ArticlePilot and feasibility studies2018
A psychosocial intervention for the management of functional dysphonia: complex intervention development and pilot randomised trial.
Article in Pilot and feasibility studies, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Psychosocial interventions for adults with newly diagnosed chronic disease: A systematic review.Journal of health psychology · 2022Pooled it
- Use of proton pump inhibitors to treat persistent throat symptoms: multicentre, double blind, randomised, placebo controlled trial.BMJ (Clinical research ed.) · 2021Trial
- Lansoprazole for persistent throat symptoms in secondary care: the TOPPITS RCT.Health technology assessment (Winchester, England) · 2021Trial
- Factors associated with voice-related quality of life among patients with temporomandibular disorders.Journal of applied oral science : revista FOB · 2024Article
- Integrative Review and Framework of Suggested Mechanisms in Primary Muscle Tension Dysphonia.Journal of speech, language, and hearing research : JSLHR · 2022Review
- The Puzzle of Medically Unexplained Symptoms-A Holistic View of the Patient With Laryngeal Symptoms.JAMA otolaryngology-- head & neck surgery · 2020Article
- Web-Based Perceived Present Control Intervention for Voice Disorders: A Pilot Study.Journal of voice : official journal of the Voice Foundation · 2020Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundMedically unexplained loss or alteration of voice-functional dysphonia-is the commonest presentation to speech and language therapists (SLTs). Besides the impact on personal and work life, functional dysphonia is also associated with increased levels of anxiety and depression and poor general health. Voice therapy delivered by SLTs improves voice but not these associated symptoms. The aims of this research were the systematic development of a complex intervention to improve the treatment of functional dysphonia, and the trialling of this intervention for feasibility and acceptability to SLTs and patients in a randomised pilot study.
methodsA theoretical model of medically unexplained symptoms (MUS) was elaborated through literature review and synthesis. This was initially applied as an assessment format in a series of patient interviews. Data from this stage and a small consecutive cohort study were used to design and refine a brief cognitive behavioural therapy (CBT) training intervention for a SLT. This was then implemented in an external pilot patient randomised trial where one SLT delivered standard voice therapy or voice therapy plus CBT to 74 patients. The primary outcomes were of the acceptability of the intervention to patients and the SLT, and the feasibility of changing the SLT's clinical practice through a brief training. This was measured through monitoring treatment flow and through structured analysis of the content of intervention for treatment fidelity and inter-treatment contamination.
resultsAs measured by treatment flow, the intervention was as acceptable as standard voice therapy to patients. Analysis of treatment content showed that the SLT was able to conduct a complex CBT formulation and deliver novel treatment strategies for fatigue, sleep, anxiety and depression in the majority of patients. On pre-post measures of voice and quality of life, patients in both treatment arms improved.
conclusionThese interventions were acceptable to patients. Emotional and psychosocial issues presented routinely in the study patient group and CBT techniques were used, deliberately and inadvertently, in both treatment arms. This CBT "contamination" of the voice therapy only arm reflects the chief limitation of the study: one therapist delivered both treatments.
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