Kim Mary E, Sund Lauren Timmons, Morton Mariah, Kim James, Choi Janet S, Castro M Eugenia
Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of USC, University of Southern California Caruso, Los Angeles, California.
Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of USC, University of Southern California Caruso, Los Angeles, California.
J Voice. 2025 Jan;39(1):282.e19-282.e27. doi: 10.1016/j.jvoice.2022.07.009. Epub 2022 Jul 18.
The COVID-19 pandemic expanded the use of telemedicine, but there is no literature exploring both patient and provider satisfaction specifically in the provision of voice therapy. This study aims to investigate patient and provider satisfaction with virtual voice therapy, its associated factors, and any correlation between the two.
Cross-sectional study. Participants included 226 adults who underwent voice therapy delivered via telepractice at the USC Voice Center between April and October 2020. Patients and providers self-reported their level of satisfaction on a visual analog scale (VAS; range 0-100). Patient satisfaction was additionally measured using a previously validated Telemedicine Satisfaction Questionnaire (TSQ; range 1-5), and a binary question about their desire to choose telemedicine over in-person therapy in the future. Three speech-language pathologists rated provider satisfaction for all 226 patients. Patient satisfaction survey was completed by 55 patients. Multivariable linear regression analyses and linear mixed-effects models were used to assess the results.
Patient and provider mean (SD) VAS satisfaction scores were 86.8 (18.6) and 80.6 (19.7), respectively. The mean (SD) TSQ score was 4.4 (0.6). In a multivariable model, patient satisfaction levels were significantly higher for hypofunctional than for hyperfunctional dysphonia diagnoses. Forty-four (73%) patients reported they would prefer telemedicine voice therapy over in-person appointments, which was significantly correlated with internet reliability (P = 0.04). For providers, satisfaction was significantly lower for patients whose diagnosis had changed after initiation of voice therapy (Δ = -16.0 [95% CI: -28.7 to -3.2]) and for encounters with Asian patients compared to White patients (Δ = -11.6 [95% CI: -18.9 to -4.2]). Patient and provider satisfaction scores were weakly correlated (r = 0.19).
Our findings suggest that virtual voice therapy is not simply an alternative to in-person service, but rather an effective method useful beyond the current pandemic with proper diagnosis and technical support.
新冠疫情扩大了远程医疗的使用，但尚无文献专门探讨患者和提供者在提供嗓音治疗方面的满意度。本研究旨在调查患者和提供者对虚拟嗓音治疗的满意度、其相关因素以及两者之间的任何相关性。
横断面研究。参与者包括2020年4月至10月间在南加州大学嗓音中心通过远程医疗接受嗓音治疗的226名成年人。患者和提供者通过视觉模拟量表（VAS；范围0 - 100）自我报告他们的满意度水平。此外，使用先前验证的远程医疗满意度问卷（TSQ；范围1 - 5）以及一个关于他们未来是否希望选择远程医疗而非面对面治疗的二元问题来衡量患者满意度。三名言语语言病理学家对所有226名患者的提供者满意度进行评分。55名患者完成了患者满意度调查。使用多变量线性回归分析和线性混合效应模型来评估结果。
患者和提供者的平均（标准差）VAS满意度得分分别为86.8（18.6）和80.6（19.7）。平均（标准差）TSQ得分为4.4（0.6）。在多变量模型中，功能减退性发声障碍诊断的患者满意度水平显著高于功能亢进性发声障碍诊断的患者。44名（73%）患者报告他们更喜欢远程医疗嗓音治疗而非面对面预约，这与网络可靠性显著相关（P = 0.04）。对于提供者而言，与白人患者相比，嗓音治疗开始后诊断发生变化的患者（差值 = -16.0 [95%置信区间：-28.7至-3.2]）以及与亚洲患者的会诊的满意度显著较低（差值 = -11.6 [95%置信区间：-18.9至-4.2]）。患者和提供者的满意度得分呈弱相关（r = 0.19）。
我们的研究结果表明，虚拟嗓音治疗不仅仅是面对面服务的替代方案，而是在进行适当诊断和技术支持的情况下，在当前疫情之外也是一种有效的方法。
