Workplace Productivity and Voice Disorders: A Cognitive Interviewing Study on Presenteeism in Individuals with Spasmodic Dysphonia

Objective: The objective of this study was to obtain initial reactions and suggested modifications to two existing presenteeism scales: the Stanford Presenteeism Scale 6 (SPS-6) and the Work Productivity and Activity Impairment Questionnaire-Specific Health Problem (WPAI-SHP) among a cohort of employed individuals with a focal laryngeal dystonia, spasmodic dysphonia (SD). Study design- The study design is a qualitative study. Methods: Nine speakers with SD underwent cognitive interviews, during which they were asked to evaluate the relevance of statements and clarity of wording on the SPS-6, the WPAI-SHP, and an additional set of voice-related statements designed by the researchers. Participants were asked to complete the scales, rank order statements in terms of perceived importance, and suggest additional statements of relevance. Results- Although all participants noted that their SD did have an effect on their jobs, there were suggestions for modifying both the WPAI-SHP and the SPS-6. Participants regarded specific voice-related statements that were generated by the researchers to be of greater importance than the majority of the statements on the SPS-6. Minor changes in the wording of the instructions on the WPAI-SHP were recommended. Conclusions: Presenteeism is an important construct to measure in individuals with a chronic voice disorder such as SD. However, existing presenteeism scales might best be administered in conjunction with additional statements that are more voice related so that clinicians can be made aware of specific difficulties encountered in the workplace

Employer Detection of Spasmodic Dysphonia Across Varying Severity Levels

Objective: To determine the ability of human resources personnel (HRP) with experience in phone interviews to detect the presence or absence of adductor spasmodic dysphonia (ADSD) in potential applicants via auditory stimuli alone. Methods/Design: Thirty HRP were exposed to a brief definition of ADSD. They subsequently performed an auditory-perceptual task in which they were asked to detect the presence of the voice disorder in 20 speakers with ADSD and 20 age- and gender-matched controls. ADSD samples were categorized a priori as perceptually within normal limits (WNL) to mild, moderate, or severe. Frequency counts and percentages were calculated for each speaker that was correctly and incorrectly identified as having ADSD. Mean accuracy ratings, and positive and negative likelihood ratios (LR+ and LR-) also were determined. Accuracy scores were grouped according to severity for ADSD speakers. Results:On average, listeners were 78.83% accurate in discriminating ADSD speakers, and 90.17% in discriminating controls. Based on group averages, 16 speakers with ADSD were correctly identified as having ADSD, and 4 were incorrectly identified as control speakers (sensitivity = 0.80 or 80%). Based on group averages, 20 out of 20 control speakers were correctly identified as not having a voice disorder(specificity = 1.0 or 100%).HRP were accurate at determining ADSD from 87%-100% of the time for perceptually severe ADSD speakers. In moderate cases, accuracy fell between 77%-100%, and dropped between 10% to 87% accurate for mild speakers. Differences related to severity were statistically significant. Conclusions: Results suggest that job applicants with more severe forms of ADSD may not be able to escape detection during phone interviews. However, those with mild symptoms may not be identified as having voice disorders

The ADA and Voice Disorders: Exploring Workplace Productivity Issues in Individuals with Spasmodic Dysphonia

This seminar provides an overview of the Americans with Disabilities Act as applied to individuals with voice disorders. Workplace productivity is examined using a concept known as presenteeism. Preliminary interviews with individuals with spasmodic dysphonia reveal whether existing scales that measure presenteeism might be useful for those with voice disorders

The ADA and Voice Disorders: Exploring Workplace Productivity Issues in Individuals with Spasmodic Dysphonia

This seminar provides an overview of the Americans with Disabilities Act as applied to individuals with voice disorders. Workplace productivity is examined using a concept known as presenteeism. Preliminary interviews with individuals with spasmodic dysphonia reveal whether existing scales that measure presenteeism might be useful for those with voice disorders