Publications by authors named "Janet Baker"

27 Publications

  • Page 1 of 1

Health-related Quality of Life of Older Women Religious: Negative Influence of Frailty.

West J Nurs Res 2020 12 21;42(12):1088-1096. Epub 2020 Jun 21.

Ursuline College, Pepper Pike, OH, USA.

The purpose of the current study was to describe the health-related quality of life (HRQOL) of older women religious (WR) and examine variables that may influence HRQOL.The sample consisted of WR, 65 years or older, living in the Cleveland Catholic Diocese. The participants completed a medical history, body-mass index (BMI) and blood pressure measurement, and self-report measures of HRQOL, frailty, social support, resilience, and depression. The study sample was composed of 108 older WR with a mean age of 75.6 (range 65-93 years). The women reported high levels of daily functioning, resilience, and social support, with low levels of depression. WR describe a relatively high level of HRQOL. Frailty was an independent negative predictor of HRQOL in all subscales except general health. Resilience and fear of falling had significant effects on several HRQOL subscales.
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http://dx.doi.org/10.1177/0193945920936171DOI Listing
December 2020

Health and Daily Functioning of Older Women Religious.

J Am Geriatr Soc 2019 09 14;67(9):1866-1870. Epub 2019 May 14.

Breen School of Nursing, Ursuline College, Pepper Pike, Ohio.

Objectives: Women religious in the United States are aging as a population. These women live in a communal setting, eat from the same kitchen, are nulliparous, and have similar access to healthcare. The purpose of this study was to examine the general health and health practices of a modern sample of older women religious.

Design: Cross-sectional descriptive study.

Setting: Cleveland Catholic Diocese, Cleveland, Ohio.

Participants: Older women religious (n = 108), 65 years or older, living independently within the Cleveland Catholic Diocese who could participate in a study interview, undergo a morphometric examination, and complete several questionnaires in English.

Measurements: Study participants completed a study interview in which their demographic information, medical history, body mass index (BMI), and blood pressure were obtained. Participants completed several questionnaires including the Tilburg Frailty Indicator, Falls Efficacy Scale-International, Lawton Instrumental Activities of Daily Living Scale, Geriatric Depression Scale-Short Form, and the HbL Medication Risk Questionnaire.

Results: The women in our sample were all white with a mean age of 75.6 years (range = 65-93 y). The vast majority (n = 104 [96%]) had at least a bachelor's degree. Prevalence for chronic diseases was notable for cataracts (60%), hypertension (60%), thyroid disorders (30%), osteoporosis (17%), and diabetes (7%). Nearly half of the sample (n = 48 [44%]) met BMI criteria for obesity, and another 39 women (36%) were overweight. Most women participated in yearly dental examinations (84.5%), eye examinations (79.4%), mammography (84.5%), and pneumovax vaccination (80.4%). Just over half of the women had the recommended colonoscopy (58.8%) and bone density (56.7%) screenings. Twenty women (19%) reported significant frailty, and 38 (35%) reported a significant fear of falling. The majority (80%) would benefit from a discussion about their medications.

Conclusion: Older women religious experience health issues that could benefit from targeted preventive health education and screening. J Am Geriatr Soc 67:1866-1870, 2019.
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http://dx.doi.org/10.1111/jgs.15984DOI Listing
September 2019

Self-expression and identity after total laryngectomy: Implications for support.

Psychooncology 2018 11 12;27(11):2638-2644. Epub 2018 Jul 12.

School of Medical and Health Sciences, Edith Cowan University, Western Australia, Australia.

Objective: To explore how individuals with a laryngectomy (IWL) from diverse backgrounds make meaning and adjust to the physical and functional changes from a total laryngectomy. To examine the extent primary supporters (PS) and health professionals (HP) are able to support IWL with the psychosocial and existential challenges rendered by a surgery that significantly impacts a person's talking, breathing, swallowing, and appearance.

Methods: A constructivist grounded theory approach and symbolic interactionism were used to guide data collection and analysis. Semi-structured interviewing occurred.

Results: Twenty-eight participants (12 IWL, 9 PS, and 7 HP) were interviewed. The findings suggest that IWL experience significant change to their self-identity and there is evidence of a range of passive and active reframing patterns (destabilised, resigned, resolute, and transformed). The loss of self-expression included changes to communicative participation, personal style, food preferences, and social roles. Short and longer-term supports appear to influence outcomes but are often ill-equipped to manage the psychosocial needs of IWL.

Conclusions: Loss of self-expression after total laryngectomy influences self-identity and adjustment. How individuals reframe their identity appears to be tied with how they view their disabilities and disfigurement. These perceptions also appear to be influenced by the reactions of others and the support available. Further resourcing, education, and training are needed so that PS and HP can provide holistic care.
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http://dx.doi.org/10.1002/pon.4818DOI Listing
November 2018

Validating the Changes to Self-identity After Total Laryngectomy.

Cancer Nurs 2019 Jul/Aug;42(4):314-322

Authors Affiliations: College of Nursing and Health Sciences, Flinders University, Adelaide (Dr Bickford and Adjunct Associate Professor Baker and Professor Coveney); and School of Medicine and Health Sciences, Edith Cowan University, Western Australia (Associate Professor Hersh).

Background: A total laryngectomy often prolongs life but results in long-term disablement, disfigurement, and complex care needs. Current clinical practice addresses the surgical options, procedures, and immediate recovery. Less support is available longer-term despite significant changes to aspects of personhood and ongoing medical needs.

Objective: The aim of this study was to explore the experience of living with and/or supporting individuals with a laryngectomy at least 1 year after surgery.

Methods: Constructivist grounded theory methods and symbolic interactionism were used to guide collection and analysis of interview data from 28 participants (12 individuals with a laryngectomy, 9 primary supporters, and 7 health professionals).

Results: The phenomena of "validating the altered self after total laryngectomy" highlighted how individuals, postlaryngectomy, navigate and negotiate interactions due to the disruption of their self-expression, related competencies, and roles. Several reframing patterns representing validation of the self emerged from the narratives. They were as follows: destabilized, resigned, resolute, and transformed. The data describe the influence of the processes of developing competence and building resilience, combined with contextual factors, for example, timing and turning points; being supported; and personal factors on these reframing patterns.

Conclusion: The findings further our understanding of the long-term subjective experience of identity change after laryngectomy and call attention to the persisting need for psychosocial support.

Implications For Practice: This research provides important evidence for evaluating and strengthening the continuum of services (specialist to community) and supporting social participation, regardless of communication method, and for competency training for all involved to optimize person-centered practices.
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http://dx.doi.org/10.1097/NCC.0000000000000610DOI Listing
April 2020

Teaching Strategies to Increase Nursing Student Acceptance and Management of Unconscious Bias.

J Nurs Educ 2017 Nov;56(11):692-696

Background: Medical providers' unconscious biases may contribute to health disparities. Awareness and self-reflection strategies commonly used to teach cultural competence in academic settings are generally ineffective in reducing unconscious bias or motivating change.

Method: This article describes the innovative teaching strategies implemented in a graduate setting (N = 75) to increase nursing learners' acceptance and management of unconscious bias. Strategies used guided the debriefing and feedback that incorporated implicit association testing, interactive audience polling, categorized management strategies, and perspective taking.

Results: Strategies resulted in positive learner feedback, including a high likelihood to learn more about unconscious bias, acceptance of unconscious bias influence on health disparities, and importance of using management strategies to address personal bias.

Conclusion: Increasingly diverse patient populations require nurses who have the skills to understand, assess, and correct unconscious biases. To accomplish this goal, consistent exposure to unconscious bias curricula that includes focused debriefing, feedback, and management strategies is needed at all levels of nursing education. [J Nurs Educ. 2017;56(11):692-696.].
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http://dx.doi.org/10.3928/01484834-20171020-11DOI Listing
November 2017

Innovative Teaching for Undergraduate Nursing Students Through Mastery Modeling.

Nurs Educ Perspect 2018 May/Jun;39(3):184-186

About the Authors Kathleen A. Gordon, MSN, RN, CNS, CNE, CHSE, is an assistant professor and simulation lab coordinator, Department of Nursing, Aultman College of Nursing and Health Sciences, Canton, Ohio. Kelly E. Carmany, MSN, RN, CNE, is an assistant professor, Aultman College of Nursing and Health Sciences. Janet R. Baker, DNP, APRN, ACNS-BC, CPHQ, CNE, is associate dean of the Graduate Nursing Program at The Breen School of Nursing, Ursuline College, Pepper Pike, Ohio. Laura M. Goliat, DNP, RN, FNP-BC, is an assistant professor, The Breen School of Nursing, Ursuline College. For more information, contact Mrs. Gordon at

Mastery modeling was implemented to support the transfer of classroom diabetes content to the clinical area. Interactive teaching methodologies that exemplified mastery modeling included scripted classroom video and vignettes, simulation-based learning experiences, and a worksheet relating to diabetes-specific groups to use in the clinical setting. When mastery modeling teaching methodologies were implemented, transfer of knowledge through clinical reasoning was noted at a higher level for the diabetes-specific groups over the standard groups.
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http://dx.doi.org/10.1097/01.NEP.0000000000000234DOI Listing
September 2019

Continuity of midwifery care for rural women through caseload group practice: Delivering for almost 20 years.

Aust J Rural Health 2015 Dec;23(6):339-45

Midwifery, Northeast Health Wangaratta, Wangaratta, Victoria, Australia.

Objective: To describe the clinical outcomes and sustainability factors of a long-standing midwifery led caseload model of rural maternity care.

Design: Retrospective clinical audit from 1998 to 2011 and autoethnographic narrative of the midwifery program told by the longest serving midwives under three key themes relating to sustainable practice.

Setting: Regional Health Service with annual birth rate of 500. Maternity care is provided by either public antenatal clinic/GP shared care or midwife-led care.

Participants: Women attending a rural caseload midwifery group practice between the period 1998-2011 and midwives working in the same group practice during that period.

Main Outcome Measures: Antenatal attendance, maternal mortality, infant morbidity and mortality, mode of birth, known midwife at birth, initiation of breastfeeding.

Results: There were 1674 births between 1998 and 2011. Clinical outcomes for women and infants closely reflected national maternity indicator data. The group practice midwives attribute sustainability of the program to the enjoyment of flexibility in their working environment, to establishing trust amongst themselves, the women they care for, and with the obstetricians, GPs and health service executives. The rigorous application of midwifery principles including robust clinical governance have been hallmarks of success.

Conclusion: This caseload midwifery group practice is a safe, satisfying and sustainable model of maternity care in a rural setting. Clinical outcomes are similar to standard care. Success can be attributed to strong leadership across all levels of policy, health service management and, most importantly, the rural midwives providing the service.
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http://dx.doi.org/10.1111/ajr.12232DOI Listing
December 2015

Revitalization.

CANNT J 2014 Apr-Jun;24(2):4-5

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October 2014

Patterns of emotional expression and responses to health and illness in women with functional voice disorders (MTVD) and a comparison group.

J Voice 2014 Nov 21;28(6):762-9. Epub 2014 Jun 21.

Health Professional Education, School of Medicine, Flinders University, Adelaide, South Australia, Australia. Electronic address:

Objectives: To determine whether emotional expression, alexithymia, illness behavior, and coping strategies differed between women with muscle tension voice disorder (MTVD) and those without voice disorder and between women with and without mucosal pathology of the vocal folds, and to explore possible links between psychosocial constructs and clinical features in women with MTVD.

Study Design And Method: A within-subjects design matched 20 women with MTVD and 20 women without voice disorder on validated self-report measures of the psychosocial constructs. The effect of mucosal pathology was assessed using between-groups analyses. Correlations assessed relationships between psychosocial constructs and clinical features.

Results: Comparisons between women with MTVD and those without voice disorder showed an elevated sense of illness identity and greater belief in the presence of somatic illness in women with MTVD. There was a trend toward women with MTVD showing lower levels of emotional awareness. Women without vocal fold pathology reported lower levels of emotional awareness than those with pathology, whereas women with pathology reported greater use of a mixed pattern of adaptive and maladaptive coping strategies than those with no pathology. Low vocal load was associated with higher scores on alexithymia, higher numbers of vocal symptoms were associated with the use of adaptive coping, and greater impact of symptoms was associated with higher levels of emotional awareness and greater belief in the presence of somatic illness.

Conclusions: These findings encourage further investigation of relationships between emotional awareness, illness behavior, and coping in women with functional voice disorders.
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http://dx.doi.org/10.1016/j.jvoice.2014.03.005DOI Listing
November 2014

This is who I am.

CANNT J 2013 Jul-Sep;23(3):35-7

Hemodialysis Unit, Halton Healthcare Services, Oakville, ON.

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January 2014

Speech-specific tuning of neurons in human superior temporal gyrus.

Cereb Cortex 2014 Oct 16;24(10):2679-93. Epub 2013 May 16.

Department of Neurology.

How the brain extracts words from auditory signals is an unanswered question. We recorded approximately 150 single and multi-units from the left anterior superior temporal gyrus of a patient during multiple auditory experiments. Against low background activity, 45% of units robustly fired to particular spoken words with little or no response to pure tones, noise-vocoded speech, or environmental sounds. Many units were tuned to complex but specific sets of phonemes, which were influenced by local context but invariant to speaker, and suppressed during self-produced speech. The firing of several units to specific visual letters was correlated with their response to the corresponding auditory phonemes, providing the first direct neural evidence for phonological recoding during reading. Maximal decoding of individual phonemes and words identities was attained using firing rates from approximately 5 neurons within 200 ms after word onset. Thus, neurons in human superior temporal gyrus use sparse spatially organized population encoding of complex acoustic-phonetic features to help recognize auditory and visual words.
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http://dx.doi.org/10.1093/cercor/bht127DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4162511PMC
October 2014

A new year--a new approach.

CANNT J 2013 Jan-Mar;23(1):4-5

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July 2013

Living with the altered self: a qualitative study of life after total laryngectomy.

Int J Speech Lang Pathol 2013 Jun 16;15(3):324-33. Epub 2013 Apr 16.

Flinders University, Adelaide, Australia. jane.bickford@fl inders.edu.au

Total laryngectomy (TL), a life-preserving surgery, results in profound physical and communication changes for the individual. Physical and psychosocial adjustment to a TL is complex, and quality-of-life (QoL) measures have provided useful knowledge to assist clinical management. However, many tools were developed without considering the perspectives of people who have experienced TL. To improve understanding of the phenomena of living with TL, a qualitative study was conducted which explored the views and experiences of seven men and five women from a range of ages, geographical locations, and social situations who had undergone a TL. Data were collected through in-depth, semi-structured interviews, journals, and field notes, and analysed using a constructivist grounded theory approach and symbolic interactionism. The emergent concept was identifying with the altered self after TL as reflected in dynamic multi-level changes (physical, communication, and psycho-emotional) continuously interacting with intrinsic and extrinsic interpersonal factors including personal and socio-cultural constructs, e.g., age, gender, resilience, beliefs, and supports. This process affected the strategies these individuals used to negotiate their social experiences. The extent to which communication changes disrupted social roles affecting a person's sense of self appeared to relate to long-term adjustment.
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http://dx.doi.org/10.3109/17549507.2013.785591DOI Listing
June 2013

Psychosocial risk factors which may differentiate between women with Functional Voice Disorder, Organic Voice Disorder and a Control group.

Int J Speech Lang Pathol 2013 Dec 17;15(6):547-63. Epub 2012 Oct 17.

Flinders University , Adelaide, SA , Australia.

This study aimed to explore psychosocial factors contributing to the development of functional voice disorders (FVD) and those differentiating between organic voice disorders (OVD) and a non-voice-disordered control group. A case-control study was undertaken of 194 women aged 18-80 years diagnosed with FVD (n = 73), OVD (n = 55), and controls (n = 66). FVD women were allocated into psychogenic voice disorder (PVD) (n = 37) and muscle tension voice disorder (MTVD) (n = 36) for sub-group analysis. Dependent variables included biographical and voice assessment data, the number and severity of life events and difficulties and conflict over speaking out (COSO) situations derived from the Life Events and Difficulties Schedule (LEDS), and psychological traits including emotional expressiveness scales. Four psychosocial components differentiated between the FVD and control group accounting for 84.9% of the variance: severe events, moderate events, severe COSO, and mild COSO difficulties. Severe events, severe and mild COSO difficulties differentiated between FVD and OVD groups, accounting for 80.5% of the variance. Moderate events differentiated between PVD and MTVD sub-groups, accounting for 58.9% of the variance. Psychological traits did not differentiate between groups. Stressful life events and COSO situations best differentiated FVD from OVD and control groups. More refined aetiological studies are needed to differentiate between PVD and MTVD.
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http://dx.doi.org/10.3109/17549507.2012.721397DOI Listing
December 2013

First-pass selectivity for semantic categories in human anteroventral temporal lobe.

J Neurosci 2011 Dec;31(49):18119-29

Medical Engineering and Medical Physics, Harvard-MIT Division of Health Science and Technology, Cambridge, Massachusetts 02139, USA.

How the brain encodes the semantic concepts represented by words is a fundamental question in cognitive neuroscience. Hemodynamic neuroimaging studies have robustly shown that different areas of posteroventral temporal lobe are selectively activated by images of animals versus manmade objects. Selective responses in these areas to words representing animals versus objects are sometimes also seen, but they are task-dependent, suggesting that posteroventral temporal cortex may encode visual categories, while more anterior areas encode semantic categories. Here, using the spatiotemporal resolution provided by intracranial macroelectrode and microelectrode arrays, we report category-selective responses to words representing animals and objects in human anteroventral temporal areas including inferotemporal, perirhinal, and entorhinal cortices. This selectivity generalizes across tasks and sensory modalities, suggesting that it represents abstract lexicosemantic categories. Significant category-specific responses are found in measures sensitive to synaptic activity (local field potentials, high gamma power, current sources and sinks) and unit-firing (multiunit and single-unit activity). Category-selective responses can occur at short latency (as early as 130 ms) in middle cortical layers and thus are extracted in the first pass of activity through the anteroventral temporal lobe. This activation may provide input to posterior areas for iconic representations when required by the task, as well as to the hippocampal formation for categorical encoding and retrieval of memories, and to the amygdala for emotional associations. More generally, these results support models in which the anteroventral temporal lobe plays a primary role in the semantic representation of words.
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http://dx.doi.org/10.1523/JNEUROSCI.3122-11.2011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3286838PMC
December 2011

The therapeutic relationship once established, need never be broken.

Authors:
Janet Baker

Int J Speech Lang Pathol 2010 Aug;12(4):309-12: discussion 329-32

Department of Speech Pathology and Audiology, Flinders University, Adelaide, Australia.

In the lead article, Hersh (2010) draws attention to the significant phase of ending therapy for clients and in particular, for their therapists. Hersh highlights three main tensions that underpin this process: real versus ideal endings, making and breaking of the therapeutic relationship, and balancing of respect for client autonomy over considerations of caseload and resources. In this paper, I offer a commentary on the first two of these issues by drawing upon my experience as a speech-language pathologist/family therapist specializing in voice, and as an academic fostering the development of student clinicians. This is then linked to parallel discussions in the recent psychoanalytic and psychotherapy literature. I support Hersh's premise that the implicit processes and emotions associated with this final phase of therapy need to be made more explicit and suggest that this is more likely to occur when clinicians acknowledge that they too experience rewards and losses in the therapeutic relationship. I challenge the notion that any therapeutic relationship once established is ever entirely broken.
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http://dx.doi.org/10.3109/17549501003749842DOI Listing
August 2010

Women's voices: lost or mislaid, stolen or strayed?

Authors:
Janet Baker

Int J Speech Lang Pathol 2010 Apr;12(2):94-106

Department of Speech Pathology and Audiology, The Flinders University of South Australia, GPO Box 2100, Adelaide, SA 5001, Australia.

It is estimated that disorders of voice affect 3-4% of people from all strata of Australian society and while some voice disorders may be caused by organic conditions, most patients are troubled by non-organic or functional voice disorders (FVD). As professionals dealing with these problems, we wonder about the role of strong negative emotions arising from stressful life experiences preceding onset, or dispositional factors that may influence ways in which an individual responds to such incidents. We wonder too, how these complex processes may be inter-related, and if this may account for one person misusing or damaging the voice, while another loses the voice altogether. Evidence for the possible relationship between negative emotions arising out of stressful events and onset of FVD in women is briefly presented. The findings suggest that women with FVD may have difficulty in the processing of negative emotions, and when considered in a wider socio-cultural perspective, it is proposed that some have temporarily lost their voices, while others have been rendered powerless and had their voices stifled. These findings serve as the foundation for a broader discussion about the possible implications for the speech pathology profession which might be at risk of losing its voice.
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http://dx.doi.org/10.3109/17549500903480060DOI Listing
April 2010

Chronic kidney disease: what's in a name?

CANNT J 2009 Apr-Jun;19(2):19-22

University Hospital, London Health Sciences Centre, London, ON.

There is a lack of precision and clarity in the terms used to describe chronic kidney disease (CKD). Inconsistent terminology is confusing for both practitioners and patients. The purpose of this article is to review and examine various terms used to label CKD and to propose an evidence-based recommendation to support the use of a standard terminology for CKD.
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September 2009

Metformin in combination with structured lifestyle intervention improved body mass index in obese adolescents, but did not improve insulin resistance.

Endocrine 2009 Aug 23;36(1):141-6. Epub 2009 Apr 23.

Children's Hospital, London Health Sciences Centre, London, ON, N6A 5W9, Canada.

This study assessed the efficacy of adding metformin to a structured lifestyle intervention in reducing BMI in obese adolescents with insulin resistance. Obese adolescents (25) aged 10-16 years with a body mass index (BMI) > 95th percentile and insulin resistance (Homeostasis Model Assessment-HOMA) > 3.0 were assessed in a community clinic. A structured lifestyle intervention comprising nutritional and exercise education and motivational support in both individual and group sessions was delivered over 6 months. Subjects were randomized to lifestyle intervention alone or with metformin (1500 g daily). The primary outcome measures were a change in BMI and modification of metabolic risk factors, including insulin resistance, plasma lipids and adipocytokines. Eleven adolescents receiving lifestyle and metformin intervention and 14 receiving lifestyle alone completed the study. BMI decreased by 1.8 kg/m(2) with lifestyle and metformin but did not change with lifestyle alone. HOMA was significantly decreased in the lifestyle intervention group, but not following metformin, while the adiponectin/leptin ratio improved significantly in both groups. Dyslipidemic profiles improved most significantly with metformin. We conclude that metformin in combination with a 6-month structured lifestyle intervention is effective in reducing BMI in obese adolescents but did not improve insulin resistance. Lifestyle intervention, with or without metformin, improved metabolic risk factors such as plasma lipids and adipocytokines.
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http://dx.doi.org/10.1007/s12020-009-9196-9DOI Listing
August 2009

The role of psychogenic and psychosocial factors in the development of functional voice disorders.

Authors:
Janet Baker

Int J Speech Lang Pathol 2008 ;10(4):210-30

The Flinders University of South Australia, Australia.

The primary objective of this discussion paper is to review the available evidence for the role of psychogenic and psychosocial factors in the development of functional voice disorders (FVD). Current theoretical models linking these factors to the aetiology of FVD and to vocal hyperfunction are then considered. Since there is a paucity of solid empirical evidence to date, general patterns of evidence derived from single case reports and case series are examined first, followed by those empirical studies using more sophisticated methodologies. The discussion is structured around a framework that includes the following psychosocial areas of enquiry: demographic profiles of individuals with FVD; stressful incidents preceding onset; personality traits; coping styles and psychiatric disorder. Current evidence and associated theoretical models suggest that cognitive, affective, neurophysiological and behavioural aspects culminate in the development of these complex voice disorders. The implications of these findings are discussed with respect to clinical practice and clinical training, with suggestions for future scientific research.
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http://dx.doi.org/10.1080/17549500701879661DOI Listing
October 2012

Development of a modified diagnostic classification system for voice disorders with inter-rater reliability study.

Logoped Phoniatr Vocol 2007 ;32(3):99-112

Department of Psychiatry, Flinders University, and Clinical Epidemiology, Flinders Medical Centre, South Australia, Australia.

Diversity in nomenclature and on-going dilemmas over the conceptual bases for the classification of voice disorders make it virtually impossible for the collation and accurate comparison of evidence-based data across different clinical settings. This has significant implications for treatment outcome studies. The first aim of this study was to develop a modified diagnostic classification system for voice disorders with clearly defined operational guidelines by which we might reliably distinguish voice disorders from one another. The second aim was to establish the face validity and reliability of the system as an effective diagnostic tool for the allocation of patients to different diagnostic groups for clinical and research purposes. After the Diagnostic Classification System for Voice Disorders (DCSVD) had been developed, it was used in an inter-rater reliability study for the independent assessment of 53 new consecutive patients referred to the Voice Analysis Clinics of three tertiary hospitals. There were three raters present for the assessment and diagnostic allocation of each patient. The high levels of inter-rater reliability suggest this may be a robust classification system that has good face validity and even at this early stage, strong construct validity.
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http://dx.doi.org/10.1080/14015430701431192DOI Listing
February 2008

Remember me: a permanent memorial created through the art of quilting.

CANNT J 2005 Oct-Dec;15(4):42-3

PRI Clinic, Halton Healthcare Services Corporation, Oakville, Ontario.

For those with end stage renal disease, dialysis can become a way of life that goes on for years at a time. As care providers to this chronic population, staff very often become connected not only to the patient, but also to their families. When a patient dies, staff would like to be able to acknowledge this special connection while supporting family members, remaining patients and each other. Quilting embodies the values of beauty, sentiment and history. A quilt was crafted to celebrate the lives of the 120 patients who have died since the opening of our dialysis program. This permanent memorial will serve as a tribute to friends whom we have known and do not want to forget.
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March 2006

Psychogenic voice disorders and traumatic stress experience: a discussion paper with two case reports.

Authors:
Janet Baker

J Voice 2003 Sep;17(3):308-18

Department of Psychiatry, The Flinders University of South Australia, School of Medicine, Adelaide, Australia.

Psychogenic dysphonia refers to loss of voice where there is insufficient structural or neurological pathology to account for the nature and severity of the dysphonia, and where loss of volitional control over phonation seems to be related to psychological processes such as anxiety, depression, conversion reaction, or personality disorder. Such dysphonias may often develop post-viral infection with laryngitis, and generally in close proximity to emotionally or psychologically taxing experiences, where "conflict over speaking out" is an issue. In more rare instances, severe and persistent psychogenic dysphonia may develop under innocuous or unrelated circumstances, but over time, it may be traced back to traumatic stress experiences that occurred many months or years prior to the onset of the voice disorder. In such cases, the qualitative nature of the traumatic experience may be reflected in the way the psychogenic voice disorder presents. The possible relationship between psychogenic dysphonia and earlier traumatic stress experience is discussed, and the reportedly low prevalence of conversion reaction (4% to 5%) as the basis for psychogenic dysphonia is challenged. Two cases are presented to illustrate the issues raised: the first, a young woman who was sexually assaulted and chose to "keep her secret," and the second, a 52-year-old woman who developed a psychogenic dysphonia following a second, modified thyroplasty for a unilateral vocal fold paresis.
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http://dx.doi.org/10.1067/s0892-1997(03)00015-8DOI Listing
September 2003

Inpatient pediatric consultation-liaison: a case-controlled study.

J Pediatr Psychol 2003 Sep;28(6):423-32

University of Louisville School of Medicine, Kentucky 40202, USA.

Objective: To conduct a prospective case-controlled study of pediatric inpatients referred for consultation in a tertiary care children's medical center.

Method: Referrals (n = 104) were matched with nonreferrals (n = 104) for age (4 to 18 years), gender, and illness type/severity and completed parent- and self-report (dependent on age) behavioral rating scales to assess for adjustment/functioning. Nurses completed in-hospital ratings of behavioral/adjustment difficulties. Goal attainment and satisfaction ratings were obtained from the referring physicians, parents/guardians, and the consultant.

Results: Referrals exhibited more behavior/adjustment/coping difficulties than nonreferrals by parent, nurse, and self report. Frequently employed interventions included coping-strategies intervention, cognitive and behavioral therapies, and case management. Referring physician and consultant ratings of goal attainment were high, as were physician ratings of satisfaction and parent/guardian ratings of overall helpfulness.

Conclusions: Pediatric inpatients referred by their physicians had significantly more internalizing and externalizing disturbances than their nonreferred hospitalized peers. Many of the behavioral and adjustment problems that lead to in-hospital consultation referral were evident in global behavior difficulties prior to hospitalization. Referring pediatricians, parents/guardians, and consultants rate the outcome as benefiting the patients via assisting in the overall management of their health concerns, coping, and adjustment.
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http://dx.doi.org/10.1093/jpepsy/jsg032DOI Listing
September 2003

Persistent dysphonia in two performers affecting the singing and projected speaking voice: a report on a collaborative approach to management.

Authors:
Janet Baker

Logoped Phoniatr Vocol 2002 ;27(4):179-87

Department of Psychiatry, School of Medicine, The Flinders University of South Australia, GPO Box 2100, Adelaide, South Australia 5001, Australia.

The projected speaking voice and the singing voice are highly sensitive to external and internal influences, and teachers of spoken voice and singing are in a unique position to identify subtle and more serious vocal difficulties in their students. Persistent anomalies may herald early onset of changes in vocal fold structure, neurophysiological control, or emotional stability. Two cases are presented to illustrate the benefits of a collaborative approach to diagnosis and management. The first, a 21-year-old male drama and singing student with an abnormally high speaking voice and falsetto singing voice was found to have a psychogenic dysphonia referred to as "puberphonia" or "mutational falsetto". The second, a 34-year-old female alto with strained phonation and perceived stutter of the vocal folds was diagnosed with "adductor spasmodic dysphonia" or "focal laryngeal dystonia" of neurological origin.
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http://dx.doi.org/10.1080/140154302762493234DOI Listing
May 2003

Psychogenic voice disorders--heroes or hysterics? A brief overview with questions and discussion.

Authors:
Janet Baker

Logoped Phoniatr Vocol 2002 ;27(2):84-91; discussion 91

Department of Psychiatry, School of Medicine, The Flinders University of South Australia, GPO Box 2100, 5001 Adelaide, South Australia, Australia.

A brief overview of the field in relation to psychogenic voice disorders is given with reference to past and present terminology used, the common presentations seen, followed by the more subtle or ambiguous examples which may challenge our notions of psychogenic or clear-cut functional versus organic dichotomies. Issues related to aetiology, personality and psychological correlates are discussed, and a number of questions regarding the phenomenology of psychogenic dysphonia and its therapeutic resolution are raised. Since prevalence continues to be significantly in favour of women, it is suggested psychogenic voice disorder as a feminist issue might be worthy of our further consideration.
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http://dx.doi.org/10.1080/140154302760409310DOI Listing
April 2003