title: Disease-specific self-efficacy in spasmodic dysphonia patients.
abstract: OBJECTIVE
  Self-efficacy (SE) is an optimistic self-belief that one can perform a novel task. This concept involves empowerment, self-esteem, and adaptation to a stressful situation. SE is a strong predictor of health behaviors. Our objectives were to study SE in spasmodic dysphonia (SD) and to develop a disease-specific SE-SD scale.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Academic hospital.
  
  
  METHODS
  Disease-specific SE-SD items were developed with laryngologists, speech pathologists, and SD patients. These items, General SE Scale, Voice Handicap Index-10 (VHI-10), Consensus Auditory Perceptual Evaluation of Voice (CAPE-V), and Hospital Anxiety and Depression Scale (HADS), were administered to SD patients who presented for botulinum toxin injections.
  
  
  RESULTS
  One hundred forty-five SD patients (mean age 59.5 ± 13.6 years) had a general SE score (Cronbach's α = 0.894) of 33.4 ± 5.2 out of 40. This was negatively correlated with HADS-A (r = -0.42, P < 0.001) and HADS-D (r = -0.42, P < .001), but not correlated with VHI-10 (r = -0.098, P = .243) and CAPE-V (r = -0.047, P = .57). Factor analysis selected 8 items from the general SE scale and 5 disease-specific SE-SD items to generate a 13-item disease-specific SE-SD scale (Cronbach's α = 0.907). Disease-specific SE-SD score was 42.1 ± 6.9 out of 52 and was negatively correlated with VHI-10 (r = -0.19, P = .005), HADS-A (r = -0.43, P < .001), and HADS-D (r = -0.57, P < .001), but not correlated with CAPE-V (r = -0.024, P = .60).
  
  
  CONCLUSIONS
  SD patients established on botulinum toxin injections have high degrees of general and disease-specific SE. Patients with higher SE-SD demonstrate lower vocal handicap and lower levels of anxiety and depression. A 13-item disease-specific SE-SD scale has been developed.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania 19102, USA. amandahu@phillyent.com
authors.forename: Amanda
authors.initials: A
authors.lastname: Hu
authors.forename: Derek
authors.initials: D
authors.lastname: Isetti
authors.forename: Allen D
authors.initials: AD
authors.lastname: Hillel
authors.forename: Patricia
authors.initials: P
authors.lastname: Waugh
authors.forename: Bryan
authors.initials: B
authors.lastname: Comstock
authors.forename: Tanya K
authors.initials: TK
authors.lastname: Meyer
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D055154:Dysphonia / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D020377:Self Efficacy
chemical_list: D019274:Botulinum Toxins, Type A