Coping and dysphonia; diagnostic, perceptive and self-assessment data
Margo Zwitserlood-Nijenhuis, Mieke Moerman, Arno Lieftink, Philippe Dejonckere
In this study the relation between dysphonia and coping with stress was assessed in males and females with primary organic (OD) and primary functional dysphonia (FD). Forty-five patients answered a coping questionnaire consisting of 5 subscales. Outcomes were compared with the diagnosis, perceptual ratings and self-assessment ratings. Results reveal that coping subscales of the dysphonia group are significantly different from the controls. Significant differences in Emotion-focused coping (E) were found for the interaction factor gender with diagnosis. Subgroups OD and FD score equal for the other subscales. Perception ratings and coping aresignificantly related (respectively Grade (G) with Avoidance coping (V) and G with seeking distraction (AZ)) for the dysphonia group in general and for females more specifically. Self-assessment data demonstrate significant relations in the males subgroup for Task-focused coping (T) with i) voice disorder severity, ii) impairment in everyday life and iii) VHI. For females the relation between T and i) impairment in everyday life and ii) impairment in occupation appears significant. Interestingly males and females use coping the opposite way: females T-scores increase as self-assessment ratings increase; males T-scores decrease as self-assessment ratings increase. We conclude that dysphonia is associated with a so-called passive coping style represented by low T- and V-scores, for females combined with high E-scores. This study suggests that patients with voice disorders and a passive coping strategy could profit from combined therapy, i.e. voice therapy and psychological counselling, especially if ineffective coping leads to vocal load increase.
Margo Zwitserlood-Nijenhuis 1, Mieke Moerman2, Arno Lieftink1, Philippe Dejonckere1,
1. Division ENT, University Medical Hospital Utrecht,The Netherlands
2. Hospital Jan Palfijn Gent, Belgium
Postal address: UMC Utrecht,
Zorggroep Stemstoornissen, F02.504,
Margo Zwitserlood-Nijenhuis MSc, logopedist,
Postbus 85500,
3508 GA Utrecht
the Netherlands
E-mail address: margo.zwitserlood@hccnet.nl
Phone: +31(0)302507730 (work), +31(0)302944228 (home), Fax: +31(0)302522627