Dysphonia, a disorder of vocal function, is a very important determinant of one's sense of functioning in society and, more specifically, of communicating with the world around one. Perceived disability due to this condition is associated with limitations in daily functioning and a significant decrease in quality of life. There are many factors that have a direct and indirect impact on vocal dysfunction, and one of the most significant is stress, which research shows has a significant impact on the development of dysphonia.
Through the eyes of the patient
In the paper 'Sense of stress and voice impairment in patients with dysphonia' by A. Cielecka, E. Sielska-Badurek and K. Niemczyk, from the Department of Otolaryngology and Laryngology, Medical University of Warsaw, we can find reference to how patients struggling with voice disorders perceive the impact of stress on the development of these disorders. The research described in the aforementioned paper was carried out at the phoniatric clinic of SPCCH WU. Based on the results, conclusions were drawn regarding the influence of perceived stress levels on voice disorders. Relationships and correlations between stress and dysphonia were also compared in the context to a control group of healthy people, i.e. those without voice disorders. Another important aspect of the study was the self-assessment of disability experienced by patients with voice disorders[1].
The research methods used to conduct the study were questionnaires: Voice Handicap Self-Assessment Scale(VHI) and Perceived Stress Scale(SPS), and a metric.
After compiling the collected material using descriptive statistics, an analysis by group was carried out, and the correlations that exist in terms of the specific variables selected during the study were checked. The authors of the study identified 5 independent variables, such as: "gender, age, education, type of dysphonia and duration of therapy"[1] and 9 dependent variables: "overall VHI score, VHI - I score, VHI - II score, VHI - III score, overall KPS score, emotional tension (NP) subscale score, external stress (SZ) subscale score, intrapsychic stress (IS) subscale score and lie scale score"[1].
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Conclusions
The patients subjected to the study rated their voice impairment at an average level, as indicated by their VHI score. This result indicates a slightly better sense of fitness in relation to other countries in the world - such as Brazil, where the VHI level is even higher than that obtained from the study. The parameters obtained are most similar in value to the German results, which were determined in 2004. However, it should be borne in mind that the patients who took part in the study described in the aforementioned paper underwent phoniatric-logopaedic rehabilitation, where its average duration was 34 months.
Surprising to the authors was the score on the Lying Scale, where healthy subjects ranked at a sten 5, indicating an average score in the Polish population, while among patients with dysphonia, the score reached a sten 8, a much higher score on a population basis. What can be understood by this? As the authors of the paper explain, the score should be interpreted as a need for social approval, a symptom of which is the tendency to put oneself in a favourable light. These tendencies can be directed consciously - based on knowledge of social expectations - but they can also arise unconsciously. In the context of the research conducted, this is crucial, as the greater the need for acceptance, the less reliable the results. The authors of the study point out, however, that there is a significant relationship between high scores on the lying scale and the sense of stress, which turns out to be statistically higher in these individuals, as it can be concluded from this that people with voice disorders are characterised by a higher sense of stress.
Self-assessment of voice impairment is another factor that is in significant correlation with feelings of stress. The higher the level of experiencing anxiety, the higher the level of experiencing disability due to voice disorders.
In conclusion, the authors note that there are no significant differences in perceived stress levels between dysphonia sufferers and healthy individuals. Nevertheless, the correlation between higher levels of stress and voice disorders, particularly in relation to self-reported voice disability, attracts attention. In addition, observations indicate that people who manifest voice disorders present a higher than average need for social approval[1].
