Jaber Batoul, Remman Reina, Matar Nayla
Higher Institute of Speech-Language Pathology, Saint-Joseph University, Beirut, Lebanon.
Higher Institute of Speech-Language Pathology, Saint-Joseph University, Beirut, Lebanon.
J Voice. 2020 Sep;34(5):675-681. doi: 10.1016/j.jvoice.2019.01.012. Epub 2019 Feb 11.
A patient's voice can vary from one moment to another, and these variations cannot be captured by a one-time assessment. Multiple assessments may give a more holistic idea of the severity of the patient's dysphonia and by asking the patient to do the recordings he becomes involved in his therapeutic plan from the beginning.
This study aims to evaluate the added value of a repetitive assessment outside the speech therapist's (SLP) clinic, to have a broader vision of the voice disorder and identify parameters that change after working hours to be able to explain this disorder and find solutions for it.
Twelve dysphonic Lebanese teachers, aged between 20 and 60 years, recorded their voices once at the SLP's office, and five other times at home every day after working hours. The recordings included a standardized text and a sustained /ɑ/. For perceptive evaluation of voice quality, six SLPs (three experts and three naïve) analyzed the recordings using the GRBAS scale. For self-assessment, patients filled two self-assessment grids at the office: (SSVS: subjective assessment for vocal overwork) and the Lebanese Voice Handicap Index (VHI-10lb) questionnaire. They responded orally to a third scale ranging from 0 to 100 assessing the severity of dysphonia every day after completing the repetitive home recordings. For objective evaluation of the acoustic parameters, PRAAT software was used.
Results reveal significant difference between the scores of the voices recorded in the office compared to the home repetitive assessment for the G and R of the perceptual evaluation with P < 0.01, as well as for the Jitter, the fundamental frequency, and the harmonic-to-noise ratio with P < 0.05. The recordings made at home revealed a more severe dysphonia. The self-evaluation scales 1 and 2 (VHI-10Ib, SSVS) did not correlate with the results of the objective and perceptual analysis, whereas the results of the oral self-assessment 3 seem to be in agreement with the results of Jitter (P < 0.05), and Grade of dysphonia (P < 0.05).
In teachers, the severity of dysphonia is more pronounced when the voice is recorded after working hours. Daily self-evaluation allows the patient to be more aware of his vocal disorder and voice fluctuations and might improve participation and compliance with therapy. It may also be used to monitor the response to speech therapy.
患者的嗓音在不同时刻可能会有所变化，而一次性评估无法捕捉到这些变化。多次评估可能会更全面地了解患者发音障碍的严重程度，并且让患者参与录音能使其从一开始就融入治疗计划。
本研究旨在评估在言语治疗师（SLP）诊所之外进行重复性评估的附加价值，以便更全面地了解嗓音障碍情况，并确定工作时间后发生变化的参数，从而能够解释这种障碍并找到解决方案。
12名年龄在20至60岁之间的黎巴嫩发音障碍教师，在言语治疗师办公室录制一次声音，之后每天工作时间结束后在家中再录制五次。录音内容包括一篇标准化文本和一个持续的/ɑ/音。为了对嗓音质量进行感知评估，六名言语治疗师（三名专家和三名新手）使用GRBAS量表对录音进行分析。对于自我评估，患者在办公室填写两份自我评估表格：（SSVS：嗓音过度使用主观评估）和黎巴嫩嗓音障碍指数（VHI - 10lb）问卷。在完成重复性家庭录音后，他们每天口头回答一个从0到100的量表，以评估发音障碍的严重程度。对于声学参数的客观评估，使用了PRAAT软件。
结果显示，与家庭重复性评估相比，办公室录制声音的感知评估中G和R项得分存在显著差异（P < 0.01），以及抖动、基频和谐波噪声比也存在显著差异（P < 0.05）。在家中录制的声音显示出发音障碍更为严重。自我评估量表1和2（VHI - 10Ib，SSVS）与客观和感知分析结果不相关，而口头自我评估3的结果似乎与抖动结果（P < 0.05）和发音障碍等级（P < 0.05）一致。
对于教师而言，工作时间后录制声音时发音障碍的严重程度更为明显。每日自我评估能让患者更清楚地意识到自己的嗓音障碍和嗓音波动情况，可能会提高患者对治疗的参与度和依从性。它还可用于监测言语治疗的效果。
