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  • 1.
    Hengen, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lundeborg Hammarström, Inger
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Perceived Voice Quality and Voice-Related Problems Among Older Adults With Hearing Impairments2018In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 61, no 9, p. 2168-2178Article in journal (Refereed)
    Abstract [en]

    The auditory system helps regulate phonation. A speakers perception of their own voice is likely to be of both emotional and functional significance. Although many investigations have observed deviating voice qualities in individuals who are prelingually deaf or profoundly hearing impaired, less is known regarding how older adults with acquired hearing impairments perceive their own voice and potential voice problems. Purpose: The purpose of this study was to investigate problems relating to phonation and self-perceived voice sound quality in older adults based on hearing ability and the use of hearing aids. Method: This was a cross-sectional study, with 290 participants divided into 3 groups (matched by age and gender): (a) individuals with hearing impairments who did not use hearing aids (n = 110), (b) individuals with hearing impairments who did use hearing aids (n = 110), and (c) individuals with no hearing impairments (n = 70). All participants underwent a pure-tone audiometry exam; completed standardized questionnaires regarding their hearing, voice, and general health; and were recorded speaking in a soundproof room. Results: The hearing aid users surpassed the benchmarks for having a voice disorder on the Voice Handicap Index (VHI; Jacobson et al., 1997) at almost double the rate predicted by the Swedish normative values for their age range, although there was no significant difference in acoustical measures between any of the groups. Both groups with hearing impairments scored significantly higher on the VHI than the control group, indicating more impairment. It remains inconclusive how much hearing loss versus hearing aids separately contribute to the difference in voice problems. The total scores on the Hearing Handicap Inventory for the Elderly (Ventry amp; Weinstein, 1982), in combination with the variables gender and age, explained 21.9% of the variance on the VHI. Perceiving ones own voice as being distorted, dull, or hollow had a strong negative association with a general satisfaction about the sound quality of ones own voice. In addition, groupwise differences in own-voice descriptions suggest that a negative perception of ones voice could be influenced by alterations caused by hearing aid processing. Conclusions: The results indicate that hearing impairments and hearing aids affect several aspects of vocal satisfaction in older adults. A greater understanding of how hearing impairments and hearing aids relate to voice problems may contribute to better voice and hearing care.

  • 2.
    Hengen, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences.
    Peterson, Malin
    Specialpedagogiskt Centre, Sweden.
    McAllister, Anita
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Patient characteristics and intervention effect as measured by Voice Handicap Index2017In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 42, no 2, p. 93-98Article in journal (Refereed)
    Abstract [en]

    Objective: To analyze patients with a confirmed voice disorder in order to identify patterns regarding age, gender, and occupation compared to the general public. To explore effects of voice therapy according to the Voice Handicap Index (VHI) score pre- and post-therapy in relation to the number of sessions, age, and gender. Design: Prospective cohort study. Materials and methods: This study was conducted as a collaborative project between Linkoping University and hospitals in the south-east health care region in Sweden. Six voice clinics participated by asking their patients voluntarily to complete the Swedish version of the VHI at the beginning and end of therapy. Results and conclusions: The two most prevalent diagnoses were dysphonia (43%) and phonasthenia (25%). Among the working population, the three most common occupational fields were education, health care, and child-care. The majority of the patients were women (74.3%), and the mean age of all patients was 55 years. A significant improvement in VHI scores was found after therapy, with an average decrease of 19 median points in total score and a substantial effect size (0.55). The number of sessions did not significantly correlate with the mean VHI score difference but had a weak correlation to the start and end scores. Increasing age correlated with a higher median VHI score both at the start and end of therapy but did not affect the average decrease between the two measurements.

  • 3.
    Hengen, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Peterson, Malin
    Sollentuna.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Röstbehandling: Kartläggning av patienter och utvärdering av interventionseffekt med Rösthandikappindex2014In: Norsk tidsskrift for logopedi, ISSN 0332-7256, no 2, p. 26-30Article in journal (Refereed)
    Abstract [sv]

    Denna studie är ett samarbetsprojekt mellan Linköpings Universitet och fyra landsting i sydöstra och södra sjukvårdsregionen. Syftet är att kartlägga patienter i röstbehandling samt jämföra patienternas RHI-skattningar före och efter genomgången röstbehandling för att undersöka huruvida ålder, kön samt antalet behandlingstillfällen påverkar resultatet. Studien bygger på 350 patienters självskattningar. Wilcoxon teckenrangtest visar en signifikant skillnad i RHI-poäng före och efter behandling med en minskning av 19 medianpoäng i RHI-index med stor effektstyrka (0,55). Kvinnor utgjorde en majoritet av patienterna (74,3 %) och medelåldern totalt var 55 år. Äldre patienter hade högre medianvärde på RHI vid behandlingsstart och behandlingsslut. En högre ålder påverkade dock inte den observerade skillnaden mellan skattningarna.

  • 4.
    Hengen, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Petersson, Malin
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Utvärdering av röstbehandling med Rösthandikappindex (RHI)2013Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    In accordance to the Swedish law of Health- and medical treatments, every intervention should systematically evolve and be improved in terms of safety (HSL, SFS 1982:763). Voice therapy is no exception. Six voice clinics participated in a collaborative project between Linköping University and the south-east hospital region by letting every patient receiving voice therapy complete the Swedish version of the Voice Handicap Index, RHI, at the beginning and end of their treatment. This study has a two-parted aim. The first aim of this study was to examine whether the sum of the participants’ scores on RHI changed after completed therapy and if gender, age, vocal strain within the occupation or the number of therapy sessions had an effect on their score. The second aim of the study was to construct a survey to analyze working speech-language pathologist’s views on RHI as a tool for evaluating voice problems and voice therapy.

    The material from the survey consisted of the answers from 23 respondents.  The patient data includes the results from 350 patients’ scores. Analysis of the data reveals that the typical voice patient is a woman in her fifties with the diagnosis dysphonia. The prevalence of certain diagnoses varies greatly between the participating voice clinics. Wilcoxon sign rank test points to a significant difference in RHI-scores before (MD = 42) and after (MD = 23) therapy with an average decrease of 19 median points in the RHI-index with a substantial observed effect size (.55). The observed difference surpasses the previously suggested threshold limit for clear intervention effect during the development of VHI and RHI. Age had a significant effect on the median score of RHI at the start and end of therapy, but the observed difference between the two measurements were not affected. Differences could be observed between the voice clinics regarding the average number of therapeutic appointments, the average length of the therapy and the average difference in RHI-scores after completed therapy.

    From the responses in the survey, the participating SLPs were generally predominately positive to the idea of RHI as a tool for evaluating voice problems and voice therapy. The majority of the respondents did however mention weaknesses in RHI when used as a tool for evaluation.

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