Voice Rest Adherence after Phonomicrosurgery

项目总结/摘要 标题：发音显微外科手术后的语音休息依从性 这项建议的目的是检查手术后声音休息的坚持性和影响因素 了声音休息是良性病变的声音显微手术后康复的重要组成部分， 被认为可以让声带愈合并减少疤痕组织。目前没有标准或 指导持续时间和类型的声音休息规定。目前的建议主要基于 临床经验和不同的医生，语言病理学家和临床设置。依从性估计 所述规定的推荐是基于在声音休息期结束时的患者报告 非常多变和主观。少数研究表明，对声音休息的坚持程度很差。 这种不依从性是精确测量手术和声音休息的主要障碍之一 结果，并为语音休息创建标准化协议。也没有关于影响因素的信息 依从性，如障碍和支持，对生活质量的影响，个性等。 本研究的主要目的是测量两种类型的患者的主观和客观依从性， 语音手术后立即进行语音休息（完全语音休息（CVR）和相对语音休息（RVR））， 与依从性水平相关的预测因子和因素。在缺乏具体指导方针的情况下， 休息类型，坚持将通过语音休息上的语音使用量来指示。这将是一个随机的 对50名接受声音外科手术的参与者进行的对照试验。本研究的目的1将比较患者- 使用患者报告的感知依从性，以通过声音剂量计客观测量的估计声音使用 7天的声音休息期。这两种坚持措施将在内部和之间进行比较， CVR和RVR组。目标2将确定与高或低水平的坚持相关的声音休息因素。 术前因素包括人口统计学信息，认知评分和患者评分， 声音、动机、健谈程度、个性和感知控制。在完成7天的VR后， 将根据对生活质量的影响、使用的替代通信模式、经济影响， 支持和障碍。这些因素将在CVR和RVR之间进行比较，并作为水平的预测因子。 的坚持。 这项研究的数据将在多个层面上发挥作用。它将提供关于遵守情况的经验数据 推荐的两种类型的语音休息之间的差异以及患者感知之间的差异 和测量的粘附性。此外，临床医生可以定制他们的治疗，以最大限度地提高术后结果， 他们可以主动地识别不良依从性的预测因素并修改他们的语音休息建议， 增加术前患者教育或在可行时包括一段时间的试验治疗。列入 在我们努力实现以下目标的过程中， 制定手术后语音建议的指南。

PROJECT SUMMARY/ABSTRACT Title: Voice Rest Adherence after Phonomicrosurgery The goal of this proposal is to examine adherence to post-surgical voice rest and the factors that affect it. Voice rest is an essential component of rehabilitation after phonomicrosurgery for benign lesions, and is thought to allow the vocal folds to heal and minimize scar tissue. There are currently no standards or guidelines for duration and type of voice rest prescribed. Current recommendations are based primarily on clinical experience and vary by physician, speech pathologist and clinical setting. Estimation of adherence to the prescribed recommendation is based on patient reports at the end of the voice rest period and can be highly variable and subjective. A small number of studies have shown poor levels of adherence to voice rest. This non-adherence has been one of the primary obstacles to accurately measuring surgical and voice rest outcomes and, creating standardized protocols for voice rest. There is also no information on factors that affect adherence such as barriers and supports, impact on quality of life, personality etc. The primary aims of this study are to measure subjective and objective adherence for two types of voice rest (complete voice rest (CVR) and relative voice rest (RVR)) immediately after phonosurgery and, predictors and factors associated with level of adherence. In the absence of specific guidelines for both voice rest types, adherence will be indicated by amount of voice use on voice rest. This will be a randomized controlled trial on fifty participants undergoing phonosurgery. Aim 1 of this study will compare patient- perceived adherence using patient reports to estimated voice use measured objectively by a vocal dosimeter for the 7-day voice rest period. These two measures of adherence will be compared within and between the CVR and RVR groups. Aim 2 will identify voice rest factors associated with high or low levels of adherence. Pre-operative factors include demographic information, scores on auditory-perceptual and patient ratings of voice, motivation, level of talkativeness, personality and, perceived control. After completing 7 days of VR, data will be obtained on impact on quality of life, alternate modes of communication used, economic impact, supports and barriers. These factors will be compared between CVR and RVR and also as predictors of level of adherence. Data from this study will be useful on multiple levels. It will provide empirical data on adherence differences between the two types of voice rests recommended and the difference between patient perception and measured adherence. In addition, clinicians can tailor their treatment to maximize post-surgical outcome if they can proactively identify predictors of poor adherence and modify their voice rest recommendations, increase patient education pre-operatively or include a period of trial therapy when feasible. The inclusion of adherence in the decision making process for voice rest recommendations is critical as we work towards developing guidelines for post-surgical voice recommendations.