嗓音障碍：一个定义性问题
Voice Disorders: A Defining Problem.
文献信息
| PMID | 42934082 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Dan Weinstein |
| 作者单位 | Department of Otolaryngology, University of Minnesota, 420 Delaware St SE, MMC 396, Minneapolis, Minnesota, 55455. |
| 期刊 | Journal of voice : official journal of the Voice Foundation |
| SCI 分区 | Q1 |
| IF | 2.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 由于人群异质性以及各研究所采用的嗓音障碍操作性定义不同，已报道的嗓音障碍患病率差异很大。本研究旨在比较使用既往发表的操作性定义对五个问题的回答，并将其与嗓音影响测量指标进行比较，同时从非临床人群中引出对“嗓音障碍”的定义以及寻求诊疗的可能原因。
方法： 对明尼苏达州立博览会的成年参与者进行横断面便利抽样调查，问卷包括五种不同的嗓音障碍操作性定义、针对功能性嗓音影响的条目以及定性反思。对五种操作性定义的回答采用百分比一致率和kappa系数进行分析，并使用描述性统计将定义与功能性嗓音影响测量指标进行相关性分析。对自由文本回答进行系统编码，以识别常见主题和亚主题。
结果： 在795名参与者中，操作性定义之间的比较显示嗓音障碍患病率范围为：当前4%-7%，过去12个月7%-15%，终生39%-62%。在各操作性定义之间，百分比一致率范围为70%-95%，kappa系数为0.37-0.77。在任何操作性定义下报告当前存在嗓音问题的受访者中，VHI-10平均得分为12.2-14.5（SD=6.0-7.7）。共有577名参与者对一个或多个操作性定义作出阳性回答。其中，48人（8.3%）报告曾寻求诊疗。关于什么构成嗓音问题以及什么会促使寻求诊疗的自由文本回答突出显示了疼痛/不适这一显著主题。该主题在既有的操作性定义和功能性嗓音影响量表中很少体现。
结论： 使用现有操作性定义测量的嗓音问题患病率总体上与其他评估嗓音影响的方法一致，但具体定义的措辞对患病率估计产生了有意义的影响，尤其是在长时间跨度上。未来需要进一步研究以阐明寻求诊疗的动机，以及在嗓音问题患病率估计中纳入疼痛/不适的重要性。
英文摘要
OBJECTIVES: Reported voice disorder prevalences vary widely across studies due to population heterogeneity and differences in operational definitions of voice disorders employed by those studies. The objective of this study was to compare responses to five questions using previously published operational definitions of voice disorder to each other and to measures of voice impact, and elicit definitions of "voice disorder" and potential reasons for care-seeking from nonclinical persons.
METHODS: A cross-sectional convenience sample of adult attendees of the Minnesota State Fair completed a survey including five different operational definitions of a voice disorder, items targeting measures of functional voice impact, and qualitative reflections. Responses to the five operational definitions were analyzed using percent agreement and kappa coefficients, with descriptive statistics used to correlate definitions with measures of functional voice impact. Free-text responses were coded systematically to identify common themes and subthemes.
RESULTS: In 795 participants, comparison between operational definitions showed prevalence of voice disorders ranging from 4%-7% currently, 7%-15% in the past 12 months, and 39%-62% lifetime. Across operational definitions, percent agreement ranged from 70%-95%, with kappa coefficients 0.37-0.77. Mean VHI-10 scores among respondents reporting a current voice problem on any operational definition were 12.2-14.5 (SD=6.0-7.7). A total of 577 participants indicated a positive response to one or more operational definitions. Of these, 48 individuals (8.3%) reported having sought care. Free-text responses regarding what constitutes a voice problem and what would prompt care-seeking highlighted pain/discomfort as a salient theme. This theme is rarely represented in established operational definitions and functional voice impact scales.
CONCLUSIONS: The prevalence of voice problems measured using existing operational definitions was generally concordant with other ways to assess voice impact, but the specific definition wording meaningfully impacted prevalence estimates, especially across long time horizons. Future studies are needed to further elucidate care-seeking motivations and the importance of including pain/discomfort in voice problem prevalence estimates.