Role of Social-Cognitive Motivational Factors in Achieving Voice Therapy Outcomes

社会认知动机因素在实现声音治疗结果中的作用

• 批准号: 7545006
• 负责人: Eva van Leer
• 金额: $ 2.83万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2010-09-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7545006
• 关键词: Achievement; Adherence; Area; Behavior; Behavior Therapy; Behavioral; Belief; Body Weight decreased; Cardiac; Clinical; Clinical Research; Cognitive; Control Groups; Daily; Dedications; Development; Diagnosis; Edema; Exercise; Goals; Health; Health behavior; Hygiene; Individual; Intervention; Intuition; Investigation; Knowledge; Larynx; Learning; Left; Life Style; Measures; Mechanics; Methods; Motivation; Muscle; Nature; Nodule; Outcome; Outcome Measure; Participant; Patient Participation; Patients; Physical Efforts; Play; Production; Psychology; Psychotherapy; Public Health Education; Quality of life; Randomized; Range; Rehabilitation therapy; Research; Research Design; Research Proposals; Risk; Role; Science; Self Efficacy; Speech; Speech Pathology; Speech-Language Pathology; Standards of Weights and Measures; Techniques; Testing; Therapeutic; Thinking; Time; Treatment Efficacy; Treatment Failure; Treatment outcome; Voice; Voice Disorders; Water; Work; base; behavior change; desire; drinking; improved; knowledge base; motivational intervention; patient oriented; programs; skill acquisition; skills; smoking cessation; social; success; theories; therapy design; tool; voice therapy

DESCRIPTION (provided by applicant): Behavioral treatment of voice disorders (i.e. voice therapy) entails daily voice exercises, implementation of improved voice technique in connected speech, and other behavioral changes thought to improve laryngeal health. Thus, voice therapy requires patient participation and motivation for behavior change. For other health interventions that require active participation, such as weight loss and smoking cessation, motivation for behavior change has been partitioned into 3 factors: (1) an individual's commitment to the goals of the behavior change, (2) confidence in ability to achieve the specific, required behaviors (i.e. selfefficacy), and (3) belief in the ability to develop relevant skills. It has been found that these factors influence successful attainment of the desired behaviors. It is reasonable to assume that these social-cognitive motivational variables may play a role in voice therapy as well. However, the relationship of these variables to voice therapy success has not been studied, and it is unclear how a patient's motivation may be therapeutically enhanced. Therefore, the broad aims of this application are: 1) to quantify the relationship between patient motivation and outcome in voice therapy and 2) to determine if motivation-enhancing therapeutic strategies improve motivation for therapy and voice therapy outcomes. Measures of vocal function and motivation will be obtained in 40 voice therapy participants with a diagnosis of vocal nodules, or pre-1 peri-nodular edema at baseline (i.e. prior to voice therapy; Time 1) and completion of voice therapy (Time 2). Twenty of these participants will be randomly assigned to voice therapy without explicit manipulation of patient motivation, while the remaining 20 participants will receive voice therapy with enhanced motivational content. To capture social-cognitive motivational factors, established measures will be used to assess goal commitment and skill attribution, and an original, previously tested measure will be used to assess self-efficacy for voice therapy. Vocal function will be assessed through established measures that capture change in vocal hyperfunction, including perceptual assessment, laryngeal efficiency, voice-related quality of life, and patient-perceived benefit from therapy. The proposed research is significant in filling a gap in knowledge concerning the most effective methods for assessment and enhancement of patient-centered motivational factors in voice therapy. This work has a high likelihood of yielding meaningful findings related to an important clinical issue.

描述（由申请人提供）：声音障碍的行为治疗（即声音治疗）需要每天进行声音练习，在连贯语音中实施改进的声音技术，以及被认为可以改善喉部健康的其他行为改变。因此，声音治疗需要患者的参与和行为改变的动机。对于其他需要积极参与的健康干预措施，例如减肥和戒烟，行为改变的动机分为 3 个因素：(1) 个人对行为改变目标的承诺，(2) 对实现行为改变目标的信心具体的、必需的行为（即自我效能），以及（3）对发展相关技能的能力的信念。已经发现这些因素影响成功实现期望的行为。可以合理地假设这些社会认知动机变量也可能在声音治疗中发挥作用。然而，这些变量与声音治疗成功的关系尚未被研究，也不清楚如何通过治疗增强患者的动机。因此，该应用的主要目标是：1）量化声音治疗中患者动机和结果之间的关系，2）确定增强动机的治疗策略是否可以提高治疗动机和声音治疗结果。将对 40 名声音治疗参与者进行声音功能和动机测量，这些参与者在基线（即声音治疗之前；时间 1）和完成声音治疗（时间 2）时诊断为声带小结或 1 前结周水肿。其中 20 名参与者将被随机分配接受语音治疗，而无需明确操纵患者动机，而其余 20 名参与者将接受具有增强动机内容的语音治疗。为了捕捉社会认知动机因素，既定的措施将用于评估目标承诺和技能归因，并且原始的、先前测试过的措施将用于评估声音治疗的自我效能。将通过捕捉声音功能亢进变化的既定措施来评估声音功能，包括感知评估、喉效率、与声音相关的生活质量以及患者从治疗中感知到的益处。拟议的研究对于填补有关评估和增强声音治疗中以患者为中心的动机因素的最有效方法的知识空白具有重要意义。这项工作很有可能产生与重要临床问题相关的有意义的发现。