The role of patient perceptions and hyperfunctional voice disorders in predicting voice therapy attendance.

OBJECTIVES/HYPOTHESIS: Attendance is essential to voice therapy's effectiveness in the treatment of voice and laryngeal disorders. With such high rates of drop-out and non-attendance, it is important to understand the factors that influence this behavior. This study sought to identify potential predictors of attendance to voice therapy at an interdisciplinary voice clinic. STUDY DESIGN: Single-institution retrospective cohort study. METHODS: In this retrospective cohort study, patients evaluated at an interdisciplinary voice clinic who received a referral for voice therapy were identified. Age, gender, voice-related diagnoses, Voice Handicap Index-10 scores, Reflux Symptom Index scores, and measures of patient perceptions (self-rated severity, importance of voice in one's life, and "feelings about voice therapy") were recorded to evaluate associations with attendance to at least one therapy session. Standard statistical analysis and logistic regressions were performed. RESULTS: Of 168 subjects included, 111 (66.1 %) attended at least one session of voice therapy. Patients diagnosed with primary hyperfunctional voice disorders had a significantly higher attendance rate than other groups. Attenders had higher self-ratings of severity and more positive "feelings about voice therapy" compared to non-attenders. Regression models found three significant predictors of therapy attendance: primary diagnosis of hyperfunctional voice disorder, self-rated severity, and "feelings about voice therapy." CONCLUSION: In this cohort, patients with more positive feelings about voice therapy, higher self-rated severity, and a diagnosis of primary hyperfunctional voice disorder were more likely to attend voice therapy.

Patients' Perceptions of and Attitudes Toward Voice Therapy: A Pilot Study.

Patient perceptions of the therapeutic process have been shown to influence outcomes in various healthcare fields. However, the voice therapy literature lacks a thorough examination of patients' perceptions of the voice therapy process. This cross-sectional pilot study analyzed patient perceptions of voice therapy across four different areas: patient understanding of therapy, the home therapy program, perception of improvement of symptoms, and prioritization of therapy. The study included patients receiving voice therapy for various disorders (n = 49). Results showed significant differences by patient age and the number of therapy sessions completed. Patients indicate increased understanding (P = 0.0676) and appeared to notice more improvement as therapy progressed (P = 0.010). Younger patients indicate higher adherence to their home program (P < 0.001, P = 0.003). Additionally, correlations were found between patient understanding and the extent to which they prioritize therapy (r = 0.53, P < 0.001) and the extent to which patients notice improvement (r = 0.51, P < 0.001). This study highlights possible age and gender differences and the ways in which perceptions may change over time and affect outcomes.