During COVID-19, government measures to prevent disease spread included advice to work from home. In addition to occupational risk factors, the increased use of telecommunication and changed work environment may contribute to voice and vocal tract discomfort (VTD). This study established the prevalence, incidence, characteristics and impact of self-perceived dysphonia and VTD in those working from home during COVID-19. Methods. A cross-sectional, observational study using an online survey recruited 1575 participants. It captured information about dysphonia and VTD presence, onset, and severity. Those with dysphonia completed the voicerelated quality of life to measure impact. Regression analyses identified risk factors for voice and vocal tract problems. Results. Dysphonia and VTD prevalence rates were 33% and 68%, respectively, incidences were 28% and 50%. Perceived dysphonia severity was mild in 72% of cases. Dry throat was the most common VTD symptom at 66%. Mean voice-related quality of life score was 82.4 (standard deviation § 13.2). Raising or straining the voice while working predicted new onset dysphonia and VTD. Increasing telecommunication use was associated with worse dysphonia and VTD onset. Conclusion. Those working from home have seen a rise in dysphonia and VTD, which were associated with communication modality and change in environment. If home offices become the 'new normal' post-COVID, workplaces should consider voice training for employees to limit potential difficulties.
Context. Dysphagia is usually associated with malignancies of the head, neck, and upper gastrointestinal tract but also occurs in those with tumors outside anatomic swallow regions. It can lead to aspiration pneumonia, malnutrition, reduced quality of life, and psychosocial distress. No studies have yet reliably described dysphagia prevalence in those with malignancies outside anatomic swallow regions.Objective. The objective of this study was to establish the prevalence and predictors of dysphagia in adults with solid malignancies outside the head, neck, and upper gastrointestinal tract.Methods. A cross-sectional, observational study using consecutive sampling was conducted. There were 385 participants (mean age 66 AE 12 years) with 21 different primary cancer sites from two acute hospitals and one hospice. Locoregional disease was present in 33%, metastatic in 67%. Dysphagia was screened by empirical questionnaire and confirmed through swallow evaluation. Demographic and clinical predictors were determined by univariate and multivariate binary regression.Results. Dysphagia occurred in 19% of those with malignancies outside anatomic swallow regions. Prevalence was 30% in palliative care and 32% in hospice care. Dysphagia was most strongly associated with cough, nausea, and worse performance status. It was also associated with lower quality of life and nutritional difficulties.Conclusion. Dysphagia was common and usually undiagnosed before study participation. It occurred at all disease stages but coincided with functional decline. It may therefore represent a cancer frailty marker. Oncology and palliative care services should routinely screen for this symptom. Timely dysphagia identification and management may improve patient well-being and prevent adverse effects like aspiration pneumonia and weight loss.
This search yielded 20 eligible studies. Swallowing itself was impaired in only 9.3% of patients with TMDs. A range of additional OD signs and symptoms were also commonly reported (e.g. masticatory pain (87.4%) and fatigue (62%)). Study limitations included the small number of studies which were eligible for inclusion. As signs and symptoms of OD are frequently reported by patients with TMDs, psychometrically robust prospective research is warranted to determine current and optimal management of this condition.
Dysphagia is often associated with head and neck and upper gastrointestinal (GI) tract cancers. Evidence suggests that those with solid malignancies in other primary sites may also have swallowing difficulties. Timely and accurate identification of dysphagia is important given the impact it has on hydration, medical treatment, nutrition, prognosis, and quality of life. A systematic review was conducted to identify swallow screening, evaluation, and quality of life tools for those with solid malignancies outside the head and neck and upper GI tract. Ten electronic databases, one journal and two published conference proceedings were searched. Following deduplication, 7435 studies were examined for relevance. No tools were validated solely in this cancer population, though some included this group in larger cohorts. Comments are provided on the diagnostic properties and applicability of these tools. In the absence of appropriate diagnostic instruments, the exact prevalence of dysphagia and its impact on clinical and psychosocial well-being remain unknown. Accurate and adequate measurement of therapeutic intervention is also compromised. This review establishes the need for validated dysphagia evaluation tools for this clinical population.
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