Adam M. B. Day

Voice‐related quality of life (V‐RQOL) outcomes in laryngectomees

Laryngeal cancer has a significant impact on patients. This study compared the Voice‐Related Quality of Life (V‐RQOL) outcomes specific to 3 different postlaryngectomy voice rehabilitation methods.

Auditory-Perceptual Speech Outcomes and Quality of Life after Total Laryngectomy

Objective (1) To determine potential relationships between speech intelligibility, acceptability, and self-reported quality of life (QOL) after total laryngectomy and (2) to determine whether relationships are stronger when QOL is measured by a head and neck cancer–specific or discipline-specific QOL scale. Study Design Cross-sectional. Setting University-based laboratory and speech clinic. Subjects and Methods Twenty-five laryngectomized individuals completed disease-specific (University of Washington Quality of Life; UW-QOL) and discipline-specific (Voice Handicap Index–10; VHI-10) QOL scales. They also provided audio recordings that included the Sentence Intelligibility Test (SIT) and a reading passage. Thirty-three listeners transcribed the SIT sentences to yield intelligibility scores. Fifteen additional listeners judged speech acceptability of the reading passage using rating scales. Results The QOL scores were moderate across the UW-QOL physical (mean = 77.63) and social-emotional (mean = 78.02) subscales and the VHI-10 (mean = 17.91). Speech acceptability and intelligibility varied across the samples, with acceptability only moderately related to intelligibility (r = 0.41, P < .05). Relationships were weak between ratings of intelligibility and self-reported QOL (range, r = 0.00-0.22) and weak to moderate between acceptability with QOL (range, r = 0.01-0.46). The only statistically significant, but moderate, relationship was found between speech acceptability with the UW-QOL speech subscore (r = 0.46, P < .05). Conclusion Listeners’ ratings of speech acceptability and intelligibility were not strongly predictive of disease-specific or voice-related QOL, suggesting that listener-rated and patient-reported outcomes are complementary.

Nature and the natural environment as health facilitators: the need to reconceptualize the ICF environmental factors

Purpose: This work examines the environmental factors component of the International Classification of Functioning, Disability, and Health (ICF) relative to current health-facilitating evidence about natural environmental factors. We argue that the environmental factors component warrants reconceptualization in order to offer an extended and more systematic framework for identifying and measuring health-facilitating natural environmental factors. Method: Current evidence highlighting the potential health-facilitating benefits of natural environmental factors is synthesized and considered in the context of the ICF framework and its coding system. Results: In its current form, the ICF’s conceptual framework and coding system are inadequate for identifying and measuring natural environmental factors in individuals and groups with and/or without health conditions. Conclusion: The ICF provides an advanced framework for health and disability that reflects contemporary conceptualizations about health. However, given the scope of emerging evidence highlighting positive health and well-being outcomes associated with natural environmental factors, we believe the environmental factors component requires further advancement to reflect this current knowledge. Reconceptualizing the environmental factors component supports a more holistic interpretation of the continuum of environmental factors as both facilitators and barriers. In doing so, it strengthens the ICF’s utility in identifying and measuring health-facilitating natural environmental factors. Implications for Rehabilitation Natural environmental factors constitute salient features of the environment with implications to health and disability, not simply aesthetic qualities. Fostering contact with nature and the natural environment may provide opportunities for respite and promote health benefits for individuals who experience a range of disability. Positive human-nature-health relationships may contribute to the maintenance and promotion of health at the population level.

Exploring use of the ICF in health education

Abstract Purpose: Currently, little is known regarding use of the International Classification of Functioning, Disability and Health (ICF) in health education applications. Therefore, this review sought to examine the scope of work that has been conducted regarding the application of the ICF in health education. Methods: A review of the current literature related to use of the ICF in health education programs was conducted. Twelve electronic databases were searched in accordance with a search protocol developed by a health sciences librarian. In total, 17 878 records were reviewed, and 18 articles met the criteria for inclusion in this review. Results: Current evidence regarding use of the ICF in healthcare education revealed that program and participant properties can be essential facilitators or barriers to successful education programs. In addition, gaps in comprehensive outcome measurement were revealed as areas for future attention. Educational applications of the ICF are very much a work in progress as might be expected given the ICF’s existence for only a little over a decade. Conclusions: To advance use of the ICF in education, it is important to incorporate the measurement of both knowledge acquisition and behavior change related to ICF-based programs. Ultimately, widespread implementation of the ICF represents not only a substantial opportunity but also poses a significant challenge. Implications for Rehabilitation ICF integration in health education is a relatively new, but growing phenomenon that is primarily limited to developed educational and healthcare systems. When incorporating the ICF into health education initiatives, special consideration should be paid to both the intended audience and the method of delivery.

Longitudinal variations of laryngeal overpressure and voice-related quality of life in spasmodic dysphonia

Adductor spasmodic dysphonia (AdSD) is a voice disorder characterized by variable symptom severity and voice disability. Those with the disorder experience a wide spectrum of symptom severity over time, resulting in varied degrees of perceived voice disability. This study investigated the longitudinal variability of AdSD, with a focus on auditory–perceptual judgments of a dimension termed laryngeal overpressure (LO) and patient self‐assessments of voice‐related quality of life (V‐RQOL).

Examining the Construct Validity of the V-RQOL in Speakers Who Use Alaryngeal Voice

PURPOSE The construct validity of the Voice-Related Quality of Life (V-RQOL; Hogikyan & Sethuraman, 1999) measure was evaluated in a sample of 109 individuals who have undergone total laryngectomy. METHOD A principal components factor analysis was performed on participant responses to the 10-question V-RQOL measure. RESULTS Factor analysis of the V-RQOL in our alaryngeal sample confirmed the presence of two factors (physical and social-emotional), which is consistent with the identified domains in the current V-RQOL. However, the current data indicate that some of the questions proposed by the original authors of the V-RQOL (Questions 7 and 9) do not align with their proposed domains in this postlaryngectomy sample. CONCLUSION The results indicate that some V-RQOL questions do not align with their proposed domains. Consequently, an alternative scoring algorithm may be warranted for alaryngeal populations, and the authors make suggestions for this change that are simple and efficient. Based on the findings of the present factor analysis, use of this modified scoring procedure may serve to increase the sensitivity of the V-RQOL for those who are laryngectomized and use alaryngeal methods of voice and speech. Consequently, the value and application of the V-RQOL may be expanded in the clinical setting.