Defining the Lived Experience of Older Adults With Voice Disorders

Etter, Nicole M.; Stemple, Joseph C.; Howell, Dana M.

doi:10.1016/j.jvoice.2012.07.002

Cited by 47 publications

(32 citation statements)

References 36 publications

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“…partially meets the requirements of the item or unclear data Eur Arch Otorhinolaryngol parts of the elderly population who exhibit vocal disorders do not seek treatment or underestimate the problem and seek assistance too late [21,22]. A number of authors [12,15,17,22] attribute this behavior to the acceptance on behalf of the elderly that vocal abnormalities are a part of the natural aging process and the fact that they are not aware of the intervention possibilities and believe that the problem can be solved without treatment. Added to this, primary health care professionals admit that it is difficult to identify this type of disorders [22,35].…”

Section: Discussionmentioning

confidence: 99%

“…They can also affect physical, emotional and social skills, increasing the risk of functional disability, dependence, social isolation, a lack of productivity, illness and general worsening of health conditions [8,[10][11][12]. Studies have also shown that advancing age increases the expenditure of health systems in terms of assessing the management of laryngeal disorders associated with the voice such as vocal fold paralysis, cancer of the larynx and functional dysphonia [13,14].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of voice disorders in the elderly: a systematic review of population-based studies

Pernambuco

Espelt

Balata

et al. 2014

Eur Arch Otorhinolaryngol

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Voice disorders can occur in the elderly as a result of natural anatomical and physiological changes or greater exposure to pathological conditions in the aging, affecting communication and quality of life. Nevertheless, data about the prevalence of voice disorders in this phase of life are not well known in a population-based perspective. The aim of the present systematic review was to identify the prevalence of vocal disorders in persons aged 60 years or more in population-based studies. A systematic review was undertaken in eleven electronic databases based on preferred reporting items for systematic reviews and meta-analysis statement (PRISMA) criteria. The methodological quality of the studies was analyzed with strengthening the reporting of observational studies in epidemiology (STROBE) directives. The search was conducted independently by two researchers. Four articles satisfied the criteria of eligibility. The prevalence of vocal disorders in the general population aged 60 years or more ranged from 4.8 to 29.1%. The studies were different in terms of the methodological procedures and the STROBE directives were not completely satisfied by any of the articles selected. The prevalence of vocal disorders in the general elderly population ranged from low to moderate in population-based studies. The methodological discrepancies of the studies compromised the reliability of the estimated data. Upgrading the methodological quality of studies and designing a short, valid and easy-to-use functional voice-related instrument are urgently required in health surveys to determine the prevalence of vocal disorders among elderly individuals.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of voice disorders in the elderly: a systematic review of population-based studies

Pernambuco

Espelt

Balata

et al. 2014

Eur Arch Otorhinolaryngol

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“…Our understanding of the effects of acquired voice disorders therefore relies on a few qualitative studies conducted by a small number of research groups. [22,[27][28][29][30] Using semi-structured interviews, Miller et al evaluated the effects of perceived changes in speech, and related coping strategies, in 37 individuals with PD. [27] In another study, Etter et al used conversational interviews to gather rich descriptive data on the attitudes and feelings of 28 older adults (aged 65-90) with voice disorders.…”

Section: Voice As An Expression Of Selfmentioning

confidence: 99%

“…[27] In another study, Etter et al used conversational interviews to gather rich descriptive data on the attitudes and feelings of 28 older adults (aged 65-90) with voice disorders. [28] While some participants in both studies were determined to make themselves understood even if it required multiple attempts to speak, and others were resigned to their situation, verbatim quotes from participants demonstrate themes of (1) feeling selfconscious and negative about their voice and themselves (''I have a weird voice''; ''I might be ordering something on the phone and people say, 'Oh you poor thing, your voice sounds awful'''); [28] (2) being left out of conversations (''I just don't talk as much''; [28] ''By the time you've finished, the subject has changed and they haven't waited for your answer to come out''; [27]) (3) withdrawing from recreational and social activities [28] (''I just sit at home because nobody can hear me or understand me''; ''I had to stop my volunteer work because there was no way I could answer the phone'') and (4) frustration and fatigue due to the effort required to make oneself understood (''It's hard work trying to talk, trying to get the words out'' [27]; ''I have to use so much energy just to have a short conversation'' [28]). …”

Section: Voice As An Expression Of Selfmentioning

confidence: 99%

Native voice, self-concept and the moral case for personalized voice technology

Nathanson

2016

Disability and Rehabilitation

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Purpose (1) To explore the role of native voice and effects of voice loss on self-concept and identity, and survey the state of assistive voice technology; (2) to establish the moral case for developing personalized voice technology. Methods This narrative review examines published literature on the human significance of voice, the impact of voice loss on self-concept and identity, and the strengths and limitations of current voice technology. Based on the impact of voice loss on self and identity, and voice technology limitations, the moral case for personalized voice technology is developed. Results Given the richness of information conveyed by voice, loss of voice constrains expression of the self, but the full impact is poorly understood. Augmentative and alternative communication (AAC) devices facilitate communication but, despite advances in this field, voice output cannot yet express the unique nuances of individual voice. The ethical principles of autonomy, beneficence and equality of opportunity establish the moral responsibility to invest in accessible, cost-effective, personalized voice technology. Conclusions Although further research is needed to elucidate the full effects of voice loss on self-concept, identity and social functioning, current understanding of the profoundly negative impact of voice loss establishes the moral case for developing personalized voice technology. Implications for Rehabilitation Rehabilitation of voice-disordered patients should facilitate self-expression, interpersonal connectedness and social/occupational participation. Proactive questioning about the psychological and social experiences of patients with voice loss is a valuable entry point for rehabilitation planning. Personalized voice technology would enhance sense of self, communicative participation and autonomy and promote shared healthcare decision-making. Further research is needed to identify the best strategies to preserve and strengthen identity and sense of self.

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“…Specifically, voice aging can have a negative impact on independence, integration, and effective communication (Kendall 2007;Plank et al 2011). Indeed, voice-related effort and discomfort, combined with increased anxiety and frustration, can cause seniors to avoid social situations and withdraw from certain kinds of activities such as telephone conversations, or large parties (Verdonck-de Leeuw and Mahieu 2004;Roy et al 2007;Etter et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Effects of age on the amplitude, frequency and perceived quality of voice

Lortie

Thibeault

Guitton

et al. 2015

AGE

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The manner and extent to which voice amplitude and frequency control mechanisms change with age is not well understood. The related question of whether the assessment of one's own voice evolves with age, concomitant with the acoustical changes that the voice undergoes, also remains unanswered. In the present study, we characterized the aging of voice production mechanisms (amplitude, frequency), compared the aging voice in different experimental contexts (vowel utterance, connected speech) and examined the relationship between voice self-assessment and age-related voice acoustical changes. Eighty healthy adults (20 to 75 years old) participated in the study, which involved computation of several acoustical measures of voice (including measures of fundamental frequency, voice amplitude, and stability) as well as self-assessments of voice. Because depression is frequent in older adults, depression and anxiety scores were also measured. As was expected, analyses revealed age effects on most acoustical measures. However, there was no interaction between age and the ability to produce high/low voice amplitude/frequency, suggesting that voice amplitude and frequency control mechanisms are preserved in aging. Multiple mediation analyses demonstrated that the relationship between age and voice self-assessment was moderated by depression and anxiety scores. Taken together, these results reveal that while voice production undergoes important changes throughout aging, the ability to increase/decrease the amplitude and frequency of voice are preserved, at least within the age range studied, and that depression and anxiety scores have a stronger impact on perceived voice quality than acoustical changes themselves.

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Defining the Lived Experience of Older Adults With Voice Disorders

Cited by 47 publications

References 36 publications

Prevalence of voice disorders in the elderly: a systematic review of population-based studies

Prevalence of voice disorders in the elderly: a systematic review of population-based studies

Native voice, self-concept and the moral case for personalized voice technology

Effects of age on the amplitude, frequency and perceived quality of voice

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