Abstract
Summary
The potential for negative sequalae in psychosocial well-being presents clinical importance
to the assessment of voice disorders. Despite the impairment voice disorders cause
in the psychosocial domain, the clinical assessment of these disorders relies heavily
on visual perceptual judgments of the larynx, audio-perceptual, as well as acoustic
and aerodynamic measures. While these measures aid in accurate diagnosis and are necessary
for standard of care, they present little insight into the patient experience of having a voice disorder.
Design
Retrospective between-subject, non-experimental design.
Methods
Data from 335 patients from the University of Pittsburgh Voice Center were collected
from scores of the Voice Handicap Index-10 (VHI-10) and two recent questionnaires,
the Voice Present Perceived Control scale (VPPC), and the Vocal Congruency Scale (VCS).
Examining how these voice-specific scales related to three mental health screeners
for stress (Perceived Stress Scale-4), anxiety (Generalized Anxiety Disorder-7) and
depression (Patient Health Questionnaire-9) were also examined. Patient diagnoses
included primary muscle tension dysphonia (pMTD), unilateral vocal fold paralysis
(UVFP), vocal fold atrophy, and mid membranous vocal fold lesions.
Results
There were significant differences in scores from the voice-specific scales between
diagnostic groups with UVFP being the highest (worst) in VHI-10 and UVFP being the
lowest (worst) in VCS compared to healthy controls. There was no significant difference
in VPPC scores between diagnostic groups. Results showed statistically significant
inverse relationships between the VHI-10 and the VPPC and between the VHI-10 and VCS
for all diagnostic groups. A significant direct relationship was found between the
VPPC and the VCS for patients diagnosed with MTD, UVFP and Lesions. In sum, patients
with UVFP presented with the most frequent and sometimes strongest relationships between
voice and mental health measures.
Discussion
This study marks an initial investigation into the nuanced patient experience of having
a voice disorder. Three theoretically unrelated voice constructs: handicap, perceived
control, and sense of self, were measured via self-report. Results from this study
describe the patient experience correlating to these constructs with weak correlations
to stress, anxiety, and depression. Findings also clearly suggest that patient experience
varies among diagnostic groups, as well as varying constructs. Measures of multiple
constructs of patient perception provide valuable insight into a patient's experience
of their voice disorder, guidance on the direction of voice treatment, and justification
for such treatments.
Key Words
Abbreviations:
VHI (voice handicap index), PROMS (patient perceived outcome measures), PCOSE (perceived control over stressful events scale), VPPC (Voice Present Perceived Control scale), VCS (vocal congruence scale), PSS (Perceived Stress scale-4), GAD (general anxiety disorder), PHQ (patient health questionnaire)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 04, 2021
Accepted:
August 25,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
