title: Creating a mastery experience during the voice evaluation.
abstract: OBJECTIVE
  Adherence to treatment is a common challenge when working with patients with voice disorders. Improving their self-efficacy through a mastery experience has the potential to improve treatment adherence. An ideal mastery experience gives early and quick evidence that the patient will be successful with the treatment and works for a broad range of patients. This study sought to test whether a brief stimulability trial of forward focused voice could produce sufficient change in acoustic analysis measures to provide visibly improved objective results and, thus, be a potentially useful mastery experience.
  
  
  METHODS
  Prospective, repeated measures, pre- and posttreatment.
  
  
  METHODS
  Twenty-four consecutive patients with varying diagnoses referred for a voice evaluation participated in this study. Acoustic analysis was completed before and after a short stimulability trial of forward focused voice. Acoustic analysis parameters evaluated include fundamental frequency, jitter, shimmer, noise-to-harmonic ratio, and voice turbulence index. Data pre- and posttreatment were analyzed for change and compared with normative values.
  
  
  RESULTS
  Results demonstrated a significant change from pre- to posttrial, as indicated by the objective measure transitioning from being outside to within normal limits, in 75% of patients (P=0.000). When less rigid criterion of a positive change in one or more of the three acoustic measures of interest is used, improvement was noted in 96% of patients.
  
  
  CONCLUSIONS
  Pairing a trial therapy with acoustic analysis during a voice evaluation is a possible mastery experience. Future research is needed to determine if this mastery experience improves self-efficacy, treatment adherence, and treatment outcomes.
authors.affiliation: Department of Health Science and Research, Medical University of South Carolina, Charleston, South Carolina 29425, USA. bonilhah@musc.edu
authors.forename: Heather Shaw
authors.initials: HS
authors.lastname: Bonilha
authors.forename: Amy Elizabeth
authors.initials: AE
authors.lastname: Dawson
mesh_terms: D000162:Acoustics; D001676:Biofeedback, Psychology; D006801:Humans; D008499:Medical Records; D010349:Patient Compliance; D010699:Phonation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D020377:Self Efficacy; D013018:Sound Spectrography; D013061:Speech Acoustics; D013068:Speech Production Measurement; D016896:Treatment Outcome; D014832:Voice Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D014833:Voice Quality; D014834:Voice Training