Perceptions regarding communicative participation in individuals receiving botulinum toxin injections for laryngeal dystonia.
Perceptions regarding communicative participation in individuals receiving botulinum toxin injections for laryngeal dystonia.
复制标题
对接受肉毒杆菌毒素注射治疗喉肌张力障碍的个体的交流参与的看法。
DOI：
10.1111/1460-6984.12668
复制
发表时间：
2021
影响因子：
2.4
通讯作者：
Kapsner-Smith,Mara
中科院分区：
文献类型：
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作者：
Yorkston,Kathryn;Baylor,CarolynR;Eadie,Tanya;Kapsner-Smith,Mara
背景喉肌张力障碍（LD）或痉挛性发声障碍（SD）是一种神经系统疾病，其特征是局灶性肌张力障碍或喉部肌肉不自主痉挛以及相关的发声症状。通常通过注射肉毒毒素 (BoNT) 来治疗，从而削弱受影响的肌肉。 目的 这项定性研究的主要目的是探索参与者接受 LD 和 BoNT 治疗的经历。第二个目的是根据参与者在交流参与项目库（CPIB）上的分数来检查这些体验。结果将增强我们对交流参与限制的理解，协助规划针对这些限制的干预措施，并帮助临床解释 CPIB 评分。 方法与程序 使用现象学传统并重点关注 BoNT 治疗和交流参与的半结构化访谈对 26 名接受既定 BoNT 治疗方案的 LD 患者进行。访谈被记录、转录、编码和归纳分析。参与者根据 CPIB 分数分为从无参与限制到广泛参与限制的组。获得了自我和专家的声音评分。结果和结果具有不同 CPIB 分数水平的参与者在 BoNT 治疗背景下具有不同的与交流参与相关的经历。这些差异分为以下主题：BoNT 和语音；对参与的态度；应对策略；和建议。对于除最不受限制和最受限制的群体之外的所有参与者而言，声音的专家评级与 CPIB 分数无关。结论与启示虽然大多数参与者报告称 BoNT 治疗后声音有所改善，但许多参与者在交流参与方面经历了挥之不去的限制，有些甚至严重程度。参与者报告说他们以多种方式应对这些限制；其中一些策略比其他策略更成功。参与受限的人建议为日常生活和 LD 的情感损失以及家庭成员提供更多支持。这种支持可能由言语病理学家提供。本文补充了该主题的已知内容不同 CPIB 分数水平的参与者在 BoNT 治疗背景下对沟通参与有不同的经历。这项研究对现有知识的补充虽然大多数参与者报告说 BoNT 治疗后声音有所改善，但许多参与者在沟通参与方面经历了挥之不去的限制，有些甚至严重程度。潜在或实际的临床影响是什么 这项工作的目的是什么？ SLP 服务采用以参与为中心的干预方法，并使用多因素方法来帮助客户在 LD 的背景下最大限度地参与生活，这完全属于 SLP 的实践范围。 SLP 可以帮助客户在肌张力障碍和 BoNT 效应的限制下找到并使用最佳声音。
BackgroundLaryngeal dystonia (LD), or spasmodic dysphonia (SD), is a neurological disorder characterized by focal dystonia or involuntary spasms of the laryngeal muscles and associated voice symptoms. It is typically treated with injection of botulinum toxin (BoNT) that weakens the affected muscles.AimsThe primary purpose of this qualitative study was to explore participants’ experience of living with LD and BoNT treatment. The secondary purpose was to examine those experiences as a function of participants’ scores on the Communicative Participation Item Bank (CPIB). Results will enhance our understanding of restrictions in communicative participation, assist in planning intervention targeting these restrictions and aid in clinical interpretation of CPIB scores.Methods & ProceduresSemi‐structured interviews using a phenomenological tradition and focusing on BoNT treatment and communicative participation were conducted with 26 people with LD who are on established BoNT treatment regimens. Interviews were recorded, transcribed, coded and analysed inductively. Participants were categorized by CPIB scores into groups ranging from none to extensive participation restrictions. Both self‐ and expert ratings of voice were obtained.Outcomes & ResultsParticipants with different levels of CPIB scores had different experiences related to communicative participation in the context of BoNT treatment. These differences were organized into the following topics: BoNT and voice; attitudes toward participation; coping strategies; and advice. For all participants except those in the least restricted and most restricted groups, expert ratings of voice did not relate to CPIB scores.Conclusions & ImplicationsAlthough most participants report improved voice with BoNT treatment, many participants experienced lingering restrictions in communicative participation, some to a severe extent. Participants reported coping with these restrictions in many ways; some of these strategies were more successful than others. Those with restricted participation recommended more support for daily life and the emotional toll of LD, as well as support for family members. This support might be offered by speech–language pathologists.What this paper addsWhat is already known on the subjectParticipants with different levels of CPIB scores had different experiences related to communicative participation in the context of BoNT treatment.What this study adds to the existing knowledgeAlthough most participants report improved voice with BoNT treatment, many participants experienced lingering restrictions in communicative participation, some to a severe extent.What are the potential or actual clinical implications of this work?SLP services that take a participation‐focused approach to intervention and use multi‐factorial approaches to help clients maximize their life participation in the context of LD are well within the SLP scope of practice. SLPs can help clients find and use their optimal voices within the constraints of the dystonia and BoNT effects.