| 21. |
- Bergström, Liza, 1974, et al.
(författare)
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Voice rehabilitation after laryngeal cancer: Associated effects on psychological well-being
- 2017
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 25:9, s. 2683-2690
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Psychological distress after laryngeal cancer treatment is prevalent. Although voice rehabilitation has shown to improve functional outcomes and positively affect health-related quality of life, to date, there has been limited study of the associated effect of behavioural voice intervention on psychological well-being/distress post laryngeal cancer. Method Sixty-three patients with Tis-T4 laryngeal cancer treated with (chemo)radiotherapy were prospectively recruited and randomised to either a voice rehabilitation (VR, n = 31) or control group (n = 32). The VR group received 10 speech pathology sessions consisting of both direct and indirect voice intervention post (chemo)radiotherapy. The control group received general voice education but not specific intervention. As part of a multidisciplinary assessment battery, psychological well-being/distress was measured using the Hospital Anxiety and Depression Scale (HADS) pre, six and 12 months post VR. Results Within-group analysis revealed a significant (p = 0.03) reduction in the proportion of patients with anxiety in the VR group between baseline and 12 months. No change over time was observed in controls. Between-group analysis revealed a trend for fewer VR cases demonstrating anxiety (p = 0.06) or depression (p = 0.08) at 6 months and significantly fewer demonstrating anxiety (p = 0.04) and depression (p = 0.04) at 12 months, compared to controls. Significant correlations were observed between patients' voice perceptions and reduced anxiety (r(pb) = -0.38) and depression (r(pb) = -0.66) within the VR group at 12 months. Conclusions The positive correlations and between-group analyses indicate a positive effect on psychological well-being associated with completing voice rehabilitation. Results highlight potential additional benefits of behavioural voice intervention beyond achieving direct change to voice function.
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| 22. |
- Bergström, Liza, 1974, et al.
(författare)
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Voice rehabilitation for laryngeal cancer patients: Functional outcomes and patient perceptions
- 2016
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Ingår i: The Laryngoscope. - : Wiley. - 0023-852X. ; 126:9, s. 2029-2035
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Tidskriftsartikel (refereegranskat)abstract
- Objectives/Hypothesis: Laryngeal cancer and its treatment, despite management with organ-preservation treatments, is known to negatively affect voice and functional outcomes. The aim of this study was to determine whether functional outcomes and patient perceptions were improved by combining organ preservation with post treatment function rehabilitation. Study Design: Randomized controlled trial. Method: Sixty-one patients with carcinoma in situ (Tis) to T4 size laryngeal cancers treated with radiotherapy were prospectively recruited. Thirty patients were randomized into the voice rehabilitation (VR) group and 31 received no VR (control group). The VR group underwent 10 speech pathology sessions postradiotherapy. Voice function was evaluated pre-VR and at 6 and 12 months follow-up using the auditory-perceptual Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale and patient perception measures. Results: The control group demonstrated significant deterioration in vocal roughness (P = 0.02) between 6 to 12 months, whilst the VR group did not, resulting in a significant difference (P < 0.01) between the two groups at 12 months. A between-group significant difference (P = 0.02) was also observed for breathiness at 12 months. Patient perceptions of improved vocal quality, acceptability, hoarseness, vocal fatigue, and ashamed (of voice) pre- to post-VR improved significantly (P < 0.02) in the VR group, although significant difference (P = 0.03) between groups was observed post-VR for hoarseness only. Conclusion: For this study group representing Tis to T4-size laryngeal cancers, patients receiving voice rehabilitation post radiotherapy demonstrated no functional decline in vocal roughness and perceived their voice to improve to a greater extent post-VR than the control group. Level of Evidence: 1b. Laryngoscope, 126:2029–2035, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.
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| 23. |
- Bhanu Prakash, B., et al.
(författare)
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Translation of the Gothenburg Trismus Questionnaire-2 into Telugu and its Validation for use in Indian Patients
- 2021
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Ingår i: Indian Journal of Surgical Oncology. - : Springer Science and Business Media LLC. - 0975-7651 .- 0976-6952. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- Trismus refers to restriction in the ability to open the mouth. Comprehensive evaluation of trismus and its treatment outcomes needs a multidimensional, self-administered, trismus specific tool. In the present scenario, Gothenburg trismus questionnaire is the only reliable instrument to quantify trismus. Translation of this questionnaire helps in providing standardized documentation of trismus related problems and to obtain a patient's perspective on treatment outcomes within various populations. The aim of this study was to translate the Gothenburg trismus questionnaire-2 (GTQ 2) into Telugu (one of the Indian Languages) and validation of the translation for its effective use in regional Telugu speaking patients. The GTQ 2 was translated according to the guidelines framed by the International Society for Pharmacoeconomics and Outcomes Research: (1) forward translation, (2) reconciliation and back translation, (3) cognitive debriefing, and (4) pilot testing. The psychometric properties of the translated version were evaluated by testing its internal consistency, construct validity, known-group validity and floor and ceiling effects. Patients who reported with or without trismus to the Head and Neck Oncology outpatient clinic were enrolled for the study. Comparison of the GTQ scores was done using Mann–Whitney U-test. The Pearson correlation coefficient was used for assessing convergent and divergent validity. Internal Consistency was calculated using Cronbach’s alpha coefficient. The translated version of the GTQ 2 was administered to 60 patients (30 trismus patients and 30 non-trismus patients). GTQ 2 was successfully translated without any significant issues. Construct validity of the translated version was confirmed and it has a good internal consistency (α > 0.7). The translated instrument can differentiate between those with and without trismus (p < 0.0005). A valid and reliable Telugu version of the Gothenburg Trismus Questionnaire-2 is now available for the benefit of Indian patients. © 2021, Indian Association of Surgical Oncology.
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| 27. |
- Carlsson, Sigrid, 1982, et al.
(författare)
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Validation of the Swedish M. D. Anderson Dysphagia Inventory (MDADI) in Patients with Head and Neck Cancer and Neurologic Swallowing Disturbances.
- 2012
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Ingår i: Dysphagia. - : Springer Science and Business Media LLC. - 1432-0460 .- 0179-051X. ; 27:3, s. 361-369
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to validate the Swedish version of the dysphagia-specific quality-of-life questionnaire, the M. D. Anderson Dysphagia Inventory (MDADI). Patients with oropharyngeal dysphagia due to neurologic disease (n=30) and head and neck (H&N) cancer patients with post-treatment subjective dysphagia (n=85) were compared to an age- and gender-matched nondysphagic control group (n=115). A formal forward-backward translation was performed and followed international guidelines. Validity and reliability were tested against the Short-Form 36 (SF-36) and Hospital Anxiety and Depression Scale (HADS). Internal-consistency reliability was calculated by means of Cronbach's α coefficient. Test-retest reliability was assessed by intraclass correlation (ICC). Convergent and discriminant validity were assessed by correlations between MDADI, SF-36, and HADS. Known-group validity was examined and statistically tested. Of 126 eligible patients, 115 agreed to participate (response rate=91.3%). The age of the participants ranged between 37 and 92 years. Most of the MDADI items showed good variability and only minor floor or ceiling effects in solitary items were found. The internal-consistency reliability (Cronbach's α) of the MDADI total score was 0.88 (after correction for systematic errors in the subjects' responses to two reversed questions). All estimates reached over the satisfactory >0.70 reliability standard for group-level comparison. ICC ranged between 0.83 and 0.97 in the test-retest. The mean MDADI total score was 66.9 (SD=14.7) for the H&N cancer patients, 65.0 (16.9) for the neurologic patients, and 97.5 (4.4) for the control group (P<0.001; study patients vs. controls). The MDADI was also sensitive to disease severity as measured by different food textures. The Swedish version of the MDADI showed good psychometric properties and is a valid instrument to assess dysphagia-related quality of life. It was also shown to be a reliable instrument after correction for systematic errors in the subjects' responses to two reversed questions. Its known-group validity enables the differentiation between dysphagic and nondysphagic patients for group-level research.
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| 28. |
- Dotevall, Hans, 1958, et al.
(författare)
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Long-term effects on swallowing and laryngeal function after treatment for severe COVID-19 disease in intensive care
- 2024
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Ingår i: EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY. - 0937-4477 .- 1434-4726. ; 281, s. 3679-3691
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Tidskriftsartikel (refereegranskat)abstract
- Purpose This study aimed to assess swallowing and laryngeal function at long-term follow-up in patients treated for severe COVID-19 in the ICU.Methods Thirty-six patients with severe COVID-19 were prospectively examined with fiberendoscopic evaluation of swallowing (FEES) about 6 and 12 months after ICU discharge. Comparison with initial FEES examinations during the time in hospital was performed in 17 patients. Analysis of swallowing function and laryngeal features was performed from video recordings. Twenty-five participants responded to Eating Assessment Tool, Voice Handicap Index, and the Hospital Anxiety and Depression Scale at follow-up.Results Penetration to the laryngeal vestibule (PAS >= 3) was seen in 22% and silent aspiration (PAS = 8) in 11% of patients on at least one swallow at follow-up. Fourteen percent had obvious residue in the vallecula and/or pyriform sinuses after swallowing thick liquid or biscuits. Self-reported eating and swallowing difficulties were found in 40% of patients. Abnormal findings in the larynx were present in 53% at follow-up. Thirty-three percent had reduced or impaired vocal fold movement, of whom 22% had bilateral impaired abduction of the vocal folds. Possible anxiety and depression were found in 36% and 24% of responders, respectively.Conclusion Although a majority of patients appear to regain normal swallowing function by 1 year after treatment for severe COVID-19, our results indicate that dysphagia, abnormal laryngeal function, and anxiety/depression may remain in a substantial proportion of patients. This suggests that swallowing and laryngeal function, and emotional symptoms, should be followed up systematically over time in this patient group.
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| 29. |
- Dotevall, Hans, 1958, et al.
(författare)
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Treatment with head-lift exercise in head and neck cancer patients with dysphagia: results from a randomized, controlled trial with flexible endoscopic evaluation of swallowing (FEES)
- 2023
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 31:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: This randomized study aimed to evaluate the effects of the Shaker head-lift exercise (HLE) to improve dysphagia following oncologic treatment for head and neck cancer (HNC). Methods: Patients with dysphagia following oncologic treatment for HNC were randomly assigned to intervention (n = 23) or control (standard dysphagia management, n = 24) groups. Swallowing was evaluated at baseline and at 8-week follow-up using flexible endoscopic evaluation of swallowing (FEES) and self-perceived swallowing with the Eating Assessment Tool (EAT-10). Analysis was performed regarding secretion, initiation of swallow, residue after swallowing, and penetration/aspiration. Results: Few statistically significant differences were found in the FEES analysis. Some improvement of self-perceived swallowing function was found in both groups. Adherence to training was high. Conclusions: This randomized study regarding the effect of the HLE demonstrated that swallowing outcome measures used in assessment of FEES did not improve in patients treated with radiotherapy for patients with dysphagia following HNC.
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