Chan Athena K, McCabe Patricia, Madill Catherine J
The University of Sydney, Sydney, NSW, Australia.
Int J Speech Lang Pathol. 2013 Jun;15(3):334-44. doi: 10.3109/17549507.2013.783110.
This study examined Australian speech-language pathologists' (SLPs) use of evidence-based practice (E(3)BP) when treating adults with functional voice disorders (FVDs). It was hypothesized that SLPs would report using the available evidence to care for their clients but may be limited by time and skills. Fifty-eight SLPs completed a 26-item survey. A combination of indirect and direct voice therapy was most frequently reported, with hum and nasal consonants, pitch extension, elimination of glottal attack, and diaphragmatic breathing being the most frequently used techniques. In the absence of higher levels of evidence, 98% of respondents reported they relied on clinical experience to guide their clinical decision-making. Despite a lack of research evidence supporting this decision, SLPs also reported simultaneously using a combination of direct voice therapies to cater to the needs of their individual clients. Barriers to EBP were lack of time, specialty training and high quality evidence. To improve SLPs' management of adults with FVDs, it is suggested that SLPs need both greater access to voice training and to use practice-based evidence by actively collecting and reporting clinical data.
本研究调查了澳大利亚言语病理学家(SLP)在治疗成人功能性嗓音障碍(FVD)时基于证据的实践(E(3)BP)的应用情况。研究假设言语病理学家会报告利用现有证据来照顾他们的客户,但可能会受到时间和技能的限制。58名言语病理学家完成了一项包含26个条目的调查。最常报告的是间接和直接嗓音治疗相结合的方法,哼鸣和鼻辅音、音调扩展、消除声门冲击以及膈式呼吸是最常用的技术。在缺乏更高水平证据的情况下,98%的受访者报告他们依靠临床经验来指导临床决策。尽管缺乏支持这一决策的研究证据,但言语病理学家也报告同时使用多种直接嗓音治疗方法来满足个体客户的需求。循证实践的障碍包括时间不足、专业培训和高质量证据。为了改善言语病理学家对成人功能性嗓音障碍的管理,建议言语病理学家需要有更多机会接受嗓音训练,并通过积极收集和报告临床数据来使用基于实践的证据。