voice therapy outcomes. Therefore, the primary aims of this study were to (1) assess the relationship between reported clinician-perceived positivity and (2) assess the relationship between clinician-perceived positivity and clinical endorsement for use. We hypothesized that clinician-perceived positivity would be one important factor driving how frequently clinicians use or avoid specific terms, and if they think the term should be used by other SLPs in clinical practice. DESIGN/METHODS This prospective study was conducted as an online survey of SLPs and SLP clinical fellows who evaluate and treat adult voice patients. The survey presented respondents with a total of 46 voice-related terms and prompted respondents to rate: (1) how frequently they use a specific voice-related term ("frequency of use"); (2) how positive or negative they perceive a specific voice-related term to be ("perceived positivity"); and (3) if they feel a specific voice-related term should versus should not be used in clinical practice ("clinical endorsement"). Inferential statistics were used to examine the relationship between perceived positivity and frequency of use, and perceived positivity and clinical endorsement. Summary statistics were used to describe frequency of use across all terms. RESULTS One hundred twelve respondents completed the survey. Clinician-perceived positivity of voice-related terminology was significantly related to its reported self-reported frequency of use (β = 1.946; 95% CI: 1.701-2.191; P < 0.0005) and clinical endorsement of use by others (β = 4.103; 95% CI: 3.750-4.456; P < 0.0005). Both of these relationships exhibited relatively large effect sizes. CONCLUSIONS This study was an important first step at identifying factors that influence SLP's use of specific terminology in voice therapy. Specifically, an SLP's perceived positivity of clinical terminology strongly influenced the frequency with which they reported using that term in voice therapy and whether or not they thought that term should be used with patients by other SLPs in voice therapy. Future work should investigate clinician characteristics that might affect terminology use, include more diverse sampling, utilize self-selected terminology or audio recordings of therapy interactions, and assess direct effects of terminology use on patient outcomes.
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Affiliation(s)
- Sarah R Kervin
- Sean Parker Institute for the Voice, Weill Cornell Medical College, New York, New York.
| | - Kaila J Harris
- Voice and Speech Laboratory, Massachusetts Eye and Ear, Boston, Massachusetts
| | - Megan Urbano
- USF Health Voice Center, USF ENT North Tampa Campus, Tampa, Florida
| | - James A Curtis
- Aerodigestive Innovations Research Lab (AIR), Department of Otolaryngology-Head & Neck Surgery, Weill Cornell Medical College of Cornell University, New York, New York
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Rao SJ, Ruckart KW, Nosow LM, Morris AK, Carter Wright S, Madden LL. Chronic Cough: Evaluation of Patients' Motivation to Undergo Cough Suppression Therapy. J Voice 2024; 38:870-875. [PMID: 35279346 DOI: 10.1016/j.jvoice.2022.02.007] [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: 12/14/2021] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Chronic cough is a persistent cough lasting greater than eight weeks. The prevalence rate is estimated to be 9% to 33% in the United States. There are several treatment modalities described in current literature including medical, surgical, and behavioral interventions. Behavioral intervention with a speech-language pathologist (SLP) includes education on laryngeal hygiene and the voluntary control of cough as well as respiratory retraining to suppress or reduce the duration of cough. Cough suppression therapy, like other behavioral therapies, requires patient motivation and commitment to participation and completion in therapy. METHODS This study was a prospective cross-sectional survey at a single academic institution. Adult patients evaluated by a laryngologist for chronic cough regardless of their primary etiology were included. Patients who were tracheostomy dependent, on oxygen therapy, had vocal fold paralysis/immobility, or had undergone previous laryngeal surgery were excluded. Patients were surveyed at the end of the initial clinic visit or at the beginning of the first cough suppression therapy session. Subjects reported their motivational factors for undergoing cough suppression therapy. RESULTS The majority of patients, 21 (58.33%), identified as female, 15 patients (41.20%) identified as male, and no patients identified as transgender, nonbinary, and/or other gender. The patients in this study had a mean age of 57.75 (12.12) years. 35 patients (97.22%) were interested in cough suppression therapy. The mean presenting cough severity index (CSI) was 19.39 (10.28) with the mean cough duration of 8.69 (12.10) years. CONCLUSIONS Patients primarily sought cough suppression therapy due to intrinsic factors rather than extrinsic influence. By understanding the relationship between symptomatology and patient motivation, clinicians can better counsel their patients and improve methods to assess candidacy for behavioral treatment.
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Affiliation(s)
- Shambavi J Rao
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Kathryn W Ruckart
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Lillian M Nosow
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Amy K Morris
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - S Carter Wright
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - Lyndsay L Madden
- Department of Otolaryngology-Head and Neck Surgery, Wake Forest School of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.
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Rubino M, Abbott KV. Scoping Review of Voice Therapy Adherence. J Voice 2024; 38:426-434. [PMID: 34911636 DOI: 10.1016/j.jvoice.2021.09.020] [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: 07/27/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The purpose of this scoping review was to summarize key findings in the voice therapy adherence literature for individuals with phonotraumatic lesions. The particular focus was to identify how adherence has been defined and measured (operationalization and criteria for successful adherence) and to describe variables which were found to have a positive, neutral, or negative relationship with adherence to voice therapy. METHODS Data were identified and charted using the PRISMA-ScR protocol via searches of CINAHL, PsycINFO, Pubmed, SCOPUS, and Web of Science. RESULTS Literature mining revealed that adherence is rarely defined but is usually operationalized. "Successful completion of therapy" was the most common operationalization. Most variables studied in this field have been found to have no relationship with adherence. An incidental finding was that, most frequently, researchers have repeatedly studied variables which have already been documented to have no relationship with adherence. CONCLUSION Research into voice therapy adherence is still emerging, and few if any variables have been identified which are strongly associated with adherence to voice therapy for people with phonotraumatic lesions. Inspiration for future research may be drawn from other disciplines, which point to relationship variables as central to the adherence process. Examination of such variables is currently underrepresented in the voice therapy literature; we suggest this and other gaps for pursuit in future research.
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Affiliation(s)
- Marianna Rubino
- Department of Communication Sciences and Disorders, University of Delaware, Newark, Delaware.
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Aguiar ACD, Almeida LNA, Pernambuco L, Ramos N, Andrade JMD, Behlau M, Almeida AA. Urica-VV Scale: A New Research Perspective of The Stage of Readiness for Treatment in Patients with Dysphonia. J Voice 2023; 37:807-821. [PMID: 34272143 DOI: 10.1016/j.jvoice.2021.06.004] [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: 03/06/2021] [Revised: 05/31/2021] [Accepted: 06/05/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To obtain evidence of validity for the URICA-V scale and estimate the psychometric properties of its items based on item response theory (IRT). METHOD A total of 658 individuals of both sexes over 18 years of age were allocated into two groups: with dysphonia group (WDG) and vocally healthy group (VHG). A digital database was constructed with personal and professional data and item-by-item responses on the URICA-V scale. Subsequently, Cronbach's alpha, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), application of IRT using Samejima's model and ROC curve analysis were used to obtain the cutoff point for the URICA-V scale. RESULTS A different version of the original URICA-V scale was obtained. Of the 32 items from the original protocol, 25 better explained the instrument and were regrouped into two domains: contemplation and maintenance. It was possible to identify which items generated higher difficulty (b) and discrimination (a) values and which contributed to the presentation of a calculation based on the theta of each participant. The ROC curve was analyzed, and a cutoff point of -0.236 was established; establishing a cutoff point facilitates the decision of which individuals are in a state of readiness for voice treatment. CONCLUSION The present study provided evidence that allows us to propose the URICA-Voice validated (URICA-VV) scale within a more contemporary perspective and with a reduced number of items and domains. In addition, a cutoff point was obtained based on IRT to measure, with greater accuracy, sensitivity and specificity, the stage of readiness and to differentiate individuals who have an indication for speech therapy.
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Affiliation(s)
- Alexandra Christine de Aguiar
- Speech therapist. Master's degree in Speech Therapy and Doctoral Student in Decision and Health Models from Federal University of Paraíba (Universidade Federal da Paraíba - UFPB)
| | - Larissa Nadjara Alves Almeida
- Speech therapist. PhD in Decision and Health Models from Federal University of Paraíba (Federal University of Paraíba - UFPB)
| | - Leandro Pernambuco
- Speech therapist. Professor, Department of Speech Therapy, Federal University of Paraíba
| | - Noemi Ramos
- Speech therapist. Master's degree in Decision and Health Models from Federal University of Paraíba (Federal University of Paraíba - UFPB)
| | - Josemberg Moura de Andrade
- Psychologist. Professor, Department of Social and Work Psychology, University of Brasília (Universidade de Brasília - UnB)
| | - Mara Behlau
- Speech therapist. Professor, Graduate Program in Human Communication Disorders, Federal University of São Paulo - (Universidade Federal de São Paulo - UNIFESP). Centro de Estudos da Voz, São Paulo - SP
| | - Anna Alice Almeida
- Speech therapist. Professor, Department of Speech Therapy, Federal University of Paraíba.
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Holmberg J, Linander I, Södersten M, Karlsson F. Exploring Motives and Perceived Barriers for Voice Modification: The Views of Transgender and Gender-Diverse Voice Clients. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-14. [PMID: 37263019 DOI: 10.1044/2023_jslhr-23-00042] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To date, transgender and gender-diverse voice clients' perceptions and individual goals have been missing in discussions and research on gender-affirming voice therapy. Little is, therefore, known about the client's expectations of therapy outcomes and how these are met by treatments developed from views of vocal gender as perceived by cisgender persons. This study aimed to explore clients' individual motives and perceived barriers to undertaking gender-affirming voice therapy. METHOD Individual, semistructured interviews with 15 transgender and gender-diverse voice clients considering voice therapy were conducted and explored using qualitative content analysis. RESULTS Three themes were identified during the analysis of the participants' narratives. In the first theme, "the incongruent voice setting the rules," the contribution of the voice on the experienced gender dysphoria is put in focus. The second theme, "to reach a voice of my own choice," centers around anticipated personal gains using a modified voice. The third theme, "a voice out of reach," relates to worries and restricting factors for not being able to reach one's set goals for voice modification. CONCLUSIONS The interviews clearly indicate a need for a person-centered voice therapy that starts from the individuals' expressed motives for modifying the voice yet also are affirmative of anticipated difficulties related to voice modification. We recommend that these themes should form the basis of the pretherapy joint discussion between the voice client and the speech-language pathologist to ensure therapy goals that are realistic and relevant to the client.
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Affiliation(s)
- Jenny Holmberg
- Department of Clinical Sciences, Umeå University, Sweden
- Umeå Centre for Gender Studies, Umeå University, Sweden
| | - Ida Linander
- Umeå Centre for Gender Studies, Umeå University, Sweden
- Department of Epidemiology and Global Health, Umeå University, Sweden
| | - Maria Södersten
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Speech-Language Pathology, Karolinska University Hospital, Stockholm, Sweden
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Vinney LA, Tripp R, Shelly S, Gillespie A. Indexing Cognitive Resource Usage for Acquisition of Initial Voice Therapy Targets. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:717-732. [PMID: 36701805 DOI: 10.1044/2022_ajslp-22-00197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE The purpose of this study was to index cognitive resource usage for acquisition of initial targets of two common voice therapy techniques (resonant voice therapy [RVT] and conversation training therapy [CTT]) based on the theorized depletion effect (i.e., when an initial task requiring high cognitive load leads to poorer performance on a subsequent task). METHOD Eleven vocally healthy participants, ages 23-41 years, read aloud the Rainbow Passage and produced consonant-vowel resonant targets (/mi, ma, mu/) followed by a baseline computerized Stroop task and a 15-min washout. Following this baseline period, participants watched and interacted with two videos instructing them in RVT or CTT initial targets. After viewing each video and practicing the associated vocal skills, participants rated the degree of mental effort required to engage in the target vocal technique on a modified Borg scale. Participants recorded their attempts at RVT on /mi, ma, mu/ and CTT on the Rainbow Passage, which were later rated by three voice-specialized speech-language pathologists as to how representative they were of each respective target technique. Changes in fundamental frequency and average auditory-perceptual ratings from baseline were examined to determine if participants adjusted their technique from RVT and CTT baseline to acquisition. RESULTS Performance on the Stroop task was, on average, worse post CTT than post RVT, but both post-CTT and post-RVT Stroop scores were poorer than baseline. These results suggest that both treatment techniques taxed cognitive resources but that CTT was more cognitively taxing than RVT. However, despite differences in raw averages, no statistically significant differences were found between the baseline, post-CTT, and post-RVT Stroop scores, likely due to the small sample size. Participant ratings of mental effort for CTT and RVT were statistically similar. Likewise, poorer post-RVT Stroop scores were associated with participants' greater perceived mental effort with RVT acquisition, but there was no significant association between mental effort ratings for CTT acquisition and post-CTT Stroop scores. Significantly higher fundamental frequency and perceived ratings of the accuracy of technique from baseline to acquisition for both CTT and RVT were found, providing evidence of vocal behavior changes as a result of each technique. CONCLUSIONS Brief exposure to initial treatment tasks in CTT is more cognitively depleting than initial RVT tasks. Results also indicate that vocally healthy participants are able to make a voice change in response to a brief therapy prompt. Finally, participant-rated measures of mental effort and secondary measures of cognitive depletion do not always correlate.
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Affiliation(s)
| | - Raquel Tripp
- Department of Communicative Sciences and Disorders, New York University, NY
| | - Sandeep Shelly
- Emory Voice Center, Department of Otolarynngology-Head and Neck Surgery, Emory University, Atlanta, GA
| | - Amanda Gillespie
- Emory Voice Center, Department of Otolarynngology-Head and Neck Surgery, Emory University, Atlanta, GA
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Ghorbani M, Hoseini FS, Yunesian M, Salehin S, Talebi SS, Keramat A. A supportive randomized clinical trial on Iranian infertile women with the history of infertility treatments dropout following unsuccessful ART cycle/s: A study protocol. Heliyon 2023; 9:e13838. [PMID: 36879964 PMCID: PMC9984792 DOI: 10.1016/j.heliyon.2023.e13838] [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: 07/16/2022] [Revised: 12/27/2022] [Accepted: 01/23/2023] [Indexed: 02/19/2023] Open
Abstract
Introduction Due to high dropout rate of infertility treatments and lack of any intervention for motivating infertile couples to continue treatments, the present study will be conducted with the aim of designing, implementing and determining the effectiveness of the proposed intervention in order to continue infertility treatments. Methods & Analysis: We will conduct this study in two stages; a review of literature and past studies will be done to identify interventions that have been performed for infertile couples, and then an appropriate intervention with the aim of continuing infertility treatments for infertile women will be designed. After that a Delphi study will be designed in accordance with collected information of previous stages and will be approved by experts. In the second stage we will implement designed intervention of a randomized clinical trial on two groups of infertile women (control and intervention) with the history of infertility treatment dropout following unsuccessful cycle. We will use descriptive statistic in first and second stage. In second stage Chi square test and independent samples T test will be used to compare variables between groups and variables in study questionnaires before and after the intervention between two groups of study. Discussion The present study will be the first study to be performed as a clinical trial on infertile women who have discontinued the treatments, with the aim of continuing treatments. Thereupon, it seems that the results of this study will be the basis for studies around the world to prevent premature cessation of infertility treatments.
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Affiliation(s)
- Maryam Ghorbani
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Fatemeh Sadat Hoseini
- Faculty Member of School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Masud Yunesian
- School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrbanoo Salehin
- Sexual Health and Fertility Research center. Shahroud University of Medical sciences. Shahroud. Iran
| | - Seyedeh Solmaz Talebi
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Afsaneh Keramat
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
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Kopf LM, Huh-Yoo J. A User-Centered Design Approach to Developing a Voice Monitoring System for Disorder Prevention. J Voice 2023; 37:48-59. [PMID: 33189486 DOI: 10.1016/j.jvoice.2020.10.015] [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: 08/17/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Many individuals will experience a voice disorder in their lifetime, especially occupational voice users. While a number of voice monitoring systems have been developed, most were designed with the clinician/researcher as the end user. For a patient to use these systems, they need field experts to help them interpret data from the system to understand its meaning. Most of these systems would have challenges in being used in a preventative context with the occupational voice user as the sole system user. OBJECTIVE The current study introduces a novel design approach: user-centered design (UCD) with paper prototypes in the creation of a voice monitoring system for voice disorder prevention (VDP). The goal of this design approach is to design systems that are engaging and intuitive for users so they will be interested in interacting with the system and be able to benefit from the system without the need of external support. METHODS The current study was conducted in two phases: an iterative design phase and a test phase. In the iterative design phase, 15 participants gave their opinions on the measures and feedback designs they felt would be the most beneficial to users. In the test phase, the researchers collected real voice data over multiple sessions for 18 additional participants and provided this data using the final feedback displays from the design phase. RESULTS By engaging in UCD, the researchers identified key design challenges for VDP: (1) educating the user, (2) balancing contextualization and granularity, and (3) addressing disconnection between user and system goals. CONCLUSION UCD holds promise for designing VDP systems that are both engaging and intuitive for occupational voice users.
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Affiliation(s)
- Lisa M Kopf
- Department of Communication Sciences and Disorders, University of Northern Iowa, Cedar Falls, Iowa; Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, Michigan.
| | - Jina Huh-Yoo
- College of Computing and Informatics, Drexel University, Philadelphia, Pennsylvania
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Marchese MR, Longobardi Y, Di Cesare T, Mari G, Terruso V, Galli J, D’Alatri L. Gender-related differences in the prevalence of voice disorders and awareness of dysphonia. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2022; 42:458-464. [PMID: 36541384 PMCID: PMC9793143 DOI: 10.14639/0392-100x-n2018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/30/2022] [Indexed: 12/24/2022]
Abstract
Objective Considering the impact of dysphonia on public health and the increasing attention to patient-centred care, we evaluated sex-related differences in the prevalence of benign voice disorders, awareness of dysphonia and voice therapy (VT) results. Methods One hundred and seventy-one patients, 129 females and 42 males, with functional or organic benign dysphonia underwent Voice Handicap Index (VHI), auditory-perceptual dysphonia severity scoring (GRBAS) and acoustic analysis (Jitter%, Shimmer%, NHR) before and after VT. Results Prevalence of each voice disorder was significantly higher among females. Mean time-to-diagnosis (time elapsed until medical consultation) was not different between males and females. The refusal of therapy and VT adherence (mean number of absences and premature dropout) were similar in the two groups. Pre-VT VHI and "G" parameter were worse in women. The percentage of women with abnormal acoustic analysis was significantly higher. Post-VT VHI gain was higher in women, whereas "G" parameter improvement did not differ by sex. Conclusions Our study showed a higher prevalence of voice disorders in females. Awareness of dysphonia was not gender related. Females started with worse voice subjective perception and acoustic analysis, but they perceived greater improvement after therapy.
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Affiliation(s)
| | - Ylenia Longobardi
- Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome, Italy
| | - Tiziana Di Cesare
- Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome, Italy,Correspondence Tiziana Di Cesare Department of Head and Neck Sciences, Catholic University of Sacred Heart, Policlinico “A. Gemelli” Foundation, l.go “A. Gemelli” 8, 00168 Rome, Italy Tel. +39 06 30154439. Fax +39 06 3051194 E-mail:
| | - Giorgia Mari
- Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome, Italy
| | - Valeria Terruso
- Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome, Italy
| | - Jacopo Galli
- Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome, Italy, Department of Aging, Neurological, Orthopedic and Head and Neck Sciences, UOC of Otolaryngology, A. Gemelli IRCCS University Hospital Foundation, Rome, Italy
| | - Lucia D’Alatri
- Institute of Otolaryngology, Catholic University of the Sacred Heart, Rome, Italy, Department of Aging, Neurological, Orthopedic and Head and Neck Sciences, UOC of Otolaryngology, A. Gemelli IRCCS University Hospital Foundation, Rome, Italy
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10
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Fabian SB, Kwon J, Rao SJ, Ruckart KW, Madden LL. Chronic Cough: Evaluation of Patients' Success in Completing Cough Suppression Therapy. J Voice 2022. [DOI: 10.1016/j.jvoice.2022.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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11
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Gerlach-Houck H, Rodgers NH. The good, the bad, and the ugly: Unpacking the pros and cons associated with change for adults who stutter. JOURNAL OF FLUENCY DISORDERS 2022; 73:105924. [PMID: 35947913 DOI: 10.1016/j.jfludis.2022.105924] [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: 03/14/2022] [Revised: 07/08/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of the current study was to document the pros and cons that adults who stutter may consider when deciding to change how they live with stuttering. METHODS Semi-structured interviews were conducted with 11 adults who stutter and 12 speech-language pathologists who specialize in stuttering therapy. Participants were asked to identify and discuss the advantages and disadvantages of making a change to how they live with stuttering. Reflexive thematic analysis was used to generate multilevel themes. RESULTS Meaningful units were extracted from interview transcripts to develop 37 discrete pros and 15 discrete cons. The pros of change clustered into five organizing themes: enriching one's social relationships, feeling better in social interactions, developing a healthier sense of self, gaining autonomy, and communicating easier. The cons of change clustered into three organizing themes: experiencing discomfort, expending resources, and recognizing that some things may not change. CONCLUSION This study documented why adults who stutter may or may not seek change. Identifying the pros and cons of behavior change is an important step in understanding why some clients who stutter are ambivalent about, or resistant to, the therapeutic process.
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Affiliation(s)
- Hope Gerlach-Houck
- Dept of Speech, Language & Hearing Sciences, Western Michigan University, USA.
| | - Naomi H Rodgers
- Dept of Special Education & Communication Disorders, University of Nebraska-Lincoln, USA
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12
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Weatherill M, Tibus E, Rodriguez AD. Motivation as a Predictor of Aphasia Treatment Outcomes: A Scoping Review. TOPICS IN LANGUAGE DISORDERS 2022; 43:252-265. [PMID: 36950030 PMCID: PMC10026711 DOI: 10.1097/tld.0000000000000286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE Motivation is a complex phenomenon that can influence a person's ability to make progress in treatment. We sought to understand how motivation is currently measured and utilized in aphasia rehabilitation by identifying treatment studies that (1) include measurement of motivation and (2) use motivation to predict treatment response. METHOD A scoping review was conducted by systematically searching PubMed, CINAHL, EBSCO, Ovid MEDLINE, and APA PsycInfo using the following search terms: (measurement OR treatment OR rehabilitation OR predict*) AND (motiv* OR engagement OR adherence OR compliance) AND (aphasia OR dysphasia). RESULTS Two studies met our inclusion criteria. Motivation was measured differently across studies. No studies used motivation to predict treatment outcomes. DISCUSSION/CONCLUSIONS Despite the importance of motivation in aphasia rehabilitation success, studies that include its measurement are sparse. Additional research is needed and should include development of measurement tools and evaluation of the predictive value of motivation on treatment outcomes.
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Affiliation(s)
- Maryanne Weatherill
- VA RR&D Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, Georgia
| | - Elizabeth Tibus
- VA RR&D Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, Georgia
| | - Amy D. Rodriguez
- VA RR&D Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Health Care System, Decatur, Georgia
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
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13
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Wang L, Liu Y, Tan H, Huang S. Transtheoretical model-based mobile health application for PCOS. Reprod Health 2022; 19:117. [PMID: 35549736 PMCID: PMC9097413 DOI: 10.1186/s12978-022-01422-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/24/2022] [Indexed: 12/19/2022] Open
Abstract
Background Lifestyle modification (diet, exercise, and behavioral interventions) is the first-line treatment for polycystic ovary syndrome (PCOS). The benefits of face-to-face lifestyle modification intervention in a short time have been demonstrated. However, few studies have investigated the mobile technology effects on lifestyle modification in PCOS. Therefore, we examined the effect of transtheoretical model-based mobile health application intervention program for PCOS. Methods A randomised controlled, single-blind trial, was carried out from October 2018 to March 2019, which included 122 participants recruited from gynecology outpatient clinics of affiliated Hospital of Zunyi Medical University in Guizhou. The study participants were randomised into intervention (n = 61) and control groups (n = 61). Participants in the intervention group undertook a TTM-based mobile health application program in addition to routine care, and participants in the control group received only routine care. Results Fifty-one participants in the intervention group and 49 in the control group completed the study. Compared to the control group, participants in the intervention group showed statistically significant decrease for BMI (P < 0.05), WC (P < 0.05), SAS (P < 0.05), and SDS (P < 0.05) scores at 6-month and 12-month, respectively. Behavior stage change of exercise and diet among paticipants with PCOS was significant at 6 months (c2 = 43.032, P < 0.05) and 12th months (c2 = 49.574, P < 0.05) between the intervention and control groups. Conclusions This study showed that the TTM-based mobile health application program can decrease BMI, WC, anxiety, and depression, and improve exercise and diet adherence in patients with PCOS in the long term. The TTM-based mobile health application program can be applied for lifestyle modification in women with PCOS. Trial registration This study was approved by the ethics committee NO.[2019]1-028 in March 2018 and was registered at the Chinese Clinical Trial Registry (website: www.chictr.org.cn, registry number: ChiCTR2000034572) Poor adherence of life management in patients with PCOS and many then go on to adherence poor health outcomes as a result. There is an urgent need for new approach to enhance to life management compliance for patients with PCOS. TTM is a common behavior change model, which can effectively promote the behavior change of patients, but it has not been used in the life management of PCOS patients. Meanwhile, the traditional life management of PCOS is mainly face-to-face intervention, few studies have investigated the mobile technology effects on lifestyle modification in PCOS. This study aimed to evaluate the long-term effects of TTM-based mobile technology (for lifestyle modification) on the maintenance of health-related behavior changes among women with PCOS. This study confirmed that the TTM-based mobile health application program can decrease BMI, WC, anxiety, and depression, and improve exercise and diet adherence in patients with PCOS in the long term. Our study conducted TTM-based mobile health application program can provide a reference for other researchers or research organizations.
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Affiliation(s)
- LianHong Wang
- Nursing Department of Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.,Nursing College of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Ying Liu
- Nursing Department of Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.,Nursing College of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Huiwen Tan
- Nursing Department of Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China.,Nursing College of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Shiming Huang
- Nursing Department of Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China. .,Nursing College of Zunyi Medical University, Zunyi, 563000, Guizhou, China.
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14
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Dacakis G, Erasmus J, Nygren U, Oates J, Quinn S, Södersten M. Development and Initial Psychometric Evaluation of the Self-Efficacy Scale for Voice Modification in Trans Women. J Voice 2022:S0892-1997(22)00078-9. [PMID: 35513936 DOI: 10.1016/j.jvoice.2022.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To develop a self-efficacy questionnaire for voice modification related to gender affirmation and to examine the internal consistency and test-retest reliability of the questionnaire among a cohort of trans women. METHODS This study was undertaken in two phases. In phase I, four Speech- Language Pathologists (SLPs) and four trans women informed the development of the Self-Efficacy Scale for Voice Modification in Trans Women (SES-VMTW). In phase II, using classical test theory, data from 31 Australian and 27 Swedish trans women who completed the SES-VMTW twice with an interim period of 3-6 weeks were analyzed for internal consistency and test-retest reliability. During this second phase, the 19 items of the SES-VMTW were subcategorized by consensus among the authors into like groups. RESULTS Phase I resulted in the 19-item SES-VMTW and four subcategories were identified: 1) Change (items related to changing voice); 2) Perception (items related to the ability to perceive changes in voice; 3) Psychological (items related to engaging in voice practice despite psychological barriers; 4) Logistical (items related to engaging in voice practice despite logistical barriers). In Phase II, initial psychometric analysis was applied to the full questionnaire as well as to the subcategories. The Cronbach's alpha for the full questionnaire (α = 0.86) at both the test and retest timepoints indicates a high level of internal consistency. Item-total correlation analysis indicated that individual items correlated with the questionnaire total score, but that they generally correlated more strongly with the total score for the relevant subcategory. The Cronbach's alpha for the four subcategories of the SES-VMTW were variable but all coefficients exceeded 0.6, thus supporting the reliability of the new scale. Good test-retest reliability was demonstrated for the full questionnaire (intraclass correlation coefficient = 0.84; 95% confidence interval, 0.73-0.90, P < 0.001) and was moderate to good for the four subcategories. CONCLUSION The findings of the current study are promising, suggesting that both the full SES-VMTW and the four subcategories can provide consistent and reliable insight into self-efficacy for trans women aiming to modify their voice as part of their gender affirmation.
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Affiliation(s)
- Georgia Dacakis
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
| | - Jaco Erasmus
- Gender Clinic, Monash Health, Clayton, Victoria, Australia
| | - Ulrika Nygren
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Jennifer Oates
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Sterling Quinn
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Maria Södersten
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Speech and Language Pathology, Medical Unit, Karolinska University Hospital, Stockholm, Sweden
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15
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Rodgers NH. Meet Them Where They're At: Maximizing Adolescents' Engagement in Stuttering Therapy. Semin Speech Lang 2022; 43:161-172. [PMID: 35697037 DOI: 10.1055/s-0042-1742450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Adolescents who stutter often pose a unique clinical challenge for clinicians. They are a population simultaneously striving for independence from adults and social connection with their peers at a time when social fears surge and lifelong habits take root. It is a time when they may seem "unmotivated" to learn and utilize new communication or coping skills related to stuttering. How can clinicians maximize adolescents' engagement in stuttering therapy to improve meaningful outcomes? The purpose of this article is to describe a transtheoretical approach to assessing adolescents' readiness to make positive changes to living with stuttering, and to provide motivational interviewing strategies that clinicians can employ to help propel adolescents toward personally significant change. These principles will be applied to the case study of a 14-year-old who stutters to demonstrate how clinicians can put this approach to work as they meet their adolescent clients "where they're at."
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Affiliation(s)
- Naomi H Rodgers
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, Nebraska
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16
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Zebrowski PM, Rodgers NH, Gerlach H, Paiva AL, Robbins ML. Applying the Transtheoretical Model to Stuttering Management Among Adolescents: Part I. Scale Development. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2492-2509. [PMID: 34525312 DOI: 10.1044/2021_ajslp-20-00186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose This article is the first in a two-part series on the application of the Transtheoretical Model to stuttering management among adolescents. In this article, we describe the process of developing measures to assess stage of change (SOC) by defining behaviors of stuttering management, as well as the two primary cognitive constructs that underlie one's readiness to make behavioral change: decisional balance (DB) and situational self-efficacy (SSE). This work hinges on the ability to develop an operational definition of what it means to successfully manage or do something positive about one's stuttering. Method We used an iterative process to develop the three scales. Through qualitative analysis of key informant interview and focus group transcripts with 24 adolescents who stutter and 26 clinicians specializing in stuttering, we developed stuttering-specific SOC, DB, and SSE scales. The drafted scales were cognitively tested with nine adolescents who stutter. Results Thematic analysis yielded a three-part definition of successful stuttering management that formed the basis for the SOC scale: (a) learning and using strategies to modify speech or stuttering, (b) changing negative thoughts and attitudes regarding stuttering, and (c) talking without avoiding sounds, words, or situations. Results from this analysis support a broader view of successful stuttering management; that is, it is likely that doing so requires more than just behavior change, which has long been considered the main objective of stuttering treatment. Additional analyses yielded pros and cons of managing stuttering (62 items for the DB scale) and situations in which it is difficult to manage stuttering (39 items for the SSE scale). Conclusions Qualitative analyses provided a three-part definition of "stuttering management" and a comprehensive pool of items that would allow measurement of DB and SSE that underlie readiness to manage stuttering among adolescents. In the companion article in this two-part series, we describe the next step in scale development: exploratory scale validation of the drafted SOC, DB, and SSE scales.
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Affiliation(s)
- Patricia M Zebrowski
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City
| | - Naomi H Rodgers
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln
| | - Hope Gerlach
- Department of Speech, Language and Hearing Sciences, Western Michigan University, Kalamazoo
| | - Andrea L Paiva
- Department of Psychology, University of Rhode Island, Kingston
| | - Mark L Robbins
- Department of Psychology, University of Rhode Island, Kingston
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Rodgers NH, Gerlach H, Paiva AL, Robbins ML, Zebrowski PM. Applying the Transtheoretical Model to Stuttering Management Among Adolescents: Part II. Exploratory Scale Validation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2510-2527. [PMID: 34637348 DOI: 10.1044/2021_ajslp-21-00108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose This article is the second in a two-part series on the application of the Transtheoretical Model to stuttering management among adolescents. The purpose of this article was to apply and explore the validity of newly developed Transtheoretical measures for adolescents who stutter. Method The online survey was completed by a national sample of 173 adolescents who stutter between the ages of 13 and 21 years. The multipart survey included a Stage of Change scale, Decisional Balance scale, and Situational Self-Efficacy scale. Participants also completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES), either the teenage or adult version depending on the participant's age, so preliminary construct validity of the new scales could be examined. Exploratory factor analyses were conducted to determine model fit and reduce the scales to the most meaningful items. External validity of the three-part survey was examined by comparing OASES scores across stage of change as well as evaluating the functional relations between the three scales. Results Adolescents' readiness to manage stuttering could be clearly described with five discrete stages, although most of the respondents reported being in the Maintenance stage. The pros of managing stuttering reliably predicted stage placement. Internal consistency of the scales ranged from good to excellent. OASES scores differed across stages of readiness in complex but predictable ways. Conclusions These findings suggest that the Transtheoretical Model fits the target behaviors involved stuttering management among adolescents. Further examination of the application of the model to validate a stage-based framework for change among individuals who stutter is warranted.
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Affiliation(s)
- Naomi H Rodgers
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln
| | - Hope Gerlach
- Department of Speech, Language and Hearing Sciences, Western Michigan University, Kalamazoo
| | - Andrea L Paiva
- Department of Psychology, University of Rhode Island, Kingston
| | - Mark L Robbins
- Department of Psychology, University of Rhode Island, Kingston
| | - Patricia M Zebrowski
- Department of Communication Sciences and Disorders, The University of Iowa, Iowa City
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18
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van Leer E. Enhancing Adherence to Voice Therapy via Social Cognitive Strategies. Semin Speech Lang 2021; 42:19-31. [PMID: 33596601 DOI: 10.1055/s-0040-1722755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Treatment adherence is a challenge in behavioral voice therapy. Patients commonly encounter difficulties with practicing and implementing target voice techniques outside of the clinic. Several mobile support strategies have been shown to improve adherence. These strategies are driven by social cognitive theory, which provides a theoretical but practical framework for understanding adherence behavior and solving adherence problems. Key features of the theory include (1) its model of triadic asymmetrical reciprocal causation, (2) the concept of human agency, and (3) the constructs of self-efficacy and goal commitment. The purpose of this article is to (1) explain voice therapy adherence within the framework of social cognitive theory, (2) illustrate three broad categories of adherence problems, and (3) provide examples of strategies to address each. With this exemplified knowledge, the clinician can diagnose factors that underlie patients' adherence problems and develop individualized solutions. Given the significant role adherence plays in behavioral interventions, this information holds substantial clinical relevance.
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Affiliation(s)
- Eva van Leer
- Department of Communication Sciences and Disorders, Georgia State University, Atlanta, Georgia
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19
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Gartner-Schmidt J, Gillespie AI. Conversation Training Therapy: Let's Talk It Through. Semin Speech Lang 2021; 42:32-40. [PMID: 33596602 DOI: 10.1055/s-0040-1722751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This article introduces a novel approach to voice therapy called conversation training therapy (CTT). CTT is the first voice therapy approach to remove the therapeutic hierarchy common in most treatment programs. Rather, CTT uses patient-driven conversation as the sole stimuli in therapy to increase perceptual awareness of voice production in conversational speech. The genesis as to why CTT was developed, as well as the conceptual, theoretical, and component parts of CTT, will be explained. In addition, this article will offer examples of the language of therapy, as it applies to CTT and how to trouble-shoot if problems arise. Medical documentation relevant to CTT will also be outlined. Last, results from a recent efficacy study on CTT will be reported.
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Affiliation(s)
- Jackie Gartner-Schmidt
- Department of Otolaryngology, University of Pittsburgh Voice Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Amanda I Gillespie
- Emory Voice Center, Department of Otolaryngology, Emory University School of Medicine, Emory University Hospital Midtown, Atlanta, Georgia
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20
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Preussler JM, Payton TJ, Moore HK, Denzen EM, McCann M, Mau LW. Application and Evaluation of Survivorship Care Guides for Hematopoietic Cell Transplantation Recipients. Transplant Cell Ther 2020; 27:266.e1-266.e7. [PMID: 33781534 DOI: 10.1016/j.jtct.2020.12.007] [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: 08/27/2020] [Revised: 10/23/2020] [Accepted: 12/06/2020] [Indexed: 10/22/2022]
Abstract
Hematopoietic cell transplantation (HCT) is a treatment for hematologic malignancies and disorders. Patients who receive HCT can face long-term physical and psychosocial effects. Survivorship care guides (care guides), which describe screening and preventive care practices were mailed to allogenic HCT recipients at clinically important timepoints (6, 12, and 24 months after HCT). The primary objective of this study was to evaluate how patients perceived and used the care guides. A cross-sectional, time-series survey was sent to all National Marrow Donor Program/Be The Match allogeneic HCT recipients from September 2012 to November 2016 after the care guides were sent; patients or caregivers could respond. Respondents who returned all 3 surveys were included (554 patients; 65 caregivers), for an overall response rate of 13% (maintenance rate of 45%). The majority of patients and caregivers strongly agreed or agreed that the care guides helped them understand that post-HCT care is important to staying healthy and that they were more familiar with recommended tests at check-up appointments. Most patients who did not share the care guides with their doctors at any of the timepoints believed their doctor knew which tests were needed. Results from this study can help inform and guide development of future tools and evaluations of educational resources for patients after HCT. Tools and educational resources, such as survivorship care guides, have the potential to help empower patients to be more knowledgeable and to understand and advocate for their survivorship care needs.
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Affiliation(s)
- Jaime M Preussler
- National Marrow Donor Program/Be The Match, Minneapolis, Minnesota; Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota.
| | - Tammy J Payton
- National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Heather K Moore
- National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Ellen M Denzen
- National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Meggan McCann
- National Marrow Donor Program/Be The Match, Minneapolis, Minnesota
| | - Lih-Wen Mau
- National Marrow Donor Program/Be The Match, Minneapolis, Minnesota; Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
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21
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Krekeler BN, Vitale K, Yee J, Powell R, Rogus-Pulia N. Adherence to Dysphagia Treatment Recommendations: A Conceptual Model. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:1641-1657. [PMID: 32432958 PMCID: PMC7839030 DOI: 10.1044/2020_jslhr-19-00270] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/20/2020] [Accepted: 02/13/2020] [Indexed: 05/14/2023]
Abstract
Purpose Conceptual models of complex health problems are useful when designing targeted clinical interventions and focused research studies. Understanding and studying patient adherence often involves interplay among many factors that influence whether a patient successfully follows recommendations or completes a therapy program. Functional frameworks serve to arrange these factors visually, increasing interpretability and allowing for empirical testing of relationships among concepts. The purpose of this article is to integrate relevant factors from the literature into a comprehensive framework that describes adherence to dysphagia treatment. Method Using peer-reviewed, published guidelines regarding conceptual model construction, the authors created a list of potential factors that influence patient adherence to dysphagia-related treatment recommendations. During model construction, following extensive review of the literature and existing theories that have been applied in other areas of health care, factors were identified and grouped into conceptually similar domains (clusters). Clusters were arranged into larger categories that emerged during model optimization. Ultimately, two models were created: one that illustrates the interrelated factors of patient adherence and another that illustrates a subset of modifiable risk factors that a clinical speech-language pathologist may influence when developing a dysphagia treatment plan. Results Three general categories from 14 factors emerged based on relationships between factors and aspects of patient care: health factors, individual patient factors, and contextual factors. A second model consisting of modifiable risk factors included access, treatment type, patient perceptions, self-efficacy, health literacy, support factors, and provider bias. Conclusions This conceptual model allows clinicians and researchers to identify and explore the mechanisms driving adherence. Continual refinements of this model should be made as future studies uncover how the interconnectedness of factors affects adherence in dysphagia management. The models we have presented here are ready for clinical application and should also serve researchers as they generate hypotheses and design targeted research questions.
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Affiliation(s)
- Brittany N. Krekeler
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
- Otolaryngology–Head & Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Kailey Vitale
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, WI
| | - Joanne Yee
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, WI
| | - Ryan Powell
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, WI
| | - Nicole Rogus-Pulia
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
- Otolaryngology–Head & Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, WI
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Pasternak K, Diaz J, Thibeault SL. Predictors of Voice Therapy Initiation: A Cross-Sectional Cohort Study. J Voice 2020; 36:194-202. [PMID: 32561211 DOI: 10.1016/j.jvoice.2020.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/31/2020] [Accepted: 05/11/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine predictors of voice therapy initiation. STUDY DESIGN Cross-sectional cohort study. METHODS All patients were evaluated in an interdisciplinary model at the University of Wisconsin Voice and Swallow Clinics between June 2016 and October 2017. Patients were eligible if they were diagnosed with a voice disorder and recommended for voice therapy as the only treatment. The dependent variable was attendance in at least once voice therapy session. Independent variables included therapeutic alliance, measured using the Session Rating Scale, and patient- and disease-related factors. These factors included gender, age, distance to the clinic, education level, household composition, occupational voice demand, Voice Handicap Index score, auditory-perceptual dysphonia severity (Grade, Roughness, Breathiness, Asthenia, Strain), and medical voice diagnosis. RESULTS Ninety-five patients were enrolled in the study. Voice therapy initiation rate was 70%. Having fewer school-aged children (5-18 years) in the household was significantly different between the group that initiated voice therapy and the group that did not (P = 0.048). There was no difference between groups for all other factors. CONCLUSIONS This investigation suggests that household composition, specifically having fewer school-aged children in the household, may predict initiation of voice therapy. This study confirms in a prospective fashion the absence of relationship between voice therapy initiation and most patient- and disease-related factors. Therapeutic alliance should be further investigated for its ability to predict voice therapy initiation using a measure that is validated for the population of patients with dysphonia.
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Affiliation(s)
- Kevin Pasternak
- UW Voice and Swallow Clinics, UW Health, Madison, Wisconsin.
| | - Jennylee Diaz
- Division of Speech-Language Pathology, Department of Otolaryngology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Susan L Thibeault
- Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin
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Doud AK, Hoepner JK, Holland AL. A Survey of Counseling Curricula Among Accredited Communication Sciences and Disorders Graduate Student Programs. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:789-803. [PMID: 32320624 DOI: 10.1044/2020_ajslp-19-00042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose The purpose of this article is to examine the current state of counseling curriculum within the discipline. The last systematic survey of counseling curriculum within the disciplines of communication sciences and disorders was completed with data from 1983 (McCarthy et al., 1986). The Council on Academic Accreditation in Audiology and Speech-Language Pathology (2017) states that counseling should be included in accredited programs but does not specify to what extent. Currently, there are no standards to specify number of credits, need for a stand-alone course, or guidance regarding content delivered. Method The present investigation collected data on the status of counseling curricula in accredited communication sciences and disorders graduate programs. A Qualtrics survey was distributed to identify counseling curriculum practices across accredited programs. Quantitative data such as percentages and frequency counts were compiled to summarize program offerings. Qualitative analyses were used to characterize written responses. Survey responses were also cross-validated with a review of offerings listed on program websites. Results Of programs currently accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology, 42.4% responded to the current survey. Fifty-nine percent of programs offer a stand-alone course. Review of curricula from program websites indicated that only 40% of accredited programs offer a stand-alone counseling course. Quantitative details about requirements, number of credits, and embedding counseling within other courses were compared to data from the 1983 survey. Qualitative analyses identified common learner outcomes and the nature of course or curricular content. Conclusions Investigators found a lack of consistency in incorporating counseling across programs and discussed implications of this in speech-language pathology practice. A decrease in the number of programs that offer a stand-alone counseling course was identified as compared to offerings in 1983, as well as a disparity regarding how programs provide training in counseling. Furthermore, survey responses differed from curriculum listings on program websites. Information derived from this study may serve as a starting point for the development of flexible standards that provide direction for achieving consistent preparation of counseling skills. Supplemental Material https://doi.org/10.23641/asha.12149703.
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Affiliation(s)
- Aspen K Doud
- Communication Sciences and Disorders, University of Wisconsin, Eau Claire
| | - Jerry K Hoepner
- Communication Sciences and Disorders, University of Wisconsin, Eau Claire
| | - Audrey L Holland
- Department of Speech and Hearing Sciences, University of Arizona, Tucson
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Miller JE, Windschitl PD, Treat TA, Scherer AM. Comparisons as Predictors of People’s Beliefs About the Importance of Changing Their Health Behaviors. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2020. [DOI: 10.1027/2512-8442/a000043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The current study tested relative strengths of different comparison beliefs for predicting people’s self-assessments of whether they should increase their health-relevant behaviors (exercise, sleep, and fruit and vegetable consumption). Comparison beliefs relevant to three standards (perceived global, local, expert standards) were evaluated. Data were combined from three similar studies (total N = 744) that had a cross-sectional, within-subject design. Participants completed importance-of-change scales regarding the three health behaviors and reported comparison beliefs and absolute behavior frequencies/amounts. Results were consistent across the three behaviors. Comparison beliefs predicted ratings of importance of changing one’s behavior, even beyond what is predicted by reports of absolute behavior frequency. Expert comparisons were consistently most predictive above and beyond the absolute estimates and the other comparison standards. There was no evidence of a local dominance effect when examining local versus global comparisons. Comparison beliefs have unique utility for predicting people’s perceived importance of changing their heath behavior. The fact that expert comparisons were consistently most predictive (and local comparisons the least) may have implications for interventions designed for encouraging behavior change.
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Affiliation(s)
- Jane E. Miller
- Department of Psychological and Brain Sciences, University of Iowa, IA, USA
| | - Paul D. Windschitl
- Department of Psychological and Brain Sciences, University of Iowa, IA, USA
| | - Teresa A. Treat
- Department of Psychological and Brain Sciences, University of Iowa, IA, USA
| | - Aaron M. Scherer
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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White JT, Donahue EN. Patients’ Perceptions of and Attitudes Toward Voice Therapy: A Pilot Study. J Voice 2019; 33:860-865. [DOI: 10.1016/j.jvoice.2018.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/16/2018] [Indexed: 10/28/2022]
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Zencke da Silva K, Bello JZ, Cassol M. Motivational Stage Analysis of Patients with Behavioral Dysphonia. Folia Phoniatr Logop 2019; 72:267-272. [PMID: 31189167 DOI: 10.1159/000500403] [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: 08/14/2018] [Accepted: 04/12/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To analyze the applicability of the University of Rhode Island Change Assessment (URICA)-VOICE scale before and after a therapeutic program for functional balance in voice production. PATIENTS AND METHODS The sample comprised 26 adult participants (18 female) from the -Brazilian Public Healthcare System. The URICA-VOICE scale was applied prior to the intervention and after 10 sessions of a therapeutic program. RESULTS The motivational stage values were significantly increased after the intervention compared with the first application of the scale. Precontemplation and action were the stages most commonly reported by the participants. Significant differences were found in 6 statements of the URICA-VOICE scale after voice therapy. CONCLUSIONS The motivational stage of the participants improved after voice therapy. Being motivated is important for adherence to behavioral changes regarding the voice, and this study shows that using the URICA-VOICE scale in clinical practice is essential to measure patient performance in the voice therapy process, as well as to determine the ideal moment of discharge.
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Affiliation(s)
| | | | - Mauriceia Cassol
- Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
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Carter AK, Breen LJ, Beilby JM. Self-efficacy beliefs: Experiences of adults who stutter. JOURNAL OF FLUENCY DISORDERS 2019; 60:11-25. [PMID: 30953951 DOI: 10.1016/j.jfludis.2019.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/18/2019] [Accepted: 03/27/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE Childhood-onset stuttering is a complex and multifaceted disorder. Intervention for adults who stutter has historically addressed speech fluency more so than psychosocial aspects of the disorder, including the nature of the individual's self-efficacy beliefs concerning their confidence in their capacity to enact change. Self-efficacy is an important construct related to quality of life, resilience, and maintenance of treatment gains for adults who stutter. The purpose of this qualitative study is to explore the nature of the self-efficacy beliefs expressed by adults who stutter in order to inform efficacious and holistic intervention for these individuals. METHOD Semi-structured interviews were conducted with 29 adults who stutter to describe their experiences as a person who stutters and elucidate the nature of their self-efficacy beliefs. RESULTS Thematic analysis identified several major themes that provided novel insight into the complex nature of the self-efficacy beliefs experienced by adults who stutter: speaker experiences shaped communicative confidence, there was a conflict between communication and fluency, stuttering was viewed as more than fluency, and individual perspectives shaped communicative confidence, as did the pervading influence of self. The notion that fluency and confidence are inextricably linked was evident within and across each major theme. CONCLUSION These preliminary findings provide further support for a multidimensional approach to the treatment of adults who stutter. Findings will be used to inform a novel integrated fluency and psychosocial intervention for adults who stutter that addresses fluency and self-efficacy concurrently, with a view of engendering durable improvements in speech fluency and communicative confidence.
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Affiliation(s)
- Alice K Carter
- School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Western Australia, Australia
| | - Lauren J Breen
- School of Psychology, Curtin University, Western Australia, Australia
| | - Janet M Beilby
- School of Occupational Therapy, Social Work, and Speech Pathology, Curtin University, Western Australia, Australia.
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Birchall MA, Carding P. Vocal nodules management. Clin Otolaryngol 2019; 44:497-501. [PMID: 30834711 DOI: 10.1111/coa.13324] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 02/27/2019] [Indexed: 11/30/2022]
Abstract
Vocal fold nodules present the voice clinic team with a number of clinical dilemmas which are not as simple as previously thought. The definition, aetiology, prevalence and diagnosis are all poorly understood. Furthermore, treatment evidence for both behavioural and surgical approaches is weak. This paper reviews the published evidence pertaining to all of these aspects. Specific areas of uncertainty that remain include poorly defined nomenclature, the natural history of paediatric vocal nodules, the establishment of criteria to measure successful treatment, optimal configuration of speech therapy regimens and the rationale for surgical intervention. The authors suggest the development of evidence-based guidelines for UK practice.
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Affiliation(s)
- Martin A Birchall
- Royal National Throat Nose and Ear Hospital, University College London, London, UK
| | - Paul Carding
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford, UK
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Wen S, Li J, Wang A, Lv M, Li H, Lu Y, Zhang J. Effects of transtheoretical model‐based intervention on the self‐management of patients with an ostomy: A randomised controlled trial. J Clin Nurs 2019; 28:1936-1951. [PMID: 30549366 DOI: 10.1111/jocn.14731] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 10/06/2018] [Accepted: 11/30/2018] [Indexed: 01/22/2023]
Affiliation(s)
- Sha‐Li Wen
- Department of Organ Transplantation SurgeryThe Second Xiangya Hospital of Central South University Changsha Hunan China
| | - Juan Li
- Xiangya Nursing School of Central South University Changsha Hunan China
| | - An‐Ni Wang
- Xiangya Nursing School of Central South University Changsha Hunan China
| | - Meng‐Meng Lv
- Xiangya Nursing School of Central South University Changsha Hunan China
| | - Hui‐Yuan Li
- Xiangya Nursing School of Central South University Changsha Hunan China
| | - Yan‐Fang Lu
- Department of Organ Transplantation SurgeryThe Second Xiangya Hospital of Central South University Changsha Hunan China
| | - Jing‐Ping Zhang
- Xiangya Nursing School of Central South University Changsha Hunan China
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Chalela P, Muñoz E, Gallion KJ, Kaklamani V, Ramirez AG. Empowering Latina breast cancer patients to make informed decisions about clinical trials: a pilot study. Transl Behav Med 2018; 8:439-449. [PMID: 29800408 DOI: 10.1093/tbm/ibx083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Minority representation in clinical trials is vital for researchers to assess differential effects in outcomes of therapies on biological and genetic characteristics among groups. This study assessed the effect of Choices, a bilingual multi-component intervention, on perceived understanding of clinical trials, agreement with stages of decision readiness and consideration of clinical trials as a treatment option, among Latina breast cancer patients. This randomized controlled pilot study compared Choices with a control condition providing general clinical trial information to eligible patients. Seventy-seven Latina breast cancer patients were randomly assigned to either Choices (n = 38) or the control (n = 39). Choices included three components: an educational interactive video, a low-literacy booklet, and care coordination by patient navigation (i.e., educational and psychosocial support, coordinating appointments, translating, interacting with the medical team). Choices was more effective than the control in improving perceived understanding of clinical trials (p = .033) and increasing consideration of clinical trials as a treatment option (p = .008). Additionally, intervention participants showed significant changes between baseline and post-intervention on agreement with stages of decision readiness statements (p < .002) than control participants (p > .05); the percentage of intervention women in agreement with preparation to action statements increased from 52.8% at baseline to 86.1% at post-intervention, and those in agreement with ready to action stages rose from 50.0% to 88.9%. Computer-based videos and care coordination provided by patient navigation-specifically tailored to Latinos-are effective strategies to successfully address awareness, and improved decision-making skills to make informed decisions about clinical trial participation.
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Affiliation(s)
- Patricia Chalela
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
| | - Edgar Muñoz
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
| | - Kipling J Gallion
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
| | - Virginia Kaklamani
- Cancer Therapy and Research Center, UT Health San Antonio, San Antonio, USA
| | - Amelie G Ramirez
- Institute for Health Promotion Research, UT Health San Antonio, San Antonio, USA
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31
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Factors Affecting Voice Therapy Completion in Singers. J Voice 2018; 32:564-571. [DOI: 10.1016/j.jvoice.2017.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 06/22/2017] [Accepted: 06/27/2017] [Indexed: 11/18/2022]
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32
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Ranasinghe C, King NA, Arena R, Hills AP. FITTSBALL – a dynamic tool for supervision of clinical exercise prescription. Disabil Rehabil 2018; 41:3216-3226. [DOI: 10.1080/09638288.2018.1489564] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Chathuranga Ranasinghe
- School of Exercise and Nutrition Sciences & Institute of Health and Biomedical Innovation Queensland, University of Technology, Brisbane, Australia
- Department of Allied Health Sciences, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Neil A. King
- School of Exercise and Nutrition Sciences & Institute of Health and Biomedical Innovation Queensland, University of Technology, Brisbane, Australia
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Andrew P. Hills
- College of Health Sciences, University of Tasmania, Launceston, Australia
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Krekeler BN, Broadfoot CK, Johnson S, Connor NP, Rogus-Pulia N. Patient Adherence to Dysphagia Recommendations: A Systematic Review. Dysphagia 2018; 33:173-184. [PMID: 28965240 PMCID: PMC5866734 DOI: 10.1007/s00455-017-9852-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 09/19/2017] [Indexed: 12/18/2022]
Abstract
Patient adherence to treatment recommendations is an important issue for healthcare providers, in a multitude of specialties, and is critical when assessing the efficacy and effectiveness of a particular treatment approach. Patients who have swallowing impairment often require complex and specific interventions requiring altered daily patterns of behavior. Patients with dysphagia who do not follow recommendations or prescribed exercises may not receive maximum benefit of an intervention. Poor adherence also makes it more difficult to evaluate efficacy of a treatment both clinically and in experimental settings. Further, swallow safety can be compromised if certain recommendations are not followed. Our purpose was to systematically review the literature to understand what is known about adherence within the field of dysphagia treatment. We systematically identified 12 studies that tracked and reported patient-specific adherence. In this review, we found that the average adherence rate from these studies ranges between 21.9 and 51.9%. Adherence to prophylactic treatment recommendations for patients with head and neck cancer was the focus in 9/12 studies. The findings of this review identify a large gap in knowledge regarding adherence to dysphagia treatment. Few studies account for adherence within their study designs. When planning dysphagia treatment studies, it is imperative that investigators include information regarding patient adherence to accurately interpret findings. Given the variable adherence rates found in this review, factors influencing patient adherence with dysphagia treatments should be identified to increase adherence in future trials.
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Affiliation(s)
- Brittany N Krekeler
- Department of Communication Sciences and Disorders, Medical Science Center, University of Wisconsin, 1300 University Avenue, Room 483, Madison, WI, 53706, USA.
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin, 1975 Willow Drive, 361 Goodnight Hall, Scott H, Madison, WI, 53706-1103, USA.
| | - Courtney K Broadfoot
- Department of Communication Sciences and Disorders, Medical Science Center, University of Wisconsin, 1300 University Avenue, Room 483, Madison, WI, 53706, USA
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin, 1975 Willow Drive, 361 Goodnight Hall, Scott H, Madison, WI, 53706-1103, USA
| | - Stephen Johnson
- Ebling Library, Health Sciences Learning Center, University of Wisconsin, Room 2336, 750 Highland Avenue, Madison, WI, 53705-2221, USA
| | - Nadine P Connor
- Department of Communication Sciences and Disorders, Medical Science Center, University of Wisconsin, 1300 University Avenue, Room 483, Madison, WI, 53706, USA
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin, 1975 Willow Drive, 361 Goodnight Hall, Scott H, Madison, WI, 53706-1103, USA
| | - Nicole Rogus-Pulia
- Department of Communication Sciences and Disorders, Medical Science Center, University of Wisconsin, 1300 University Avenue, Room 483, Madison, WI, 53706, USA
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin, 1975 Willow Drive, 361 Goodnight Hall, Scott H, Madison, WI, 53706-1103, USA
- Department of Medicine-Geriatrics and Gerontology, University of Wisconsin-Madison, Madison, WI, 53705, USA
- Geriatric Research Education and Clinical Center (GRECC) Veterans Administration Hospital, William S. Middleton Memorial Hospital, D5216, 2500 Overlook Terrace, Madison, WI, 53705, USA
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Behlau M. The 2016 G. Paul Moore Lecture: Lessons in Voice Rehabilitation: Journal of Voice and Clinical Practice. J Voice 2018; 33:669-681. [PMID: 29567050 DOI: 10.1016/j.jvoice.2018.02.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/22/2018] [Indexed: 12/19/2022]
Abstract
This Paul Moore Lecture honors the contributions made by authors to the Journal of Voice during a period of 30 years, from 1987. Fifty articles were selected and included under the following five topics: (1) normalcy of the larynx and voice; (2) the clinical speech-language pathologist's evaluation; (3) the patient's perspective; (4) the core of vocal rehabilitation; and (5) behavioral versus organic dysphonias. The analysis reflects a vivid landscape of the specific area and significant advances in knowledge. It also shows the valuable interdependence between science and clinical practice. The topics highlight the following information: (1) The physical appearance of a healthy larynx varies across individuals with normal voices. (2) The voice is not a binary descriptor (normal versus abnormal) but a variable measure, with many cultural influences on the perceptual auditory analysis of a voice. (3) The clinical speech-language pathologist assessment is multidimensional and multiparametric, with both subjective and objective analyses. The patients' opinion about the impact of a voice problem on his or her quality of life is significant when proposing a treatment. Therefore, it is also included in the initial assessment. (4) Vocal rehabilitation is a nonlinear process that combines direct and indirect approaches. Evidence of the positive effect of voice therapy is now well established. (5) Behavioral dysphonias may be linked to self-regulation of the use of voice and this needs to be taken into consideration. Although organic dysphonias are not necessarily the result of harmful vocal behaviors, they too can benefit from vocal rehabilitation.
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Affiliation(s)
- Mara Behlau
- "Centro de Estudos da Voz" - CEV, São Paulo, Brazil; "Universidade Federal de São Paulo-UNIFESP", São Paulo, Brazil.
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Meerschman I, Van Lierde K, Van Puyvelde C, Bostyn A, Claeys S, D'haeseleer E. Massed versus spaced practice in vocology: effect of a short-term intensive voice training versus a longer-term traditional voice training. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2018; 53:393-404. [PMID: 29205707 DOI: 10.1111/1460-6984.12358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 10/12/2017] [Accepted: 10/13/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND In contrast with most medical and pharmaceutical therapies, the optimal dosage for voice therapy or training is unknown. AIMS The aim of this study was to compare the effect of a short-term intensive voice training (IVT) with a longer-term traditional voice training (TVT) on the vocal quality and vocal capacities of vocally healthy non-professional voice users. METHODS & PROCEDURES A pre-/post-test randomized control group design with follow-up measurements was used. Twenty healthy female non-professional voice users with a mean age of 21.7 years (range = 20-24 years) were randomly assigned into a short-term IVT group (n = 10) or a longer-term TVT group (n = 10). Both groups received an identical 6-h lasting voice training. Only the distribution of practice varied between the groups: 2 h a day for 3 consecutive days for the IVT group versus two 30-min sessions a week for 6 weeks for the TVT group. In both groups, a voice assessment protocol consisting of subjective (questionnaire, participant's self-report, auditory-perceptual evaluation) and objective (maximum performance task, acoustic analysis, voice range profile, dysphonia severity index) measurements and determinations was used to evaluate the participants' voice pre- and post-training and at 6 weeks follow-up. Groups were compared over time using linear mixed models and generalized linear mixed models. Within-group effects of time were determined using post-hoc pairwise comparisons with Bonferroni corrections. OUTCOMES & RESULTS No significant time-by-group interactions were found for any of the outcome measures, indicating no significant differences in evolution over time between the groups. Significant time effects were found for maximum phonation time, lowest intensity, lowest frequency, highest frequency and dysphonia severity index, all improving over time in both groups. More in-depth within-group analyses indicate a preference for the IVT group regarding the evolution of maximum phonation time, lowest frequency and dysphonia severity index, and a preference for the TVT group regarding the evolution of lowest intensity. CONCLUSIONS & IMPLICATIONS Short-term IVT may be equally, or even more, effective in training vocally healthy non-professional voice users compared with longer-term TVT.
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Affiliation(s)
- Iris Meerschman
- Department of Speech-Language and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Kristiane Van Lierde
- Department of Speech-Language and Hearing Sciences, Ghent University, Ghent, Belgium
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Caro Van Puyvelde
- Department of Speech-Language and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Astrid Bostyn
- Department of Speech-Language and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Sofie Claeys
- Department of Otorhinolaryngology, Ghent University, Ghent, Belgium
| | - Evelien D'haeseleer
- Department of Speech-Language and Hearing Sciences, Ghent University, Ghent, Belgium
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Carter A, Breen L, Yaruss JS, Beilby J. Self-efficacy and quality of life in adults who stutter. JOURNAL OF FLUENCY DISORDERS 2017; 54:14-23. [PMID: 29195624 DOI: 10.1016/j.jfludis.2017.09.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/10/2017] [Accepted: 09/12/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Self-efficacy has emerged as a potential predictor of quality of life for adults who stutter. Research has focused primarily on the positive relationship self-efficacy has to treatment outcomes, but little is known about the relationship between self-efficacy and quality of life for adults who stutter. The purpose of this mixed- methods study is to determine the predictive value of self-efficacy and its relationship to quality of life for adults who stutter. METHOD The Self-Efficacy Scale for Adult Stutterers and the Overall Assessment of the Speaker's Experience with Stuttering were administered to 39 adults who stutter, aged 18- 77. Percentage of syllables stuttered was calculated from a conversational speech sample as a measure of stuttered speech frequency. Qualitative interviews with semi-structured probes were conducted with 10 adults and analyzed using thematic analysis to explore the lived experience of adults who stutter. RESULTS Self-efficacy emerged as a strong positive predictor of quality of life for adults living with a stuttered speech disorder. Stuttered speech frequency was a moderate negative predictor of self-efficacy. Major qualitative themes identified from the interviews with the participants were: encumbrance, self-concept, confidence, acceptance, life-long journey, treatment, and support. CONCLUSION Results provide clarity on the predictive value of self-efficacy and its relationship to quality of life and stuttered speech frequency. Findings highlight that the unique life experiences of adults who stutter require a multidimensional approach to the assessment and treatment of stuttered speech disorders.
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Affiliation(s)
- Alice Carter
- School of Psychology and Speech Pathology, Curtin University, Western Australia, Australia
| | - Lauren Breen
- School of Psychology and Speech Pathology, Curtin University, Western Australia, Australia
| | - J Scott Yaruss
- Department of Communicative Sciences and Disorders, Michigan State University, USA
| | - Janet Beilby
- School of Psychology and Speech Pathology, Curtin University, Western Australia, Australia.
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Costa BOID, Silva POC, Pinheiro RSDA, Silva HFD, Almeida AAFD. Estágio de prontidão de pacientes com disfonia comportamental pré e pós-terapia de voz de grupo. Codas 2017; 29:e20160198. [DOI: 10.1590/2317-1782/20172016198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 02/02/2017] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo Verificar a efetividade da terapia de grupo no estágio de prontidão de pacientes com disfonia comportamental, bem como identificar que itens da Escala URICA-Voz são mais sensíveis a mudanças pós-terapia de grupo em pacientes com disfonia comportamental. Método Trata-se de um estudo de intervenção realizado com 49 pacientes com disfonia comportamental. A terapia de grupo ocorreu em oito sessões, sendo a primeira e a última de avaliação e as outras seis terapêuticas, com abordagem eclética. A escala URICA-Voz foi utilizada para avaliar o estágio de prontidão em que o paciente se encontra nos momentos pré e pós-terapia de grupo para voz. Foi realizada uma análise estatística descritiva e inferencial para a análise dos resultados. Resultados A maioria dos pacientes que participaram deste estudo era do gênero feminino, não faziam uso profissional da voz e tinham lesão membranosa da prega vocal. A maior parte estava no estágio de Contemplação tanto no momento pré quanto pós-terapia. Houve mudança significativa na comparação do pré e pós-terapia, a maioria dos pacientes apresentou redução no estágio de prontidão e poucos avançaram para um estágio maior. Na comparação dos itens da Escala URICA-V, sete questões apresentaram respostas iguais ou inferiores no momento pós-terapia. Conclusão Não houve diferença estatística ao se comparar as médias do escore total URICA-V no pré e pós-terapia de grupo. Houve mudanças significativas dos estágios de prontidão dos pacientes nos momentos pré e pós-terapia fonoaudiológica de grupo. Sete itens da URICA-V tiveram número igual ou menor no momento pós-intervenção entre os pacientes avaliados.
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Misono S, Marmor S, Roy N, Mau T, Cohen SM. Multi-institutional Study of Voice Disorders and Voice Therapy Referral: Report from the CHEER Network. Otolaryngol Head Neck Surg 2017; 155:33-41. [PMID: 27371624 DOI: 10.1177/0194599816639244] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/25/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To assess perspectives of patients with voice problems and identify factors associated with the likelihood of referral to voice therapy via the CHEER (Creating Healthcare Excellence through Education and Research) practice-based research network infrastructure. STUDY DESIGN Prospectively enrolled cross-sectional study of CHEER patients seen for a voice problem (dysphonia). SETTING The CHEER network of community and academic sites. METHODS Patient-reported demographic information, nature and severity of voice problems, clinical diagnoses, and proposed treatment plans were collected. The relationship between patient factors and voice therapy referral was investigated. RESULTS Patients (N = 249) were identified over 12 months from 10 sites comprising 30 otolaryngology physicians. The majority were women (68%) and white (82%). Most patients reported a recurrent voice problem (72%) and symptom duration >4 weeks (89%). The most commonly reported voice-related diagnoses were vocal strain, reflux, and benign vocal fold lesions. Sixty-seven percent of enrolled patients reported receiving a recommendation for voice therapy. After adjusting for sociodemographic and other factors, diagnoses including vocal strain/excessive tension and vocal fold paralysis and academic practice type were associated with increased likelihood of reporting a referral for voice therapy. CONCLUSIONS The CHEER network successfully enrolled a representative sample of patients with dysphonia. Common diagnoses were vocal strain, reflux, and benign vocal fold lesions; commonly reported treatment recommendations included speech/voice therapy and antireflux medication. Recommendation for speech/voice therapy was associated with academic practice type.
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Affiliation(s)
- Stephanie Misono
- Lions Voice Clinic, Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Schelomo Marmor
- Lions Voice Clinic, Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Nelson Roy
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, Utah, USA
| | - Ted Mau
- Clinical Center for Voice Care, Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Seth M Cohen
- Duke Voice Care Center, Division of Otolaryngology-Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina, USA
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Lavaissiéri P, Melo PED. Prototype app for voice therapy: a peer review. Codas 2017; 29:e20150300. [PMID: 28300955 DOI: 10.1590/2317-1782/20172015300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 06/16/2016] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Voice speech therapy promotes changes in patients' voice-related habits and rehabilitation. Speech-language therapists use a host of materials ranging from pictures to electronic resources and computer tools as aids in this process. Mobile technology is attractive, interactive and a nearly constant feature in the daily routine of a large part of the population and has a growing application in healthcare. To develop a prototype application for voice therapy, submit it to peer assessment, and to improve the initial prototype based on these assessments. METHODS a prototype of the Q-Voz application was developed based on Apple's Human Interface Guidelines. The prototype was analyzed by seven speech therapists who work in the voice area. Improvements to the product were made based on these assessments. RESULTS all features of the application were considered satisfactory by most evaluators. All evaluators found the application very useful; evaluators reported that patients would find it easier to make changes in voice behavior with the application than without it; the evaluators stated they would use this application with their patients with dysphonia and in the process of rehabilitation and that the application offers useful tools for voice self-management. Based on the suggestions provided, six improvements were made to the prototype. CONCLUSION the prototype Q-Voz Application was developed and evaluated by seven judges and subsequently improved. All evaluators stated they would use the application with their patients undergoing rehabilitation, indicating that the Q-Voz Application for mobile devices can be considered an auxiliary tool for voice speech therapy.
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Carding P, Bos-Clark M, Fu S, Gillivan-Murphy P, Jones S, Walton C. Evaluating the efficacy of voice therapy for functional, organic and neurological voice disorders. Clin Otolaryngol 2016; 42:201-217. [DOI: 10.1111/coa.12765] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2016] [Indexed: 11/28/2022]
Affiliation(s)
- P. Carding
- Speech Pathology; Australian National Catholic University; Brisbane Qld Australia
| | - M. Bos-Clark
- Royal Devon and Exeter NHS Trust and University of ST Mark and St John; Plymouth UK
| | - S. Fu
- Department of Audiology and Speech Pathology; MacKay Medical College; New Taipei City Taiwan
| | | | - S.M. Jones
- University Hospital of South Manchester; Manchester UK
| | - C. Walton
- Speech Pathology; Australian National Catholic University; Brisbane Qld Australia
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Zhuge P, You H, Wang H, Zhang Y, Du H. An Analysis of the Effects of Voice Therapy on Patients With Early Vocal Fold Polyps. J Voice 2016; 30:698-704. [DOI: 10.1016/j.jvoice.2015.08.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/19/2015] [Indexed: 11/29/2022]
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Góes TRVD, Ferracciu CCS, Silva DROD. Associação entre a adesão da terapia vocal e perfil de atividades vocais em pacientes disfônicos comportamentais. Codas 2016; 28:595-601. [DOI: 10.1590/2317-1782/20162015232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/30/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Analisar a associação entre a adesão da terapia vocal, perfil de atividades vocais em pacientes disfônicos comportamentais e seus possíveis fatores associados. Método Participaram da amostra dezoito indivíduos com disfonia comportamental que estavam em tratamento regular no Serviço de Fonoaudiologia da instituição. Os participantes do estudo responderam ao protocolo Perfil de Participação e Atividades Vocais (PPAV) e à escala URICA-VOZ. As variáveis associadas (número de sessões, faixa etária, tipo de disfonia comportamental, gênero e tratamento fonoaudiológico anterior) foram coletadas por meio de entrevista com o paciente e análise dos seus respectivos prontuários. Os dados foram submetidos à análise estatística inferencial. Resultados A maioria dos pacientes encontrava-se no estágio de ação. Houve associação estatisticamente significante entre o aspecto Efeitos na Emoção do PPAV e os estágios de prontidão para a adesão da terapia vocal, porém os outros aspectos do PPAV não se associaram com a escala URICA-VOZ. Das variáveis associadas, o número de sessões, faixa etária e tipo de disfonia comportamental apresentaram associação com a adesão da terapia de voz. Constatou-se diferença estatisticamente significante entre o tipo de disfonia comportamental e os escores do PPAV. Conclusão O aspecto Efeitos na Emoção do PPAV e as variáveis número de sessões, faixa etária e tipo de disfonia mostraram-se associadas ao estágio de adesão da escala URICA-VOZ. Os indivíduos com disfonia organofuncional apresentaram maior impacto da alteração vocal em suas atividades diárias.
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Lopes LW, Vilela EG. Autoavaliação e prontidão para mudança em pacientes disfônicos. Codas 2016; 0:0. [DOI: 10.1590/2317-1782/20162015111] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 07/18/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Analisar se existe associação entre a autoavaliação vocal e a prontidão para mudança em pacientes disfônicos. Método Participaram 151 pacientes com queixa vocal e diagnóstico de disfonia, entre 18 e 65 anos de idade, 47 homens e 104 mulheres, atendidos no ambulatório de voz de uma instituição pública. Foram aplicados quatro instrumentos de autoavaliação, incluindo o Questionário de Qualidade de Vida em Voz (QVV), o Índice de Desvantagem Vocal (IDV) e a Escala de Sintomas Vocais (ESV), além da utilização do instrumento URICA-VOZ, para verificação do estágio de prontidão para mudança dos pacientes. Todos os instrumentos foram aplicados imediatamente antes do início da terapia vocal. As variáveis foram correlacionadas e comparadas por meio de estatística inferencial. Resultados A maioria dos pacientes encontrava-se no estágio de contemplação (76,2%, n = 115), 22 (14,6%), no estágio de pré-contemplação e 14 (9,3%), no estágio de ação. Houve correlação negativa entre o escore no URICA-VOZ e o domínio socioemocional e escore total do QVV. Ocorreu correlação positiva entre o escore do URICA-VOZ e os domínios total, emocional e funcional do IDV, assim como entre o escore do URICA-VOZ e os domínios total, de limitação e emocional da ESV. Apenas os valores do domínio socioemocional do QVV e emocional no ESV apresentaram diferenças estatisticamente significantes entre os estágios motivacionais. Conclusões Existe associação entre a autoavaliação vocal e a prontidão para mudança em pacientes disfônicos. Pacientes com maior impacto na qualidade de vida em voz no QVV e maior frequência de sintomas vocais referida na ESV apresentam maior prontidão para mudança.
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Kopf LM, Graetzer S, Huh J. Videos Influence Behavior Change Measures for Voice and Speech in Individuals with Parkinson's Disease. PROCEEDINGS WIRELESS HEALTH ... [ELECTRONIC RESOURCE]. WIRELESS HEALTH (CONFERENCE) 2015; 2015. [PMID: 26949753 DOI: 10.1145/2811780.2811932] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The majority of individuals with Parkinson's disease (PD) experience voice and speech difficulties at some point over the course of the disease. Voice therapy has been found to help improve voice and speech in individuals with PD, but the majority of these individuals do not enroll in voice therapy. The purpose of this study was to determine whether watching short videos about voice symptoms and treatment in Parkinson's disease influences readiness to change, stages of change, and self-efficacy in individuals with PD. Eight individuals with PD participated in the study. Fifteen videos were chosen, three representing each of the five stages of change. We chose videos from YouTube that represented variety in speakers, content, and genre. We found that readiness to change significantly increased after watching videos, suggesting that watching videos helped these individuals move closer to actively improving their voice and speech. In addition, five of the eight participants showed forward movement in stages of change. Finally, self-efficacy demonstrated a positive trend following video watching. Overall, our results demonstrate that watching videos available on the internet can influence individuals with Parkinson's disease in changing vocal behavior. Implications for future wireless health applications are described.
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Affiliation(s)
- Lisa M Kopf
- Michigan State University, Communicative Sciences and Disorders, East Lansing, MI 48824
| | - Simone Graetzer
- Michigan State University, Communicative Sciences and Disorders, East Lansing, MI 48824
| | - Jina Huh
- University of California, San Diego, Biomedical Informatics, San Diego, CA
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Cohen SM, Dinan MA, Kim J, Roy N. Otolaryngology utilization of speech-language pathology services for voice disorders. Laryngoscope 2015; 126:906-12. [DOI: 10.1002/lary.25574] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Seth M. Cohen
- Duke Voice Care Center, Division of Otolaryngology-Head & Neck Surgery; Duke University Medical Center; Durham North Carolina
| | | | - Jaewhan Kim
- Division of Public Health & Study Design and Biostatistics Center; University of Utah; Salt Lake City Utah
| | - Nelson Roy
- Department of Communication Sciences and Disorders, Division of Otolaryngology-Head & Neck Surgery (Adjunct); University of Utah, Salt Lake City; Utah U.S.A
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Rossi-Barbosa LA, Gama ACC, Caldeira AP. Association between readiness for behavior change and complaints of vocal problems in teachers. Codas 2015; 27:170-7. [PMID: 26107083 DOI: 10.1590/2317-1782/20152013088] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 12/12/2014] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To verify the association between readiness to behavioral change and self-reported vocal problems of teachers in schools from the municipal education network of Montes Claros, Minas Gerais, Brazil. METHODS The URICA-VOICE scale was used to measure the motivational stages of 138 teachers. Readiness to change was the variable outcome, whereas the independent variables referred to sociodemographic, economic, occupational, lifestyle, general health, and teacher's own voice factors. RESULTS The majority (59.4%) of teachers were in the pre-contemplation stage of the URICA-VOICE scale. The variables use of medication, perception of voice failure, and demand for speech and language therapy were retained for the final model. CONCLUSION The low readiness to change showed the need for increased awareness of the risks and benefits related to the voice and general health. The results can provide public health intervention strategies that deal with individuals at various stages in the decision-making process.
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Van Stan JH, Roy N, Awan S, Stemple J, Hillman RE. A taxonomy of voice therapy. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2015; 24:101-25. [PMID: 25763678 PMCID: PMC6195037 DOI: 10.1044/2015_ajslp-14-0030] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 06/30/2014] [Accepted: 02/10/2015] [Indexed: 05/23/2023]
Abstract
PURPOSE Voice therapy practice and research, as in most types of rehabilitation, is currently limited by the lack of a taxonomy describing what occurs during a therapy session (with enough precision) to determine which techniques/components contribute most to treatment outcomes. To address this limitation, a classification system of voice therapy is proposed that integrates descriptions of therapeutic approaches from the clinical literature into a framework that includes relevant theoretical constructs. METHOD Literature searches identified existing rehabilitation taxonomies/therapy classification schemes to frame an initial taxonomic structure. An additional literature search and review of clinical documentation provided a comprehensive list of therapy tasks. The taxonomy's structure underwent several iterations to maximize accuracy, intuitive function, and theoretical underpinnings while minimizing redundancy. The taxonomy was then used to classify established voice therapy programs. RESULTS The taxonomy divided voice therapy into direct and indirect interventions delivered using extrinsic and/or intrinsic methods, and Venn diagrams depicted their overlapping nature. A dictionary was developed of the taxonomy's terms, and 7 established voice therapy programs were successfully classified. CONCLUSION The proposed taxonomy represents an important initial step toward a standardized voice therapy classification system expected to facilitate outcomes research and communication among clinical stakeholders.
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Affiliation(s)
- Jarrad H. Van Stan
- MGH Institute of Health Professions, Boston, MA
- Massachusetts General Hospital, Boston
| | | | | | | | - Robert E. Hillman
- MGH Institute of Health Professions, Boston, MA
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
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van Leer E, Connor NP. Predicting and influencing voice therapy adherence using social-cognitive factors and mobile video. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2015; 24:164-76. [PMID: 25611762 PMCID: PMC4610279 DOI: 10.1044/2015_ajslp-12-0123] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 03/17/2013] [Accepted: 10/23/2014] [Indexed: 05/13/2023]
Abstract
PURPOSE Patient adherence to voice therapy is an established challenge. The purpose of this study was (a) to examine whether adherence to treatment could be predicted from three social-cognitive factors measured at treatment onset: self-efficacy, goal commitment, and the therapeutic alliance, and (b) to test whether the provision of clinician, self-, and peer model mobile treatment videos on MP4 players would influence the same triad of social cognitive factors and the adherence behavior of patients. METHOD Forty adults with adducted hyperfunction with and without benign lesions were prospectively randomized to either 4 sessions of voice therapy enhanced by MP4 support or without MP4 support. Adherence between sessions was assessed through self-report. Social cognitive factors and voice outcomes were assessed at the beginning and end of therapy. Utility of MP4 support was assessed via interviews. RESULTS Self-efficacy and the therapeutic alliance predicted a significant amount of adherence variance. MP4 support significantly increased generalization, self-efficacy for generalization, and the therapeutic alliance. An interaction effect demonstrated that MP4 support was particularly effective for patients who started therapy with poor self-efficacy for generalization. CONCLUSION Adherence may be predicted and influenced via social-cognitive means. Mobile technology can extend therapy to extraclinical settings.
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El-Banna M, Youssef G. Early Voice Therapy in Patients with Unilateral Vocal Fold Paralysis. Folia Phoniatr Logop 2015; 66:237-43. [DOI: 10.1159/000369167] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Teixeira LC, Rodrigues ALV, Silva AFGD, Azevedo R, Gama ACC, Behlau M. The use of the URICA-VOICE questionnaire to identify the stages of adherence to voice treatment. Codas 2014; 25:8-15. [PMID: 24408164 DOI: 10.1590/s2317-17822013000100003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2011] [Accepted: 12/12/2011] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To adapt the URICA questionnaire to assess the motivational stages of patients undergoing voice treatment, and to determine the association between these stages with age, type of dysphonia, level of education, profession, and number of voice therapy sessions. METHODS A cross-sectional study design was employed, using a convenience sample composed of 66 dysphonic patients--women and eight men--aged from 18 to 68 years, who were enrolled in outpatient care at two federal universities. As an exploratory tool, the URICA questionnaire was adapted to the area of voice, based on specific situations related to vocal behaviors. This questionnaire was named URICA-VOICE. It was administered individually and subjected to analyses. RESULTS Most patients, 38 (57.6%), were in the contemplation stage, 20 (30.3%) were in the pre-contemplation, and only eight (12.1%) in the action stage, which is ideal to voice therapy. There was no association between adherence stages and the variables age, type of dysphonia, level of education, and number of voice therapy sessions. The variable profession was associated with the action stage of the URICA-VOICE. CONCLUSION The URICA-VOICE showed that most dysphonic patients undergoing treatment are still in the contemplation stage, which may limit therapy outcomes. There was no relationship between the other variables and the adherence stages of the URICA-VOICE questionnaire.
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