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Assessing Adherence to Voice Therapy: A Comparison between the URICA-VOICE Questionnaire and Completion Rate
Cai-Peng Liu1, Fei Liu2, Bo-Chen Wang3
1Department of Otolaryngology-Head and Neck Surgery, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China.
Objective:
To evaluate the predictive capacities of the University of Rhode Island Change Assessment of voice (URICA-VOICE) questionnaire and completion rate in assessing adherence, and their impact on therapeutic outcomes of voice therapy in patients with voice disorders.
Method:
At the Voice Treatment Center of Sun Yat-sen Memorial Hospital, 127 patients with voice disorders were recruited between April and September 2023. Initial adherence was gauged using the URICA-VOICE questionnaire. Following voice therapy, adherence was assessed by examining the actual completion rate. The concordance between the two evaluations and their influence on treatment outcomes, including voice handicap index (VHI), Jitter, and Shimmer, was scrutinized.
Results:
Notable discrepancies arose between both assessment methodologies. The predicted poor adherence, as delineated by URICA-VOICE, stood at 62.99%, surpassing the actual poor adherence rate of 56.69% indicated by the completion rate. Considering the completion rate as the benchmark, 72 participants demonstrated actual poor adherence. Of these, 54 were precisely pinpointed by URICA-VOICE, achieving a sensitivity of 75.00%. Evaluation strategies divergently impacted outcome appraisal. With the completion rate, the enhancements in VHI, Jitter, and Shimmer were statistically superior for the 55 actually good adherent individuals compared to the 72 actually poor adherent ones (P < 0.01). In contrast, the URICA-VOICE discerned no significant variances between its 47 subjects with predicted good adherence and 80 subjects with predicted poor adherence (P > 0.05).
Conclusions:
While completion rate portrays tangible behavioral adherence, URICA-VOICE gauges prospective behavioral adherence via the evaluation of mental readiness. The latter can detect those prone to diminished adherence pre-training, but falls short in predicting end results. Direct adherence assessment via completion rate is congruent with tangible treatment efficacy. Enhancing adherence is pivotal for optimizing therapeutic results and voice quality.
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