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言语病理学家嗓音评估实践与观点的定性分析

Qualitative Analysis of Speech-Language Pathologists' Voice Evaluation Practices and Perspectives.

作者信息

Madoule Michael D, Marks Katherine L, Nagle Kathleen F, Kirchgessner Eric, Gill Aideen, Kline Joshua C, Vojtech Jenny M, Stepp Cara E

机构信息

Department of Speech, Language & Hearing Sciences, Boston University, MA.

Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA.

出版信息

Am J Speech Lang Pathol. 2025 Jul 10;34(4):2244-2259. doi: 10.1044/2025_AJSLP-24-00417. Epub 2025 Jun 30.

Abstract

PURPOSE

The purpose of this qualitative study was to examine the structure of voice evaluations and gather clinicians' opinions on the barriers to and benefits of using acoustic measures in these evaluations. A secondary goal was to investigate how clinicians assess strain and vocal effort.

METHOD

Fifteen voice-specialized speech-language pathologists from voice centers around the United States were interviewed to query their current voice evaluation practice patterns and opinions on acoustic measures. They were also asked how they evaluate strain and vocal effort. Thematic analysis was performed by two researchers based on the recorded interviews.

RESULTS

Differences among practitioners were found in almost every component of the evaluation. Four themes related to barriers to and benefits of implementing acoustic measures in a voice evaluation were identified: Collecting and analyzing acoustic measures (a) take time, (b) do not inform therapy patterns, (c) allow for the most accurate comparison, and (d) supplement patient-centered care. Three themes emerged related to evaluating vocal effort and strain: Clinicians (a) lack consensus on objective measures of strain, (b) use more than just auditory perception to evaluate strain, and (c) assess vocal effort in different ways.

CONCLUSIONS

Although some speech-language pathologists view acoustic assessment as the gold standard for guiding therapeutic decisions, others believe it may not be strictly necessary for delivering effective voice therapy. Variations in the assessment of strain and vocal effort across voice clinics suggest a need for additional research in this area.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.29391725.

摘要

目的

本定性研究旨在审视嗓音评估的结构,并收集临床医生对于在这些评估中使用声学测量方法的障碍及益处的看法。第二个目标是调查临床医生如何评估嗓音紧张度和发声用力程度。

方法

对来自美国各地嗓音中心的15名嗓音专科言语语言病理学家进行了访谈,以询问他们当前的嗓音评估实践模式以及对声学测量方法的看法。还询问了他们如何评估嗓音紧张度和发声用力程度。两名研究人员基于录音访谈进行了主题分析。

结果

在评估的几乎每个组成部分中都发现了从业者之间的差异。确定了与在嗓音评估中实施声学测量方法的障碍及益处相关的四个主题:收集和分析声学测量数据(a)耗时,(b)无法指导治疗模式,(c)能进行最准确的比较,以及(d)补充以患者为中心的护理。出现了与评估发声用力程度和嗓音紧张度相关的三个主题:临床医生(a)在嗓音紧张度的客观测量上缺乏共识,(b)不仅仅使用听觉感知来评估嗓音紧张度,以及(c)以不同方式评估发声用力程度。

结论

尽管一些言语语言病理学家将声学评估视为指导治疗决策的金标准,但另一些人认为对于提供有效的嗓音治疗可能并非严格必要。各嗓音诊所对嗓音紧张度和发声用力程度评估的差异表明该领域需要更多研究。

补充材料

https://doi.org/10.23641/asha.29391725

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