Dysphonia
Conditions
Brief summary
The purpose of this study is to assess the effects of incorporating educational online modules into voice therapy. One of the main reasons that voice therapy fails is lack of participation and engagement from the patient's side. The researchers hope to learn if increasing patient engagement via educational online modules during this waiting period between evaluation and first therapy session is useful in increasing understanding of the therapeutic framework of voice therapy.
Detailed description
Attendance and adherence are established as consistent challenges in voice therapy. Specific logistical and psychological factors linked to these challenges include the interval between evaluation and initiation of treatment and components of patient motivation. The authors propose a novel online education module involving patient self-ratings of voice quality to be completed at various time points throughout the therapeutic process, including during the waiting period between initial evaluation and first treatment session. The authors hypothesize that completion of this module will increase patient understanding of the conceptual framework of therapy, provide opportunities for inclusion of patient-driven acoustic goals and establish skills in auditory and kinesthetic awareness, which are foundational to behavioral voice therapy.
Interventions
OTHEROnline Voice quality education module
The novel online module the authors developed consists of a patient education on acoustic-perceptual rating of voice quality (CAPE-V), practice rating sample recordings of others' voices, and the patient's self-rating of their own voice in real time during a standard sentence-reading task. The module also includes the Self-Efficacy Scale for Voice Therapy.
OTHERVocal hygiene module
The generic online patient education module on vocal hygiene during the waiting period between their initial evaluation and their first therapy session that also includes the Self-Efficacy Scale for Voice Therapy
Sponsors
NYU Langone Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Age \>18 years * English-speaking * Have access to technology, including Internet * Diagnosed with dysphonia with a recommended treatment of voice therapy. * Willingness to complete all clinical/research assessments * Ability to give informed consent
Exclusion criteria
* Patients who undergo surgical intervention during the course of therapy Contraindications for participation in voice therapy * Diagnosis of Parkinson's Disease or other neurodegenerative, progressive disorder (e.g., ALS) * Previous training in acoustic-perceptual voice quality rating, for example a speech language pathology student * Visual impairments that would prevent the completion of an online module. * Those with self-reported moderate-profound hearing loss or deafness that would preclude them from participating in the study * Inability to give informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of voice handicap perception across the 3 groups | Baseline (Day 1) visit, 8 - 10 week visit | Will be measured by Voice Handicap Index -10 (VHI-10), a patient reported outcome measure used to record the patient's perception of impairment or handicap due to a voice problem. A score of over 10 is considered to be abnormal. The scores in all three groups will be compared and analyzed. |
| Change of Online education module acceptance across the 3 groups | Baseline Visit (Day 1), Last day of visit (up to 4 months from baseline) | Will be measured by attendance data (number of sessions recommended versus attended, number of no shows) using the standard patient data collected according to standard of care process. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change of perceived effectiveness of voice therapy | Baseline (Day 1) visit, 8 - 10 week visit | Self-Efficacy Scale for Voice Therapy will assess a patient's self-perception of their ability to achieve a goal. The Self-Efficacy Scale for Voice Therapy prompts patients to be brutally honest and rate their perceived capability to accomplish practice or generalization of skills in various daily and therapeutic situations and activities. Patients are asked to rate their certainty in these capabilities from 0 to 10, where 0 is not at all certain and 10 is extremely certain. |
| Change of patient's perception on voice therapy | Baseline (Day 1) visit, 8 - 10 week visit | Comparison of scores on the Patient Perception of Voice Therapy Questionnaire for therapy completers across the three groups as well as between those subjects who completed an online module (experimental and sham control groups) and those who did not (control group alone). |
| Change of perceptual voice ratings | Baseline (Day 1) visit, 8 - 10 week visit | CAPE-V will be used to measure experimental group patients and clinician perceptual voice rating. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) indicates salient perceptual vocal attributes, identified by the core consensus group as commonly used and easily understood. The attributes are: (a) Overall Severity; (b) Roughness; (c) Breathiness; (d) Strain; (e) Pitch; and (f) Loudness. The CAPE-V displays each attribute accompanied by a 100- millimeter line forming a visual analog scale (VAS). The clinician indicates the degree of perceived deviance from normal for each parameter on this scale, using a tic mark. |
Countries
United States
Outcome results
None listed