Disease-Specific Self-Efficacy in Spasmodic Dysphonia Patients

Document Type

Article

Publication Title

Otolaryngology-Head and Neck Surgery

ISSN

0194-5998

Volume

148

Issue

3

DOI

10.1177/0194599812472319

First Page

450

Last Page

455

Publication Date

1-8-2013

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.

Study Design. Prospective study.

Setting. Academic hospital.

Subject and 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 6 13.6 years) had a general SE score (Cronbach’s a = 0.894) of 33.4 6 5.2 out of 40. This was negatively correlated with HADS-A (r = 20.42, P \ 0.001) and HADS-D (r = 20.42, P \ .001), but not correlated with VHI-10 (r = 20.098, P = .243) and CAPE-V (r = 20.047, 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 a = 0.907). Disease-specific SE-SD score was 42.1 6 6.9 out of 52 and was negatively correlated with VHI-10 (r = 20.19, P = .005), HADS-A (r = 20.43, P \.001), and HADS-D (r = 20.57, P \ .001), but not correlated with CAPE-V (r = 20.024, P = .60).

Conclusion. 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.

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