The Relationship Between Speech-Language Pathologists' Perceptions of Clinical Terminology and Its Use in Voice Therapy with Adults.

Abstract

Objectives: The terminology used by speech-language pathologists (SLPs) during voice therapy is important for treatment outcomes because it can impact both patient self-efficacy and adherence. However, little is known about what factors influence the terminology that SLPs choose to use. Understanding this gap is important to ultimately optimize voice therapy outcomes. Therefore, the primary aims of this study were to (1) assess the relationship between reported clinician-perceived positivity and (2) assess the relationship between clinician-perceived positivity and clinical endorsement for use. We hypothesized that clinician-perceived positivity would be one important factor driving how frequently clinicians use or avoid specific terms, and if they think the term should be used by other SLPs in clinical practice.

Design/methods: This prospective study was conducted as an online survey of SLPs and SLP clinical fellows who evaluate and treat adult voice patients. The survey presented respondents with a total of 46 voice-related terms and prompted respondents to rate: (1) how frequently they use a specific voice-related term ("frequency of use"); (2) how positive or negative they perceive a specific voice-related term to be ("perceived positivity"); and (3) if they feel a specific voice-related term should versus should not be used in clinical practice ("clinical endorsement"). Inferential statistics were used to examine the relationship between perceived positivity and frequency of use, and perceived positivity and clinical endorsement. Summary statistics were used to describe frequency of use across all terms.

Results: One hundred twelve respondents completed the survey. Clinician-perceived positivity of voice-related terminology was significantly related to its reported self-reported frequency of use (β = 1.946; 95% CI: 1.701-2.191; P < 0.0005) and clinical endorsement of use by others (β = 4.103; 95% CI: 3.750-4.456; P < 0.0005). Both of these relationships exhibited relatively large effect sizes.

Conclusions: This study was an important first step at identifying factors that influence SLP's use of specific terminology in voice therapy. Specifically, an SLP's perceived positivity of clinical terminology strongly influenced the frequency with which they reported using that term in voice therapy and whether or not they thought that term should be used with patients by other SLPs in voice therapy. Future work should investigate clinician characteristics that might affect terminology use, include more diverse sampling, utilize self-selected terminology or audio recordings of therapy interactions, and assess direct effects of terminology use on patient outcomes.