Dysphonia, Perceived Control, and Psychosocial Distress: A Qualitative Study

Misono, Stephanie; Haut, Caroline; Meredith, Liza; Frazier, Patricia A.; Stockness, Ali; Michael, Deirdre D.; Butcher, Lisa; Harwood, Eileen M.

doi:10.1016/j.jvoice.2018.04.003

Cited by 22 publications

(15 citation statements)

References 34 publications

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“…Perceived control is another important consideration for patients with voice disorders. [24][25][26][27][28][29] Voice-specific perceived control, in particular, has been associated with better outcomes (eg, lower psychosocial distress and vocal impairment) among patients with voice disorders. 24,26,30 Moreover, this voice-specific measure is associated with better outcomes to a greater extent than are general measures of control.…”

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confidence: 99%

Association Between Communicative Participation and Psychosocial Factors in Patients With Voice Disorders

Nguyen-Feng

Asplund

Frazier

et al. 2021

JAMA Otolaryngol Head Neck Surg

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IMPORTANCECommunicative participation can be conceptualized as taking part in life situations in which people are socially engaged. Communicative participation is an important aspect in the lives of patients with voice disorders, although it has not been formally assessed among a broad sample of patients with voice disorders. The associations between communicative participation and associated concepts (vocal impairment, psychosocial distress, and voice-specific perceived control) are unknown yet important for integrated treatment approaches.OBJECTIVE The primary objective was to examine the associations between communicative participation and vocal impairment, psychosocial distress, and voice-specific perceived control. The secondary objective was to examine whether perceived control moderates the association of distress with communicative participation and vocal impairment, the latter of which would replicate previous research. The hypotheses were that communicative participation would be associated with lower vocal impairment, lower distress, and higher perceived control and that higher perceived control would moderate the association between communicative participation and both vocal impairment and psychosocial distress. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted from June 2014 to May 2017 among a consecutive sample of adult patients with voice disorders at an academic voice clinic affiliated with the University of Minnesota. Of the 744 patients approached to participate in the survey study, 590 patients agreed. Data analysis was performed from January to June 2020. MAIN OUTCOMES AND MEASURES Communicative participation (measured by the 10-item general short form of the Communicative Participation Item Bank), vocal impairment (measured by the 10-item version of the Voice Handicap Index), psychosocial distress (measured by the 18-item version of the Brief Symptom Inventory), and voice-specific perceived control (measured by the 8-item present control subscale of the Perceived Control Over Stressful Events Scale). RESULTSThe sample comprised 590 patients (mean [SD] age, 51.9 [17.1] years; 390 women [66.1%]) with voice disorders. Communicative participation was associated with lower vocal impairment (r = −0.73; 95% CI, −0.77 to −0.69), lower overall psychosocial distress (r = −0.22; 95% CI, −0.30 to −0.14), and higher voice-specific perceived control (r = 0.30; 95% CI, 0.23-0.37). Moderation analyses indicated that communicative participation was negatively associated with distress at all levels of perceived control and, replicating previous findings, greater vocal impairment was associated with higher psychosocial distress only in patients with lower perceived control. CONCLUSIONS AND RELEVANCEIn this study, communicative participation was associated with, but distinct from, vocal impairment and was also associated with psychosocial distress and voice-specific perceived control. The study's results suggest that communicative participation is an important addition to voice research...

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confidence: 99%

Association Between Communicative Participation and Psychosocial Factors in Patients With Voice Disorders

Nguyen-Feng

Asplund

Frazier

et al. 2021

JAMA Otolaryngol Head Neck Surg

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“…Based on prior studies, we hypothesized a generally negative relation between perceived control and voice handicap, although we expected some heterogeneity. 21 We also expected significant cross-lagged correlations at both positive and negative lag times based on prior research 23 suggesting a feedback loop between perceived control and voice handicap.…”

Section: Introductionmentioning

confidence: 82%

“…This heterogeneity is consistent with results of a qualitative study of perceived control and psychosocial distress in voice disorder patients. 23 In addition, there were a large number of significant findings (all indicating negative relations between daily perceived control and voice handicap) at the contemporaneous lag 0, which may suggest that closer assessment timepoints (ie, >twice daily) would capture more nuanced findings. It is also possible that in future studies, higher baseline VHI-10 scores may present different patterns with respect to the relations between voice handicap and perceived control.…”

Section: Discussionmentioning

confidence: 99%

“…21,22 In a longitudinal study, 21 baseline perceived control predicted later voice handicap, suggesting that perceived control led to lower voice handicap rather than lower voice handicap leading to greater perceived control. Qualitative interviews 23 with voice disorder patients also suggested that more perceived control was associated with adaptive responses and lower voice-related handicap. Finally, a pilot study demonstrated that a web-based intervention targeting perceived control among voice disorder patients was effective in reducing voice handicap ( d = −0.86).…”

Section: Introductionmentioning

confidence: 97%

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Assessing Change Over Time in Voice Handicap and Voice-Related Perceived Control Using Ecological Momentary Assessment

Nguyen-Feng

Frazier

Stockness

et al. 2019

Ann Otol Rhinol Laryngol

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Objectives: Voice handicap has generally been measured at a single timepoint. Little is known about its variability from hour to hour or day to day. Voice handicap has been shown to be negatively related to voice-related perceived control in cross-sectional studies, but the within-person variability in voice-related perceived control is also unknown. We aimed to use ecological momentary assessment (EMA) to (1) assess the feasibility of EMA to examine daily voice handicap and voice-related perceived control in patients with voice disorders, (2) measure within-person variability in daily voice handicap and perceived control, and (3) characterize temporal associations (eg, correlations over time) between daily voice handicap and perceived control. Methods: Adults with voice problems were recruited from a large public university medical center in the Midwest. They completed baseline measures, followed by twice-daily assessments, including selected items measuring voice handicap and perceived control, and then repeated the baseline measures at the final timepoint. Feasibility was assessed via completion rates. Within-person variability was measured using standard deviations. Temporal associations were characterized using simulation modeling analysis. Results: EMA of voice handicap and perceived control was feasible in this patient population. Momentary voice handicap varied more than perceived control, though both were variable. Multiple patterns of temporal associations between daily voice handicap and perceived control were found. Conclusions: These findings identified important variability in (1) measures of voice handicap and perceived control and (2) their associations over time. Future EMA studies in patients with voice disorders are both feasible and warranted.

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“…Qualitative studies also indicate the importance of perceived control among individuals with voice disorders. In one qualitative study 11 examining patient perspectives on the relations between psychological factors and voice symptoms, more adaptive emotional and behavioral responses, and more improvement in voice, were reported by participants who perceived greater perceived present control. Another qualitative study 12 of patients with voice disorders (N = 15) found that all patients discussed the importance of "being in control."…”

Section: Introductionmentioning

confidence: 99%

Web-Based Perceived Present Control Intervention for Voice Disorders: A Pilot Study

et al. 2020

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Dysphonia, Perceived Control, and Psychosocial Distress: A Qualitative Study

Abstract: In this qualitative pilot study, participant narratives suggested that psychological factors and emotions influence voice symptoms, facilitating development of a preliminary conceptual model of how adaptive and maladaptive responses develop and how they influence vocal function.

Cited by 22 publications

References 34 publications

Association Between Communicative Participation and Psychosocial Factors in Patients With Voice Disorders

Association Between Communicative Participation and Psychosocial Factors in Patients With Voice Disorders

Assessing Change Over Time in Voice Handicap and Voice-Related Perceived Control Using Ecological Momentary Assessment

Web-Based Perceived Present Control Intervention for Voice Disorders: A Pilot Study

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