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Choi N, Park S, Lee GJ. Effectiveness of Voice Therapy in Telepractice with Patients with Hyperfunctional Voice Disorder: A Pilot Study. J Clin Med 2024; 13:5320. [PMID: 39274533 PMCID: PMC11396346 DOI: 10.3390/jcm13175320] [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: 07/30/2024] [Revised: 09/02/2024] [Accepted: 09/05/2024] [Indexed: 09/16/2024] Open
Abstract
Background: The need for telepractice and digital treatment has increased due to issues this revision.regarding medical access and the COVID-19 pandemic. However, in many countries, telepractice is rarely performed. The purpose of this pilot study was to describe the detailed process of telepractice in patients with hyperfunctional voice disorder and investigate its effects. Methods: The three subjects who were enrolled in this pilot study had hyperfunctional voice disorders. The evaluation was performed face to face. Auditory perceptual evaluation, acoustic evaluation, aerodynamic evaluation, patient self-evaluation, and interviews were conducted. Treatment was delivered by telepractice using a smartphone application. Results: In quantitative analysis of auditory perceptual evaluation, acoustic evaluation, aerodynamic evaluation, and patient self-evaluation, all subjects showed improved voice after treatment. In-depth analysis of telepractice was performed through the interview. Conclusions: Telepractice was effective in patients with voice disorders, and the patients were satisfied with this approach. In addition to this pilot study, further large-scale studies are required, but telemedicine may improve treatment outcomes and patient satisfaction in cases where medical access is limited or during outbreaks of respiratory infections like COVID-19.
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Affiliation(s)
- Nayeon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Suna Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu 41944, Republic of Korea
| | - Gil Joon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyungpook National University Chilgok Hospital, Kyungpook National University School of Medicine, Daegu 41944, Republic of Korea
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Gray R, Michael D, Hoffmeister J, Lunos S, Zach S, Butcher L, Weinstein D, Misono S. Patient Satisfaction with Virtual vs In-Person Voice Therapy. J Voice 2024; 38:1088-1094. [PMID: 35410780 DOI: 10.1016/j.jvoice.2022.03.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/10/2022] [Accepted: 03/10/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether there is a difference in patient satisfaction between in-person and virtual voice therapy. METHODS Patient satisfaction answers to the National Research Corporation (NRC) Health patient survey were retrieved for two separate 11 month periods. The first was for an in-person cohort, from April 2019 to February 2020. The second was for a virtual cohort between April 2020 and February 2021. Two group t tests or Wilcoxon rank sum tests were used to compare responses between the in-person and virtual cohorts. The effect of modality of therapy by gender, age, and race was examined by testing interactions with separate ANOVA models. RESULTS Responses were compared between 224 patient satisfaction surveys for the virtual cohort and 309 patient satisfaction surveys for the in-person cohort. Overall, responses were highly favorable in all categories. There were no differences between the in-person and virtual cohorts' responses with respect to three main categories: likelihood of future referral of clinic or provider; communication with provider; and comprehension of the treatment plan. The interaction between modality of therapy delivery and age was significant for the question, "Did you know what to do after your visit," with 18-44 year olds in the in-person group reporting a better understanding of the treatment plan compared to the 18-44 year olds in the virtual therapy cohort (P = 0.004). There were no interactions between modality of therapy and gender, or race. CONCLUSION Virtual delivery of voice therapy was associated with comparable visit satisfaction scores to in-person delivery, with both delivery modalities demonstrating very high satisfaction. Future studies are needed to identify which patients and conditions are most suited for virtual versus in-person delivery of speech-language pathology services in voice clinics.
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Affiliation(s)
- Raluca Gray
- Department of Otolaryngology, Lions Voice Clinic, University of Minnesota, Minneapolis, Minnesota.
| | - Deirdre Michael
- Department of Otolaryngology, Lions Voice Clinic, University of Minnesota, Minneapolis, Minnesota
| | - Jesse Hoffmeister
- Department of Otolaryngology, Lions Voice Clinic, University of Minnesota, Minneapolis, Minnesota
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota
| | - Sarah Zach
- Department of Otolaryngology, Lions Voice Clinic, University of Minnesota, Minneapolis, Minnesota
| | - Lisa Butcher
- Department of Otolaryngology, Lions Voice Clinic, University of Minnesota, Minneapolis, Minnesota
| | - Dan Weinstein
- Department of Otolaryngology, Lions Voice Clinic, University of Minnesota, Minneapolis, Minnesota
| | - Stephanie Misono
- Department of Otolaryngology, Lions Voice Clinic, University of Minnesota, Minneapolis, Minnesota
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Cantarella G, Aldè M, Battilocchi L, Nitro L, Barillari MR, Ciabatta A, Bernardelli G, Consonni D, Pignataro L. Italian Speech-Language Pathologists and Telerehabilitation for Voice Disorders: A Survey on Satisfaction, Effectiveness, Limits, and Future Prospects. Telemed J E Health 2024. [PMID: 39158223 DOI: 10.1089/tmj.2023.0436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2024] Open
Abstract
Introduction: The aim of this study was to evaluate the distribution of virtual voice therapy during the coronavirus disease 2019 (COVID-19) lockdown in Italy via the collection of opinions of speech-language pathologists (SLPs). Methods: All SLPs who regularly carried out their professional activity in public hospitals, private hospitals, or private practices in Italy were asked to fill out an online survey consisting of two sections: (1) demographic information (age, gender, work setting, seniority, working time, and regular use of virtual voice therapy) and (2) opinions regarding telerehabilitation (motivation, personal satisfaction, effectiveness, and future needs and uses). Results: A total of 299 SLPs (mean age 39.1 ± 12.4 years) completed the survey. Overall, a regular use of virtual voice therapy was declared by 31.1% (93/299) of SLPs, with the highest prevalence for SLPs working in fully private facilities (46.7%; p < 0.001). Among all respondents, 25.4% had a highly positive opinion on the possible use of virtual voice therapy, even in nonemergency situations, and 55.8% planned to maintain this rehabilitation modality in the future. Discussion: Italian SLPs, regardless of age, had a positive impact with the new telerehabilitation practices. Investments in training and updating SLPs through specific courses would help to break down the strong barriers to telepractice acceptance, such as lack of familiarity with new technologies and lack of adequate preparation. Virtual voice therapy, which had never been experienced in such a way in Italy before the COVID-19 pandemic, promises to be a valuable future addition to the current traditional rehabilitation approaches.
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Affiliation(s)
- Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Specialist Surgical Sciences, Otolaryngology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Specialist Surgical Sciences, Audiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ludovica Battilocchi
- Department of Specialist Surgical Sciences, Otolaryngology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Letizia Nitro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Maria Rosaria Barillari
- Department of Mental and Physical Health and Preventive Medicine, "L. Vanvitelli" University, Naples, Italy
| | - Annaclara Ciabatta
- Department of Specialist Surgical Sciences, Otolaryngology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lorenzo Pignataro
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Department of Specialist Surgical Sciences, Otolaryngology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Guglani I, Sanskriti S, Joshi SH, Anjankar A. Speech-Language Therapy Through Telepractice During COVID-19 and Its Way Forward: A Scoping Review. Cureus 2023; 15:e44808. [PMID: 37809138 PMCID: PMC10560081 DOI: 10.7759/cureus.44808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
The overall burden of voice disorders is vast, and speech-language therapy has been in use for long to prevent, assess, diagnose, and treat different speech and language disorders. Due to the COVID-19 outbreak, these services are not readily accessible because of various precautionary measures that have been laid down by the government to check the blowout of infection; as a solution to this, there has been a rise in telepractice. The purpose of this review article is to study the usefulness of telepractice for speech-language therapy during the COVID-19 pandemic and its way forward. Search was performed in the PubMed database. A total of 102 articles were found, out of which 32 articles were included through a comprehensive inclusion and exclusion criteria. This study analyzes various papers on the use of telepractice during COVID-19 for speech-language therapy. The satisfaction was greater among women as compared to men because women could get the appointment done at home and they could easily manage their household chores. It has been recognized as an "attend anywhere" web-based platform that provides us with the 5 C's, namely, easy-to-access care, increased comfort, increased convenience, reduced cost, and higher confidentiality. Patients look for such sessions in the future, even when the pandemic is over. Telepractice has now been accepted as the new healthcare delivery model with multiple advantages and disadvantages. However, more research needs to be done on the moral and environmental aspects related to its use.
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Affiliation(s)
- Ishita Guglani
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sanskriti Sanskriti
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shiv H Joshi
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ashish Anjankar
- Biochemistry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Rameau A, Cox SR, Sussman SH, Odigie E. Addressing disparities in speech-language pathology and laryngology services with telehealth. JOURNAL OF COMMUNICATION DISORDERS 2023; 105:106349. [PMID: 37321106 PMCID: PMC10239150 DOI: 10.1016/j.jcomdis.2023.106349] [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: 08/29/2021] [Revised: 05/10/2023] [Accepted: 06/02/2023] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic disproportionately affected the health and well-being of marginalized communities, and it brought greater awareness to disparities in health care access and utilization. Addressing these disparities is difficult because of their multidimensional nature. Predisposing factors (demographic information, social structure, and beliefs), enabling factors (family and community) and illness levels (perceived and evaluated illness) are thought to jointly contribute to such disparities. Research has demonstrated that disparities in access and utilization of speech-language pathology and laryngology services are the result of racial and ethnic differences, geographic factors, sex, gender, educational background, income level and insurance status. For example, persons from diverse racial and ethnic backgrounds have been found to be less likely to attend or adhere to voice rehabilitation, and they are more likely to delay health care due to language barriers, longer wait times, a lack of transportation and difficulties contacting their physician. The purpose of this paper is to summarize existing research on telehealth, discuss how telehealth offers the potential to eliminate some disparities in the access and utilization of voice care, review its limitations, and encourage continued research in this area. A clinical perspective from a large volume laryngology clinic in a major city in northeastern United States highlights the use of telehealth in the provision of voice care by a laryngologist and speech-language pathologist during and after the COVID19 pandemic.
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Affiliation(s)
- Anaïs Rameau
- Sean Parker Institute for the Voice, Weill Cornell Medical College, New York, NY, United States of America.
| | - Steven R Cox
- Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY, United States of America
| | - Scott H Sussman
- Sean Parker Institute for the Voice, Weill Cornell Medical College, New York, NY, United States of America
| | - Eseosa Odigie
- Sean Parker Institute for the Voice, Weill Cornell Medical College, New York, NY, United States of America
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da Rocha LM, Ribeiro VV, Zambon F, Behlau M. Reliability of Vocal Self-assessment Tools in Individuals With Vocal Complaints Applied Using a Digital Platform and In-person. J Voice 2023:S0892-1997(23)00137-6. [PMID: 37344244 DOI: 10.1016/j.jvoice.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE To verify the reliability of vocal self-assessment tools in individuals with vocal complaints using a digital platform and in-person. METHODS Data from 50 Brazilian adults with vocal complaints were collected. The participants answered the Voice Symptoms Scale (VoiSS), the Voice Handicap Index - 10 (VHI-10), and questions regarding personal information and their general health. The data collection occurred in two moments, within a period of 2-14 days, with time variation between participants, and always in the same collection order: 1. using a digital platform (Google Forms); 2. In-person. The data were analyzed descriptively and inferentially using the SPSS 25.0 software and the Wilcoxon Test. RESULTS The self-perception of vocal symptoms in the Emotional factors for women presented a statistical difference between the digital platform and the in-person response (P = 0.029); higher scores were observed when answers were given in-person compared to using a digital platform. CONCLUSION Overall, the participants perceived their voice symptoms and voice handicap similarly when answers were given using a digital platform and in-person. The Emotion voice symptoms in women were the only exception, although remaining deviated; however, the perception of the symptoms may have been attenuated during the in-person care.
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Affiliation(s)
- Luise Marques da Rocha
- Centro de Estudos da Voz, Rua Machado Bitencourt Street, 361, Vila Clementino, São Paulo 04044-001, São Paulo, Brazil.
| | - Vanessa Veis Ribeiro
- Centro de Estudos da Voz, Rua Machado Bitencourt Street, 361, Vila Clementino, São Paulo 04044-001, São Paulo, Brazil; Speech-Language Pathology Course, Faculdade de Ceilândia, Universidade de Brasília, Ceilândia Sul Campus Universitário, Centro Metropolitano, Brasília 72220-275, Distrito Federal, Brazil.
| | - Fabiana Zambon
- Centro de Estudos da Voz, Rua Machado Bitencourt Street, 361, Vila Clementino, São Paulo 04044-001, São Paulo, Brazil; Sindicato dos Professores de São Paulo, Borges Lagoa Street, 208, Vila Clementino, São Paulo 04038-000, São Paulo, Brazil.
| | - Mara Behlau
- Centro de Estudos da Voz, Rua Machado Bitencourt Street, 361, Vila Clementino, São Paulo 04044-001, São Paulo, Brazil.
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Vance D, Shah P, Sataloff RT. COVID-19: Impact on the Musician and Returning to Singing; A Literature Review. J Voice 2023; 37:292.e1-292.e8. [PMID: 33583675 PMCID: PMC7808728 DOI: 10.1016/j.jvoice.2020.12.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of this study was to review current literature of the impact of COVID-19 on musicians and returning to singing. METHODS A comprehensive search of peer-review articles was completed using PubMed, GoogleScholar, Scopus, and Web of Science. The search was completed using many key terms including voice, hoarseness, dysphonia, aphonia, cough, singers, and public speakers. The bibliography from each article found was searched to find additional articles. The search process revealed 56 peer-reviewed articles, 18 primary articles, ranging from the years 2019 to 2020. CONCLUSION COVID-19 has had a major impact on singers and other musicians worldwide. It can affect the voice and can lead to paresis/paralysis of laryngeal nerves to long-term changes in respiratory function. There is a risk from aerosolization/droplet formation transmission with singing, and with playing wind and brass instruments that can be mitigated by following COVID-19 guidelines. Ways to reduce possible transmission during singing and instrument play include virtual rehearsals or performances, mask-wearing, instrument covers, smaller choirs, performing outside, excellent ventilation being socially distanced, shorter rehearsals, regularly cleaning commonly touched surfaces and washing hands, avoiding contact with others, and temperature screening.
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Affiliation(s)
- Dylan Vance
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Priyanka Shah
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Robert T Sataloff
- Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania; Lankenau Institute for Medical Research, Wynnewood, Pennsylvania.
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Smith JD, McConville K, Tiner MK, Baldner EF, Rosenberg M, Kupfer RA, Hogikyan ND, Morrison RJ. Examining Use and Effectiveness of Teletherapy for Patients with Dysphonia. J Voice 2023:S0892-1997(23)00034-6. [PMID: 36863957 DOI: 10.1016/j.jvoice.2023.01.034] [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: 12/06/2022] [Revised: 01/27/2023] [Accepted: 01/27/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVE(S)/HYPOTHESIS Virtual therapy (teletherapy) for patients with dysphonia has become ubiquitous in the COVID-19 era. However, barriers to widespread implementation are evident, including unpredictable insurance coverage attributed to limited evidence supporting this approach. In our single-institution cohort, our objective was to show strong evidence for use and effectiveness of teletherapy for patients with dysphonia. STUDY DESIGN Single institution, retrospective cohort study. MATERIAL AND METHODS This was an analysis of all patients referred for speech therapy with dysphonia as primary diagnosis from 4/1/2020 to 7/1/2021 and in whom all therapy sessions were delivered in a teletherapy format. We collated and analyzed demographics and clinical characteristics and adherence to the teletherapy program. We assessed changes in perceptual assessments and vocal capabilities (GRBAS, MPT), patient-reported outcomes (V-RQOL), and metrics of session outcomes (complexity of vocal tasks, carry-over of target voice) pre- and post-teletherapy using student's t test and chi-square test. RESULTS Our cohort included 234 patients (mean [SD] age 52 [20] years) residing a mean (SD) distance of 51.3 (67.1) miles from our institution. The most common referral diagnosis was muscle tension dysphonia (n = 145, 62.0% patients). Patients attended a mean (SD) of 4.2 (3.0) sessions; 68.0% (n = 159) of patients completed four or more sessions and/or were deemed appropriate for discharge from teletherapy program. Statistically significant improvements were seen in complexity and consistency of vocal tasks with consistent gains in carry-over of target voice for isolated tasks and connected speech. CONCLUSIONS Teletherapy is a versatile and effective approach for treatment of patients with dysphonia of varying age, geography, and diagnoses.
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Affiliation(s)
- Joshua D Smith
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA
| | - Katherine McConville
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA; Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Margaret K Tiner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA; Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Elizabeth Ford Baldner
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA; Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Marci Rosenberg
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA; Department of Speech-Language Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Robbi A Kupfer
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA
| | - Norman D Hogikyan
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA
| | - Robert J Morrison
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Vocal Health Center, Ann Arbor, Michigan, USA.
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Queiroz MRG, Pernambuco L, Leão RLDS, Araújo AN, Gomes ADOC, da Silva HJ, Lucena JA. Voice Therapy for Older Adults During the COVID-19 Pandemic in Brazil. J Voice 2022:S0892-1997(22)00314-9. [PMID: 36550002 PMCID: PMC9574462 DOI: 10.1016/j.jvoice.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To characterize the clinical practice of Brazilian speech-language-hearing therapists regarding voice therapy for older adults during the COVID-19 pandemic. METHODS Cross-sectional survey conducted remotely. Data were collected through a form shared online with approximately 1.500 speech-language-hearing therapists. The form included voice therapy practice with older adults during the COVID-19 pandemic. It was responded by 155 voice experts. RESULTS Most respondents were females with over 21 years' experience in vocal health care, working with both in-person therapy and teletherapy. Obtaining acoustic parameters and using therapy strategies for breathing and body training were the most reported changes in remote therapy during the pandemic. The main difficulties involved wearing masks in in-person therapy and assessing the voice in teletherapy. Patient adherence and goals reached were deemed positive by most participants. Associations were found between place and format of service; between patient adherence and goals reached; and between difficulties in teletherapy and use of complementary therapeutic resources. CONCLUSION The COVID-19 pandemic led Brazilian speech-language-hearing therapists to change their clinical practice with older adults in both remote and in-person therapy. The main changes involved wearing masks in in-person therapy and assessing the voice in teletherapy. Remote therapy proved to be a safe and effective possibility.
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Affiliation(s)
- Mariana Rebeka Gomes Queiroz
- Speech-Language Pathology and Audiology Department, Health Sciences Center, Graduate Program in Human Communication Health at the Federal University of Pernambuco, Recife, Pernambuco, Brazil.
| | - Leandro Pernambuco
- Department of Speech Therapy, Health Sciences Center, UFPB, João Pessoa, Paraíba, Brazil
| | - Rebeca Lins de Souza Leão
- Speech-Language Pathology and Audiology Department, Health Sciences Center, Graduate Program in Human Communication Health at the Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Ana Nery Araújo
- Speech-Language Pathology and Audiology Department, Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Adriana de Oliveira Camargo Gomes
- Speech-Language Pathology and Audiology Department, Health Sciences Center, Graduate Program in Human Communication Health at the Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Hilton Justino da Silva
- Speech-Language Pathology and Audiology Department, Health Sciences Center, Graduate Program in Human Communication Health at the Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Jonia Alves Lucena
- Speech-Language Pathology and Audiology Department, Health Sciences Center, Graduate Program in Human Communication Health at the Federal University of Pernambuco, Recife, Pernambuco, Brazil
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Kim ME, Sund LT, Morton M, Kim J, Choi JS, Castro ME. Provider and Patient Satisfaction with Telemedicine Voice Therapy During the COVID-19 Pandemic. J Voice 2022:S0892-1997(22)00211-9. [PMID: 36038478 PMCID: PMC9289043 DOI: 10.1016/j.jvoice.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The COVID-19 pandemic expanded the use of telemedicine, but there is no literature exploring both patient and provider satisfaction specifically in the provision of voice therapy. This study aims to investigate patient and provider satisfaction with virtual voice therapy, its associated factors, and any correlation between the two. METHODS Cross-sectional study. Participants included 226 adults who underwent voice therapy delivered via telepractice at the USC Voice Center between April and October 2020. Patients and providers self-reported their level of satisfaction on a visual analog scale (VAS; range 0-100). Patient satisfaction was additionally measured using a previously validated Telemedicine Satisfaction Questionnaire (TSQ; range 1-5), and a binary question about their desire to choose telemedicine over in-person therapy in the future. Three speech-language pathologists rated provider satisfaction for all 226 patients. Patient satisfaction survey was completed by 55 patients. Multivariable linear regression analyses and linear mixed-effects models were used to assess the results. RESULTS Patient and provider mean (SD) VAS satisfaction scores were 86.8 (18.6) and 80.6 (19.7), respectively. The mean (SD) TSQ score was 4.4 (0.6). In a multivariable model, patient satisfaction levels were significantly higher for hypofunctional than for hyperfunctional dysphonia diagnoses. Forty-four (73%) patients reported they would prefer telemedicine voice therapy over in-person appointments, which was significantly correlated with internet reliability (P = 0.04). For providers, satisfaction was significantly lower for patients whose diagnosis had changed after initiation of voice therapy (Δ = -16.0 [95% CI: -28.7 to -3.2]) and for encounters with Asian patients compared to White patients (Δ = -11.6 [95% CI: -18.9 to -4.2]). Patient and provider satisfaction scores were weakly correlated (r = 0.19). CONCLUSIONS Our findings suggest that virtual voice therapy is not simply an alternative to in-person service, but rather an effective method useful beyond the current pandemic with proper diagnosis and technical support.
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Affiliation(s)
- Mary E Kim
- Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of USC, University of Southern California Caruso, Los Angeles, California.
| | - Lauren Timmons Sund
- Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of USC, University of Southern California Caruso, Los Angeles, California
| | - Mariah Morton
- Auburn University School of Kinesiology, Auburn, Albama
| | - James Kim
- Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of USC, University of Southern California Caruso, Los Angeles, California
| | - Janet S Choi
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota
| | - M Eugenia Castro
- Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of USC, University of Southern California Caruso, Los Angeles, California
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Sresuganthi JR, Nallamuthu A, Boominathan P. Comparison of Client-Led Asynchronous and Clinician-Led Synchronous Online Methods for Evaluation of Subjective Vocal Measures in Teachers: A Feasibility Study. J Voice 2022:S0892-1997(22)00127-8. [PMID: 35641382 DOI: 10.1016/j.jvoice.2022.04.015] [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: 02/24/2022] [Revised: 04/21/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND COVID-19 has transformed face to face teaching in classrooms to online and hybrid modes. Increased vocal intensity/ pitch to call attention of students and transact in the online class, inappropriate posture (head, neck & upper trunk) while using the laptop and other online tools cause vocal loading leading to voice related concerns in teachers. Tele voice assessment is a feasible alternative means to seek professional help in the current situation and possibly in the future too. Client-led asynchronous and clinician-led synchronous voice recordings for clinical vocal measures among school teachers were compared in this study. METHOD Twenty-five school teachers (21 females & four males) from Chennai consented to the study. Information of voice use, its impact on the day-to-day situations, self-perception of vocal fatigue, and their recorded voice sample (phonation & speaking) were obtained online (asynchronous mode). Within a period of ten days, the clinician-led synchronous session was planned on a mutually convenient time for obtaining voice samples through zoom call. The voice samples obtained were compared for clinical measures and perceptual voice evaluation. RESULTS Participants reported of vocal symptoms and increased vocal fatigue scores. The maximum phonation time values obtained through synchronous mode were lesser when compared to asynchronous mode. Also, variability was noted in the perceptual vocal measures of voice samples obtained through synchronous mode. During synchronous voice recording & evaluation, the background noise, internet stability, audio enhancement feature, and microphone placement & quality could be monitored, and immediate feedback was provided. Additionally, the asynchronous recording can be supplemented for synchronous recording, with clear instructions & demonstration. CONCLUSION This study explored the feasibility of using synchronous and asynchronous voice recording for voice analysis in school teachers. The findings could serve as a base to understand the advantages and challenges of using client-led asynchronous and clinician-led synchronous methods for estimating vocal measures.
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Affiliation(s)
| | - Aishwarya Nallamuthu
- Department of Speech Language & Hearing Sciences, Sri Ramachandra Institute of Higher Education & Research, Chennai, Tamil Nadu, India.
| | - Prakash Boominathan
- Department of Speech Language & Hearing Sciences, Sri Ramachandra Institute of Higher Education & Research, Chennai, Tamil Nadu, India
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Dahl KL, Weerathunge HR, Buckley DP, Dolling AS, Díaz-Cádiz M, Tracy LF, Stepp CE. Reliability and Accuracy of Expert Auditory-Perceptual Evaluation of Voice via Telepractice Platforms. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2446-2455. [PMID: 34473568 PMCID: PMC9132030 DOI: 10.1044/2021_ajslp-21-00091] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 05/24/2023]
Abstract
Purpose This study assessed the reliability and accuracy of auditory-perceptual voice evaluations by experienced clinicians via telepractice platforms. Method Voice samples from 20 individuals were recorded after transmission via telepractice platforms. Twenty experienced clinicians (10 speech-language pathologists, 10 laryngologists) evaluated the samples for dysphonia percepts (overall severity, roughness, breathiness, and strain) using a modified Consensus Auditory-Perceptual Evaluation of Voice. Reliability was calculated as the mean of squared differences between repeated ratings (intrarater agreement), and between individual and group mean ratings (interrater agreement). Repeated measures analyses of variance were constructed to measure effects of transmission condition (e.g., original recording, WebEx, Zoom), dysphonia percept, and their interaction on intrarater agreement, interrater agreement, and average ratings. Significant effects were evaluated with post hoc Tukey's tests. Results There were significant effects of transmission condition, percept, and their interaction on average ratings, and a significant effect of percept on interrater agreement. Post hoc testing revealed statistically, but not clinically, significant differences in average roughness ratings across transmission conditions, and significant differences in interrater agreement for several percepts. Overall severity had the highest agreement and strain had the lowest. Conclusion Telepractice transmission does not substantially reduce reliability or accuracy of auditory-perceptual voice evaluations by experienced clinicians.
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Affiliation(s)
- Kimberly L. Dahl
- Department of Speech, Language and Hearing Sciences, Boston University, MA
| | - Hasini R. Weerathunge
- Department of Speech, Language and Hearing Sciences, Boston University, MA
- Department of Biomedical Engineering, Boston, University, MA
| | - Daniel P. Buckley
- Department of Speech, Language and Hearing Sciences, Boston University, MA
- Department of Otolaryngology—Head & Neck Surgery, Boston, University School of Medicine, MA
| | - Anton S. Dolling
- Department of Speech, Language and Hearing Sciences, Boston University, MA
| | - Manuel Díaz-Cádiz
- Department of Speech, Language and Hearing Sciences, Boston University, MA
| | - Lauren F. Tracy
- Department of Otolaryngology—Head & Neck Surgery, Boston, University School of Medicine, MA
| | - Cara E. Stepp
- Department of Speech, Language and Hearing Sciences, Boston University, MA
- Department of Otolaryngology—Head & Neck Surgery, Boston, University School of Medicine, MA
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13
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Becker DR, Gillespie AI. In the Zoom Where It Happened: Telepractice and the Voice Clinic in 2020. Semin Speech Lang 2021; 42:64-72. [PMID: 33596605 DOI: 10.1055/s-0040-1722750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Telemedicine-conveying medical information virtually for planning, diagnosis, or treatment-has been a part of the American medical system for over 100 years. A constantly evolving modality, telepractice was a supplemental care delivery system for most speech-language pathologists (SLPs) until March 2020 when the COVID-19 pandemic forced clinical operations to halt in-person activities and convert as much as possible to virtual platforms. The purpose of this article is to provide an overview of the need for telepractice prior to and beyond the current pandemic, the efficacy of telepractice for the voice-specialized SLP, limitations of telepractice, and best practices for providing care over telepractice with a specific focus on voice disorder diagnosis and treatment.
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Affiliation(s)
- Diana Rose Becker
- Emory Voice Center, Department of Otolaryngology, Emory Healthcare, Emory University Hospital Midtown, Atlanta, Georgia
| | - Amanda I Gillespie
- Emory Voice Center, Department of Otolaryngology, Emory Healthcare, Emory University Hospital Midtown, Atlanta, Georgia
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Knickerbocker K, Bryan C, Ziegler A. Phonogenic Voice Problems among Speech-Language Pathologists in Synchronous Telepractice: An Overview and Recommendations. Semin Speech Lang 2021; 42:73-84. [PMID: 33596606 DOI: 10.1055/s-0040-1722754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Many speech-language pathologists (SLPs) recently adopted a live, synchronous online distribution of clinical services due to physical distancing measures aimed at bringing the coronavirus disease 2019 (COVID-19) outbreak under control. Few SLPs had received training in telepractice to prepare them for changes from an in-person service delivery model to synchronous telepractice. The new telepractice environment may alter vocal behaviors and communication interactions in such a way that negatively impacts voice production. Thus, delivering synchronous online clinical services may require that SLPs adopt novel prevention strategies for avoiding phonogenic voice problems. Guided by two complementary injury frameworks, the Haddon Matrix and the Haddon Countermeasures, this article provides an overview of potential factors associated with phonogenic voice problems among SLPs in telepractice and proposes possible prevention strategies to maintain optimal vocal health and function with synchronous modes of online clinical practice.
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Affiliation(s)
| | | | - Aaron Ziegler
- The Wellness Group for Voice, Speech, and Swallowing, LLC
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Nemr K, Simões-Zenari M, de Almeida VC, Martins GA, Saito IT. COVID-19 and the teacher's voice: self-perception and contributions of speech therapy to voice and communication during the pandemic. Clinics (Sao Paulo) 2021; 76:e2641. [PMID: 33787658 PMCID: PMC7978665 DOI: 10.6061/clinics/2021/e2641] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/11/2021] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES We aimed to analyze the vocal self-perception of Brazilian teachers and their communication needs, vocal signs and symptoms, and voice-related lifestyles during the coronavirus disease (COVID-19) pandemic and, based on this information, to develop guidance materials intended for dissemination to these teachers and the general community. METHODS An online questionnaire designed for this survey was distributed via the researchers' networks and was available for completion by any teacher, except those who were not working at the time. There were 1,253 teachers from all over Brazil, of both sexes, covering a wide age range, working at different levels of education, and most with more than ten years of experience. Descriptive and inferential analyses of the data were performed. RESULTS On comparing the prepandemic period with the current one, participants indicated voice improvements. In contrast, they presented symptoms such as dry throat, effort in addressing remote classes, hoarseness after classes, and difficulties with the use of headphones, among others. They further indicated stress, general fatigue, impact of the pandemic on mental health, and the overlapping of many home tasks with professional tasks. Some smoked, and others hydrated insufficiently. CONCLUSION Although teachers generally noticed voice improvements during the pandemic, a proportion of them perceived worsening of voices. Many indicated several factors in which speech-language pathologists could guide them with the aim of improving performance and comfort during remote and hybrid classes, an initiative that will positively impact not only their voice and communication but also their quality of life.
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Affiliation(s)
- Katia Nemr
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Marcia Simões-Zenari
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Vanessa Cássia de Almeida
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Glauciene Amaral Martins
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Isabele Tiemi Saito
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR
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