Creating a mastery experience during the voice evaluation

Abstract

Objectives: Adherence to treatment is a common challenge when working with patients with voice disorders. Improving their self-efficacy through a mastery experience has the potential to improve treatment adherence. An ideal mastery experience gives early and quick evidence that the patient will be successful with the treatment and works for a broad range of patients. This study sought to test whether a brief stimulability trial of forward focused voice could produce sufficient change in acoustic analysis measures to provide visibly improved objective results and, thus, be a potentially useful mastery experience.

Study design: Prospective, repeated measures, pre- and posttreatment.

Methods: Twenty-four consecutive patients with varying diagnoses referred for a voice evaluation participated in this study. Acoustic analysis was completed before and after a short stimulability trial of forward focused voice. Acoustic analysis parameters evaluated include fundamental frequency, jitter, shimmer, noise-to-harmonic ratio, and voice turbulence index. Data pre- and posttreatment were analyzed for change and compared with normative values.

Results: Results demonstrated a significant change from pre- to posttrial, as indicated by the objective measure transitioning from being outside to within normal limits, in 75% of patients (P=0.000). When less rigid criterion of a positive change in one or more of the three acoustic measures of interest is used, improvement was noted in 96% of patients.

Conclusion: Pairing a trial therapy with acoustic analysis during a voice evaluation is a possible mastery experience. Future research is needed to determine if this mastery experience improves self-efficacy, treatment adherence, and treatment outcomes.