Constantinescu Gabriela, Rieger Jana, Winget Marcy, Paulsen Catherine, Seikaly Hadi
Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, Alberta, CanadaDepartment of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada.
Stanford University School of Medicine, Stanford, California.
Am J Speech Lang Pathol. 2017 May 17;26(2):241-247. doi: 10.1044/2016_AJSLP-15-0170.
Treatment for oral cancer can result in speech impairments that can have varying impacts on patient quality of life. This study explored the relationship between clinical measures of speech impairment and the perception that patients had of this change in the early stage of recovery.
This was a quasi-experimental 1-group pre-post study design carried out on 10 patients with surgical intervention for oral cancer. Two clinical measures (word intelligibility and consonant phoneme error) and 2 patient-perception measures (Speech Handicap Index total score and Speech Handicap Index patient criteria score) were collected at preoperative and 1-month postoperative appointments.
Qualitative analysis revealed discordance between clinical and patient-perceived measures in 4 of 10 patients. Change in consonant phoneme error and change in word intelligibility were significantly correlated (r = .827). Furthermore, on average, statistically significant relationships were not found between clinical and patient-perceived measures or between the 2 patient-perception measures.
Discordance between clinical and patient-perceived measures was observed in almost half of the sample, indicating that clinical tests did not fully explain the extent of impairment perceived by patients. Speech outcomes should focus on both types of measures, and patient perception outcomes should be carefully considered when recommending speech therapy.
口腔癌治疗可能导致言语障碍，对患者生活质量产生不同影响。本研究探讨了言语障碍临床指标与患者在康复早期对这种变化的认知之间的关系。
这是一项对10例接受口腔癌手术干预患者进行的单组前后对照的准实验研究设计。在术前和术后1个月的预约就诊时收集两项临床指标（单词可懂度和辅音音素错误）和两项患者认知指标（言语障碍指数总分和言语障碍指数患者标准评分）。
定性分析显示，10例患者中有4例临床指标与患者认知指标不一致。辅音音素错误变化与单词可懂度变化显著相关（r = 0.827）。此外，临床指标与患者认知指标之间或两项患者认知指标之间平均未发现统计学上的显著关系。
近一半样本中观察到临床指标与患者认知指标不一致，表明临床测试不能完全解释患者感知到的损伤程度。言语结果应同时关注这两种指标类型，在推荐言语治疗时应仔细考虑患者认知结果。
