Objective: The purpose of this study was to (1) investigate the percent change in communicative participation in individuals with spasmodic dysphonia (SD) pre- and post-Botox treatment; and (2) to investigate if percent change in communicative participation is predicted by change in self-esteem, coping, and/or VRQOL pre- and post-Botox treatment. Method: A cross-sectional study of 49 patients was conducted across three clinics and each participant completed the Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1965), the Voice Disability Coping Questionnaire (VDCQ; Epstein, Hirani, Stygall, & Newman, 2009), the Voice-Related Quality of Life scale (V-RQOL; Hogikyan & Sethuraman, 1999), and the Communication Participation Item Bank (CPIB; Baylor et al., 2013) before Botox treatment and 10-14 days following Botox treatment. Data Analysis: For Research Question 1, a paired t-test was applied to test the equality of means for CPIB and to test the pre-post changes among other composite measurements before and after the Botox treatment. For Research Question 2, a multivariable linear regression model was applied with percent change in CPIB as a main outcome, and change in RSES, VDCQ, and the V-RQOL as independent variables (or covariates) in order to test the associations. Results: The results indicated that pre- and post-Botox measures of communicative participation are not statistically significantly different among the participants with SD. Additionally, the findings suggested that individuals who have had SD for a lesser amount of time have greater variability of satisfaction with their ability to confidently participate in communication. There was borderline statistical significance in changes in self-esteem, however it was not predictive of change in communicative participation. Additionally, there was a strong positive correlation between change in coping and VRQOL, which may be indicative of adaptive coping with the chronic symptoms of SD. Conclusion: A better understanding of the relationship between communicative participation and VRQOL is warranted as there was improved communicative participation among those with more frequent injections, but poorer VRQOL among those with more frequent injections. Item analysis of the V-RQOL and the VDCQ may illustrate coping strategies and functional impairments and provide further information as to why communicative participation was highly variable among individuals with SD.
|Advisor:||Zraick, Richard I.|
|Commitee:||Bursac, Zoran, Guyette, Thomas, Hadden, Kristie, Tulunay, Ozlem|
|School:||University of Arkansas for Medical Sciences|
|Department:||Communication Sciences and Disorders|
|School Location:||United States -- Arkansas|
|Source:||DAI-A 78/02(E), Dissertation Abstracts International|
|Keywords:||Communicative participation, Dysphonia, Quality of life, Spasmodic dysphonia|
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