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Kelly R, Gordon P, Thompson R, Semple C. Availability and use of web-based interventions for patients with head and neck cancer: a scoping review. J Cancer Surviv 2023; 17:1309-1326. [PMID: 35088247 PMCID: PMC8794623 DOI: 10.1007/s11764-022-01168-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/10/2022] [Indexed: 01/28/2023]
Abstract
PURPOSE To identify and review the nature, scope and use of web-based interventions for patients with head and neck cancer (HNC). METHOD A scoping review guided by the methodological framework described by the Joanna Briggs Institute was performed to review empirical studies and websites. Seven electronic databases (CINAHL, Medline, Scopus, Embase, Cochrane, PubMed and PsycInfo) were searched from 2010 to 2020, data extracted and synthesised using thematic analysis. The Google search engine was employed, identifying the first 100 websites, using the search term head and neck cancer. Websites meeting eligibility criteria were assessed using the QUEST analysis tool, and descriptively summarised. RESULTS Thirteen empirical studies and 32 websites were included. As identified by empirical studies, web-based interventions were developed to provide (1) patient information on HNC and related treatments, (2) advice and support during treatment and (3) management strategies promoting adjustment to life with and beyond HNC. The reviewed websites provided minimal information to aid shared decision-making and facilitate preparedness for treatment, with few utilising patient narratives. Web-based interventions for HNC patients were mainly text based and focused on survivorship. CONCLUSIONS There is a paucity of theory-based, co-designed web-based interventions using patient narratives. IMPLICATIONS FOR CANCER SURVIVORS As patients increasingly look to the internet for advice and support, healthcare professionals are in a position to provide high-quality web-based interventions. There is an opportunity to rigorously develop a web-based intervention, containing narratives of peoples' lives before and after HNC treatment, aiding decision-making, preparedness for treatment and self-management.
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Affiliation(s)
- Rosemary Kelly
- School of Nursing, Ulster University, Shore Road, Newtownabbey, Co Antrim BT37 0QB Ireland
| | - Peter Gordon
- South Eastern Health and Social Care Trust, Cancer Services, Ulster Hospital, Upper Newtownards Road, Belfast, BT16 1RH Ireland
| | - Ruth Thompson
- South Eastern Health and Social Care Trust, Cancer Services, Ulster Hospital, Upper Newtownards Road, Belfast, BT16 1RH Ireland
| | - Cherith Semple
- School of Nursing, Ulster University, Shore Road, Newtownabbey, Co Antrim BT37 0QB Ireland
- South Eastern Health and Social Care Trust, Cancer Services, Ulster Hospital, Upper Newtownards Road, Belfast, BT16 1RH Ireland
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Gherson S, Tripp R, Goudelias D, Johnson AM. Rapid Implementation of Teletherapy for Voice Disorders: Challenges and Opportunities for Speech-Language Pathologists. J Voice 2023:S0892-1997(23)00206-0. [PMID: 37537109 DOI: 10.1016/j.jvoice.2023.06.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 08/05/2023]
Abstract
INTRODUCTION The COVID-19 pandemic necessitated a rapid restructuring of the clinical management of voice and upper airway disorders by speech-language pathologists (SLPs). As in-person therapy sessions were suspended, voice-specialized SLPs across healthcare settings shifted to online teletherapy. In this survey study, we queried voice therapists on their experiences with and opinions regarding the adoption of teletherapy into routine clinical practice. METHODS Voice-specialized SLPs were recruited nationwide to complete an online survey which included questions about the usability of software and hardware, patient management, the effectiveness of therapy, overall satisfaction, and suggestions for improvement. RESULTS 48 participants completed the survey. The majority of respondents reported frequent technical difficulties and poor access to or understanding of appropriate equipment. Overall, participants endorsed better patient access, attendance, and compliance, as well as increased scheduling flexibility. While 95% of the respondents stated they would recommend teletherapy to another SLP, only 20% supported a shift to exclusively virtual sessions. Forty percent of respondents endorsed a hybrid model consisting of initial in-person sessions followed by virtual ones. DISCUSSION Incorporating teletherapy into clinical voice practice has, for the most part, followed Carl May's normalization process theory framework, in that clinicians have invested understanding, training, time and effort, and appraisal into its implementation. However, the unusually rapid pace of change necessitated by the pandemic has presented its own set of challenges. Given the inherent conveniences of virtual therapy, the online modality is likely here to stay. It is critical that we understand the facilitators and barriers to its successful adoption.
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Affiliation(s)
- Shirley Gherson
- Department of Otolaryngology, New York University Grossman School of Medicine, New York, NY
| | - Raquel Tripp
- Department of Communicative Sciences and Disorders, New York University, New York, NY
| | - Deanna Goudelias
- Department of Communicative Sciences and Disorders, New York University, New York, NY
| | - Aaron M Johnson
- Department of Otolaryngology, New York University Grossman School of Medicine, New York, NY.
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Barbosa I, Behlau M, Almeida LN, Ramos N, Lopes L, Almeida AA. Validation of the Brazilian Scale of Perceived Control Over Voice in the Present using Item Response Theory. J Voice 2023:S0892-1997(23)00028-0. [PMID: 36868955 DOI: 10.1016/j.jvoice.2023.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 03/05/2023]
Abstract
OBJECTIVE this study aims to verify the stages of evidence of validity of the voice-adapted present perceived control scale (V-APPCS) in its translated and cross-culturally adapted version for the Brazilian Portuguese "Voice-Adapted Present Perceived Control Scale" and to estimate the psychometric measurements of the properties of its items based on the item response theory (IRT). METHODS the instrument underwent a process of translation and cross-cultural adaptation for the Brazilian Portuguese, the process was carried out by two qualified translators, native in the destination language, and fluent in the language and culture of origin. The first translated version of the protocol was forwarded to a back-translation, performed by a third bilingual Brazilian translator. The translations were analyzed and compared by a committee composed of five speech therapists who are specialists in voice and with proficiency in the English language. The empirical study used data from 168 individuals, 127 had voice problems and 41 vocally healthy ones. For the stages of validity evidence, the following analyses were performed: Cronbach's alpha, exploratory factor analysis, confirmatory factor analysis and IRT. RESULTS The stages of translation and cross-cultural adaptation allowed linguistic adjustments to be made so that the items were understandable and suitable for use in Brazil. The adequacy, structure, and application of the items were confirmed through the application of the final version of the scale in twenty individuals in a real context. The instrument in its Brazilian version presented good internal consistency, with bifactorial structure the exploratory factor analysis, besides presenting satisfactory values in the adjustment indexes of the model, confirming the structure of the confirmatory factor Analysis. The IT was applied to evaluate the parameters discrimination (a) and difficulty (b) of the items of the instrument; item 5 "I have control over my day-to-day reactions to the voice problem." Presented itself as a more discriminative item and item 8 "My reaction to the voice problem is not under my control." As an item of greater difficulty. CONCLUSION The V-APPCS, translated, cross-culturally adapted, and validated, is robust and adequate to represent the construct in the Brazilian versions.
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Affiliation(s)
- Iandra Barbosa
- Universidade Federal da Paraíba, UFPB and Universidade Federal do Rio Grande do Norte, UFRN, Brazil; Centro de Estudos da Voz- CEV, São Paulo, Brazil
| | - Mara Behlau
- Centro de Estudos da Voz- CEV, São Paulo, Brazil
| | | | - Noemi Ramos
- Universidade Federal da Paraíba, UFPB, João Pessoa, Paraíba
| | - Leonardo Lopes
- Centro de Estudos da Voz- CEV, São Paulo, Brazil; Universidade Federal da Paraíba, UFPB, João Pessoa, Paraíba
| | - Anna Alice Almeida
- Centro de Estudos da Voz- CEV, São Paulo, Brazil; Universidade Federal da Paraíba, UFPB, João Pessoa, Paraíba.
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Dueppen A, Joshi A, Roy N, Yiu Y, Procter T, Goodwin M, Thekdi A. Exploring Personality and Perceived Present Control as Factors in Postsurgical Voice Rest: A Case Comparison. J Voice 2023:S0892-1997(22)00415-5. [PMID: 36639311 PMCID: PMC10333449 DOI: 10.1016/j.jvoice.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE This case comparison explored the relation between personality, perceived present control, and postoperative voice rest (as estimated by self-report and objective voice use) following surgery for benign vocal fold lesions. METHOD Two participants were included. Both participants were diagnosed with benign vocal fold pathology, underwent phonosurgery, and were assigned to either complete voice rest (CVR) or relative voice rest (RVR) postoperatively. During voice rest (VR), a visual analog scale (VAS) and a dosimeter (the Vocalog2) were used daily to estimate self-perceived and objective voice use, respectively. The participants also completed questionnaires on voice-related demographics, the Voice Handicap Index (VHI), Ten-Item Personality Inventory (TIPI), and Perceived Present Control (PPC). After 7 days of CVR or RVR, participants completed a postoperative questionnaire and a final VAS for overall voice use. RESULTS A wide discrepancy was observed in one of two participant's subjective perception of voice use (using the VAS) versus objective dosimetry data wherein she reported significantly more voice use than was observed objectively. Differences in personality and PPC between the participants did not appear to affect their voice use following the VR protocols. CONCLUSION The amount of voice use in both VR protocols for these two participants suggests that personality and PPC did not affect their adherence to recommendations of VR. Patients may perceive their voice use differently across time, which might play a role in their adherence to voice rest recommendations: voice use measured as instances versus a unit of time (seconds).
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Affiliation(s)
- Abigail Dueppen
- Department of Communication Sciences and Disorders, University of Houston, Houston, Texas; Department of Otolaryngology - Head & Neck Surgery, Houston Methodist Hospital, Houston, Texas
| | - Ashwini Joshi
- Department of Communication Sciences and Disorders, University of Houston, Houston, Texas; Department of Otolaryngology - Head & Neck Surgery, Houston Methodist Hospital, Houston, Texas.
| | - Nelson Roy
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah
| | - Yin Yiu
- Department of Otolaryngology - Head & Neck Surgery, Houston Methodist Hospital, Houston, Texas
| | - Teresa Procter
- Department of Otolaryngology - Head & Neck Surgery, Houston Methodist Hospital, Houston, Texas
| | - Maurice Goodwin
- Department of Otolaryngology - Head & Neck Surgery, Houston Methodist Hospital, Houston, Texas
| | - Apurva Thekdi
- Department of Otolaryngology - Head & Neck Surgery, Houston Methodist Hospital, Houston, Texas
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Stambler DM, Feddema E, Riggins O, Campeau K, Breuch LAK, Kessler MM, Misono S. REDCap Delivery of a Web-Based Intervention for Patients With Voice Disorders: Usability Study. JMIR Hum Factors 2022; 9:e26461. [PMID: 35333191 PMCID: PMC8994149 DOI: 10.2196/26461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 05/10/2021] [Accepted: 12/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background Web-based health interventions are increasingly common and are promising for patients with voice disorders because web-based participation does not require voice use. To address needs such as Health Insurance Portability and Accountability Act compliance, unique user access, the ability to send automated reminders, and a limited development budget, we used the Research Electronic Data Capture (REDCap) data management platform to deliver a patient-facing psychological intervention designed for patients with voice disorders. This was a novel use of REDCap. Objective We aimed to evaluate the usability of the intervention, with this intervention serving as a use case for REDCap-based patient-facing interventions. Methods We used REDCap survey instruments to develop the web-based voice intervention modules, then conducted usability evaluations using (1) heuristic evaluations by 2 evaluators, and (2) formal usability testing with 7 participants, consisting of predetermined tasks, a think-aloud protocol, ease-of-use measurements, a product reaction card, and a debriefing interview. Results Heuristic evaluations found strengths in visibility of system status and real-world match, and weaknesses in user control and help documentation. Based on this feedback, changes to the intervention were made before usability testing. Overall, usability testing participants found the intervention useful and easy to use, although testing revealed some concerns with design, content, and terminology. Some concerns were readily addressed, and others required adaptations within REDCap. Conclusions The REDCap version of a complex web-based patient-facing intervention performed well in heuristic evaluation and formal usability testing. REDCap can effectively be used for patient-facing intervention delivery, particularly if the limitations of the platform are anticipated and mitigated.
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Affiliation(s)
| | - Erin Feddema
- Department of Otolaryngology, University of Minnesota, Minneapolis, MN, United States
| | - Olivia Riggins
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, United States
| | - Kari Campeau
- Department of English, University of Colorado-Denver, Denver, CO, United States
| | | | - Molly M Kessler
- Department of Writing Studies, University of Minnesota, Minneapolis, MN, United States
| | - Stephanie Misono
- Department of Otolaryngology, University of Minnesota, Minneapolis, MN, United States
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Sharp E, Cook R. Voice Symptoms and Wellbeing in School Teachers in England. J Voice 2022:S0892-1997(22)00034-0. [PMID: 35307220 DOI: 10.1016/j.jvoice.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/28/2022] [Accepted: 02/04/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Negative psychological factors such as depression and other common mental disorders have been found to be associated with voice problems in teachers. However, there is little research with teachers that investigates the relationship between positive psychological factors such as wellbeing and voice problems. Although negative and positive mental states are on a continuum of psychological health, research suggests negative and positive effects are not necessarily inversely correlated and therefore need to be investigated separately. OBJECTIVE/HYPOTHESIS To explore the relationship between voice symptoms and wellbeing in teachers working in primary and secondary schools in England. We hypothesise that as wellbeing increases voice symptoms will decrease. DESIGN Cross sectional study using a self-administered web-based questionnaire conducted with primary and secondary school teachers in England. METHODS The study included 1205 teachers from 608 primary and secondary schools, including state and fee paying, and mainstream and special schools. Voice symptoms were measured using The Voice Symptom Scale and wellbeing was measured using the Warwick Edinburgh Mental Wellbeing Scale. Information was also obtained on health, lifestyle, sociodemographic and environmental factors. Analysis was conducted using a linear multi-level regression model. RESULTS A statistically significant relationship between voice symptoms and wellbeing was identified (-0.31 95% CI -0.41, -0.20 P =< 0.001). Other factors found to be statistically significantly associated with voice symptoms were age, sex, gastroesophageal reflux, class size, background noise, speaking louder than normal and respiratory infection. Hours teaching per week, deprivation of school, voice training, teaching subject, smoking status and asthma were not associated with voice symptoms. CONCLUSIONS This study suggests that there is an association between vocal symptoms and wellbeing. Teachers with higher wellbeing had fewer voice symptoms.
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Affiliation(s)
- Emily Sharp
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK.
| | - Robert Cook
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
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Kessler MM, Breuch LAK, Stambler DM, Campeau KL, Riggins OJ, Feddema E, Doornink SI, Misono S. User Experience in Health & Medicine: Building Methods for Patient Experience Design in Multidisciplinary Collaborations. JOURNAL OF TECHNICAL WRITING AND COMMUNICATION 2021; 51:380-406. [PMID: 35873946 PMCID: PMC9307135 DOI: 10.1177/00472816211044498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Health and medical contexts have emerged as an important area of inquiry for researchers at the intersection of user experience and technical communication. In addressing this intersection, this article advocates and extends patient experience design or PXD (Melonçon, 2017) as an important framework for user experience research within health and medicine. Specifically, this article presents several PXD insights from a task-based usability study that examined an online intervention program for people with voice problems. We respond to Melonçon's call (2017) to build PXD as a framework for user experience and technical communication research by describing ways traditional usability methods can provide PXD insights and asking the following question: What insights can emerge from combining traditional usability methods and PXD research? In addressing this question, we outline two primary methodological and practical considerations we found central to conducting PXD research: 1) engaging patients as participants, and 2) leveraging multidisciplinary collaboration.
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Affiliation(s)
- Molly M Kessler
- Department of Writing Studies, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Lee-Ann K Breuch
- Department of Writing Studies, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Danielle M Stambler
- Department of Writing Studies, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Kari L Campeau
- Department of English, University of Colorado Denver, Denver, CO, USA
| | - Olivia J Riggins
- Department of Writing Studies, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Erin Feddema
- Department of Otolaryngology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Sarah I Doornink
- Department of Otolaryngology, University of Minnesota Twin Cities, Minneapolis, MN, USA
| | - Stephanie Misono
- Department of Otolaryngology, University of Minnesota Twin Cities, Minneapolis, MN, USA
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Nguyen-Feng VN, Asplund A, Frazier PA, Misono S. Association Between Communicative Participation and Psychosocial Factors in Patients With Voice Disorders. JAMA Otolaryngol Head Neck Surg 2020; 147:2774498. [PMID: 33355630 PMCID: PMC7758827 DOI: 10.1001/jamaoto.2020.4956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/02/2020] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Communicative participation can be conceptualized as taking part in life situations in which people are socially engaged. Communicative participation is an important aspect in the lives of patients with voice disorders, although it has not been formally assessed among a broad sample of patients with voice disorders. The associations between communicative participation and associated concepts (vocal impairment, psychosocial distress, and voice-specific perceived control) are unknown yet important for integrated treatment approaches. OBJECTIVE The primary objective was to examine the associations between communicative participation and vocal impairment, psychosocial distress, and voice-specific perceived control. The secondary objective was to examine whether perceived control moderates the association of distress with communicative participation and vocal impairment, the latter of which would replicate previous research. The hypotheses were that communicative participation would be associated with lower vocal impairment, lower distress, and higher perceived control and that higher perceived control would moderate the association between communicative participation and both vocal impairment and psychosocial distress. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was conducted from June 2014 to May 2017 among a consecutive sample of adult patients with voice disorders at an academic voice clinic affiliated with the University of Minnesota. Of the 744 patients approached to participate in the survey study, 590 patients agreed. Data analysis was performed from January to June 2020. MAIN OUTCOMES AND MEASURES Communicative participation (measured by the 10-item general short form of the Communicative Participation Item Bank), vocal impairment (measured by the 10-item version of the Voice Handicap Index), psychosocial distress (measured by the 18-item version of the Brief Symptom Inventory), and voice-specific perceived control (measured by the 8-item present control subscale of the Perceived Control Over Stressful Events Scale). RESULTS The sample comprised 590 patients (mean [SD] age, 51.9 [17.1] years; 390 women [66.1%]) with voice disorders. Communicative participation was associated with lower vocal impairment (r = -0.73; 95% CI, -0.77 to -0.69), lower overall psychosocial distress (r = -0.22; 95% CI, -0.30 to -0.14), and higher voice-specific perceived control (r = 0.30; 95% CI, 0.23-0.37). Moderation analyses indicated that communicative participation was negatively associated with distress at all levels of perceived control and, replicating previous findings, greater vocal impairment was associated with higher psychosocial distress only in patients with lower perceived control. CONCLUSIONS AND RELEVANCE In this study, communicative participation was associated with, but distinct from, vocal impairment and was also associated with psychosocial distress and voice-specific perceived control. The study's results suggest that communicative participation is an important addition to voice research and clinical care.
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Affiliation(s)
| | - Alexa Asplund
- Department of Psychology, University of Minnesota Duluth, Duluth
| | | | - Stephanie Misono
- Department of Otolaryngology–Head and Neck Surgery, University of Minnesota, Twin Cities, Minneapolis
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Nguyen-Feng VN, Frazier PA, Stockness A, Lunos S, Hoedeman AN, Misono S. Assessing Change Over Time in Voice Handicap and Voice-Related Perceived Control Using Ecological Momentary Assessment. Ann Otol Rhinol Laryngol 2019; 128:829-837. [PMID: 31027429 DOI: 10.1177/0003489419842267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Voice handicap has generally been measured at a single timepoint. Little is known about its variability from hour to hour or day to day. Voice handicap has been shown to be negatively related to voice-related perceived control in cross-sectional studies, but the within-person variability in voice-related perceived control is also unknown. We aimed to use ecological momentary assessment (EMA) to (1) assess the feasibility of EMA to examine daily voice handicap and voice-related perceived control in patients with voice disorders, (2) measure within-person variability in daily voice handicap and perceived control, and (3) characterize temporal associations (eg, correlations over time) between daily voice handicap and perceived control. METHODS Adults with voice problems were recruited from a large public university medical center in the Midwest. They completed baseline measures, followed by twice-daily assessments, including selected items measuring voice handicap and perceived control, and then repeated the baseline measures at the final timepoint. Feasibility was assessed via completion rates. Within-person variability was measured using standard deviations. Temporal associations were characterized using simulation modeling analysis. RESULTS EMA of voice handicap and perceived control was feasible in this patient population. Momentary voice handicap varied more than perceived control, though both were variable. Multiple patterns of temporal associations between daily voice handicap and perceived control were found. CONCLUSIONS These findings identified important variability in (1) measures of voice handicap and perceived control and (2) their associations over time. Future EMA studies in patients with voice disorders are both feasible and warranted.
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Affiliation(s)
| | - Patricia A Frazier
- 1 University of Minnesota, Department of Psychology, Minneapolis, MN, USA
| | - Ali Stockness
- 2 University of Minnesota, Department of Otolaryngology, School of Medicine, Minneapolis, MN, USA
| | - Scott Lunos
- 3 University of Minnesota, Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, Minneapolis, MN, USA
| | - Alexis N Hoedeman
- 4 University of Wisconsin-Madison, Department of Communication Sciences and Disorders, Madison, WI, USA
| | - Stephanie Misono
- 2 University of Minnesota, Department of Otolaryngology, School of Medicine, Minneapolis, MN, USA
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