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- Bergström, Liza, 1974, et al.
(författare)
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Community listeners' perceptions of voice function post-radiotherapy for laryngeal cancer.
- 2018
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Ingår i: International Journal of Speech-Language Pathology. - : Informa UK Limited. - 1754-9507 .- 1754-9515. ; 20:5, s. 494-501
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Tidskriftsartikel (refereegranskat)abstract
- Successful communication is influenced by communication partners, the community and communication environment. This study examines community members' perceptions of voice function following laryngeal cancer management compared to ratings by clinicians and patients.Sixty-six (Tis-T3) laryngeal cancer patients post-radiotherapy, 10 community members and three speech-language pathologists (clinicians) were recruited. Patients completed voice recordings and self-rated voice quality and acceptability, six months post-radiotherapy. Community members and clinicians rated patient voice recordings using (a) Voice Quality/Acceptability questionnaire, (b) Communicative Suitability Scale (voice function in different vocally demanding environments) and (c) a gender perception question.Ratings for voice quality differed significantly (p < 0.001) between community members and clinicians and approached significance (p= 0.08) between community members and patients. No significant difference for voice acceptability was noted between community members and clinicians/patients. Community members rated the irradiated voice significantly different (p ≤ 0.02) across communication environments with more vocally demanding environments being rated as "Barely Sufficient". Incorrect sex identification (gender perception) occurred with 25% of females.Community communication partners identify functional voice impairments post-radiotherapy, particularly across more vocally demanding environments and for female speakers. Implications for voice rehabilitation including appropriate patient selection is highlighted.
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| 3. |
- 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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| 4. |
- 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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| 5. |
- Karlsson, Therese, et al.
(författare)
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A prospective longitudinal study of voice characteristics and health-related quality of life outcomes following laryngeal cancer treatment with radiotherapy
- 2016
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 55:6, s. 693-699
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Tidskriftsartikel (refereegranskat)abstract
- Background To investigate potential changes in perceptual, acoustic and patient-reported outcomes over 12 months for laryngeal cancer patients treated with radiotherapy.Material and methods A total of 40 patients with Tis-T3 laryngeal cancer treated with curative intent by radiotherapy were included in this prospective longitudinal descriptive study. Patients were followed pre-radiotherapy, one month, six months and 12 months post-radiotherapy, where voice recordings and patient-reported outcome instruments (European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire Core30, Head and Neck35, Swedish Self-Evaluation of Communication Experiences after Laryngeal Cancer) were completed at each appointment. Perceptual analysis, using the Grade-Roughness-Breathiness-Asthenia-Strain scale and vocal fry parameters, and acoustic measures including harmonics-to-noise ratio (HNR), jitter, shimmer and mean spoken fundamental frequency (MSFF) were produced from voice recordings.Results All patients presented with dysphonic voices pre-radiotherapy, where 95% demonstrated some degree of vocal roughness. This variable improved significantly immediately post-radiotherapy, however, then deteriorated again between six and 12 months. Vocal fry also increased significantly at 12 months. Acoustic measures were abnormal pre- and post-treatment with no significant change noted except for MSFF, which lowered significantly by 12 months. Health-related quality of life (HRQL) deteriorated post-radiotherapy but returned to pretreatment levels by 12 months.Conclusion By 12 months, most perceptual, acoustic, patient-reported voice and HRQL outcomes for laryngeal cancer patients treated by radiotherapy had showed no significant improvements compared to pretreatment function. Further studies are required to investigate potential benefits of voice rehabilitation following radiotherapy.
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