Self-Ratings of Vocal Status in Daily Life: Reliability and Validity for Patients With Vocal Hyperfunction and a Normative Group Purpose The aim of this study was to establish reliability and validity for self-ratings of vocal status obtained during the daily activities of patients with vocal hyperfunction (VH) and matched controls. Method Eight-four patients with VH and 74 participants with normal voices answered 3 vocal status questions—difficulty producing ... Research Article
Research Article  |   November 08, 2017
Self-Ratings of Vocal Status in Daily Life: Reliability and Validity for Patients With Vocal Hyperfunction and a Normative Group
 
Author Affiliations & Notes
  • Jarrad H. Van Stan
    Massachusetts General Hospital, Boston
    MGH Institute of Health Professions, Boston, MA
    Harvard Medical School, Boston, MA
  • Marc Maffei
    Massachusetts General Hospital, Boston
    MGH Institute of Health Professions, Boston, MA
  • Maria Lúcia Vaz Masson
    Massachusetts General Hospital, Boston
    Harvard Medical School, Boston, MA
    Federal University of Bahia, Brazil
  • Daryush D. Mehta
    Massachusetts General Hospital, Boston
    MGH Institute of Health Professions, Boston, MA
    Harvard Medical School, Boston, MA
  • James A. Burns
    Massachusetts General Hospital, Boston
    Harvard Medical School, Boston, MA
  • Robert E. Hillman
    Massachusetts General Hospital, Boston
    MGH Institute of Health Professions, Boston, MA
    Harvard Medical School, Boston, MA
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Jarrad H. Van Stan: jvanstan@mgh.harvard.edu
  • Editor-in-Chief: Krista Wilkinson
    Editor-in-Chief: Krista Wilkinson×
  • Editor: Preeti Sivasankar
    Editor: Preeti Sivasankar×
Article Information
Research Issues, Methods & Evidence-Based Practice / Speech, Voice & Prosody / Research Articles
Research Article   |   November 08, 2017
Self-Ratings of Vocal Status in Daily Life: Reliability and Validity for Patients With Vocal Hyperfunction and a Normative Group
American Journal of Speech-Language Pathology, November 2017, Vol. 26, 1167-1177. doi:10.1044/2017_AJSLP-17-0031
History: Received March 9, 2017 , Revised June 3, 2017 , Accepted June 12, 2017
 
American Journal of Speech-Language Pathology, November 2017, Vol. 26, 1167-1177. doi:10.1044/2017_AJSLP-17-0031
History: Received March 9, 2017; Revised June 3, 2017; Accepted June 12, 2017

Purpose The aim of this study was to establish reliability and validity for self-ratings of vocal status obtained during the daily activities of patients with vocal hyperfunction (VH) and matched controls.

Method Eight-four patients with VH and 74 participants with normal voices answered 3 vocal status questions—difficulty producing soft, high-pitched phonation (D-SHP); discomfort; and fatigue—on an ambulatory voice monitor at the beginning, 5-hr intervals, and the end of each day (7 total days). Two subsets of the patient group answered the questions during a 2nd week after voice therapy (29 patients) or laryngeal surgery (16 patients).

Results High reliability resulted for patients (Cronbach's α = .88) and controls (α = .95). Patients reported higher D-SHP, discomfort, and fatigue (Cohen's d = 1.62–1.92) compared with controls. Patients posttherapy and postsurgery reported significantly improved self-ratings of vocal status relative to their pretreatment ratings (d = 0.70–1.13). Within-subject changes in self-ratings greater than 20 points were considered clinically meaningful.

Conclusions Ratings of D-SHP, discomfort, and fatigue have adequate reliability and validity for tracking vocal status throughout daily life in patients with VH and vocally healthy individuals. These questions could help investigate the relationship between vocal symptom variability and putative contributing factors (e.g., voice use/rest, emotions).

Acknowledgments
This work was supported by the Voice Health Institute (Boston, MA), the National Institutes of Health (NIH) National Institute on Deafness and Other Communication Disorders under Grant R33 DC011588 (awarded to Dr. Hillman), and the National Counsel of Technological and Scientific Development from Brazil (CNPq–Conselho Nacional de Desenvolvimento Científico e Tecnológico; scholarship awarded to Dr. Masson). The article's contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
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