Revista CEFAC
https://revistacefac.org.br/article/doi/10.1590/1982-0216/202426312523
Revista CEFAC
Original Articles

Structure of treatment goals set by expert voice-specialized speech-language pathologists for patients with vocal needs

Estructura de los objetivos terapéuticos formulados  por fonoaudiólogos/as en la intervención de usuarios/as  con necesidades vocales

Jaime Crisosto-Alarcón; Arturo Flores

http://dx.doi.org/10.1590/1982-0216/202426312523 Revista CEFAC, vol.26, n3, e12523, 2024
PDF English
PDF Español
SciELO
Downloads: 0
Views: 187

Abstract

Purpose: to determine the structure of treatment goals set by expert voice-specialized speech-language pathologists in treatment plans for patients with vocal needs.

Methods: a cross-sectional documentary research was conducted to analyze 129 treatment goals proposed in treatment plans by 30 expert voice-specialized speech-language pathologists. These goals were thematically analyzed and organized according to the therapeutic content addressed. The goals including the notion of patient in their wording, the statement of a specific purpose, the method for achieving it, and the presence of outcome criteria, were evaluated.

Results: most treatment goals analyzed correspond to those aimed at modifying vocal parameters (67.4%). The contents referring to muscle tone (13.8%), vocal hygiene and education (10%), breathing (7.75%), and posture (1.55%) are represented to a lesser extent. From the total number of treatment goals analyzed, 82.17% include the notion of patient, 88.37% indicate the method, 100% indicate the purpose, 52.71% state the outcome criteria used, and 17.05% include other components in their structure.

Conclusions: diversity in goal setting shows different visions by the professionals involved in the therapeutic process.

Keywords

 Dysphonia; Planning; Clinical Decision-Making; Achievement; Voice Training

Resumen

Objetivo: determinar la estructura de los objetivos operacionales formulados por los/las fonoaudiólogos/ as en las planificaciones terapéuticas para usuarios con necesidades vocales.

Métodos: investigación documental transversal en que se analizaron 129 objetivos operacionales propuestos en las planificaciones terapéuticas de 30 fonoaudiólogos/as. Estos objetivos se sometieron a un proceso de análisis temático y se organizaron según el contenido terapéutico abordado. Se examinó la inclusión de la noción de usuario en la redacción, la declaración de una finalidad específica, el método para alcanzarla y la presencia de criterios de logro.

Resultados: de la totalidad de objetivos analizados, la mayoría corresponde a aquellos que están orientados a la modificación de parámetros vocales (67.4%). En menor medida, están representados los contenidos referentes a tonicidad muscular (13.8%), educación e higiene vocal (10%), respiración (7.75%) y postura (1.55%). Del total, un 82.17% incluye la noción de usuario, un 88.37% señala el método, el 100% indica la finalidad y un 52.71% declara los criterios de logro utilizados. Un 17.05% incluye otros componentes en su estructura.

Conclusiones: la diversidad en la formulación de los objetivos evidencia distintas visiones acerca del proceso terapéutico por parte de los profesionales involucrados.

Palabras clave

Disfonía; Planificación; Toma de Decisiones Clínicas; Logro; Entrenamiento de la Voz

Referencias

1. Van Stan JH, Whyte J, Duffy JR, Barkmeier-Kraemer J, Doyle P, Gherson S et al. Rehabilitation Treatment Specification System: Methodology to identify and describe unique targets and ingredients. Arch Phys Med Rehabil. 2021;102(3): 521-31. https://doi.org/10.1016/j.apmr.2020.09.383 PMID: 33065124.

2. Levack C, Weatherall M, Hay-Smith E, Dean S, McPherson K, Siegert R. Goal setting and strategies to enhance goal pursuit for adults with acquired disability participating in rehabilitation. Cochrane Database Syst. Rev. 2015;7:CD009727. https://doi.org/10.1002/14651858.CD009727.pub2 PMID: 26189709.

3. Inostroza-Moreno G. Orientaciones filosóficas en la intervención fonoaudiológica de voz. El desafío actual de dar el alta. Rev. Investig. Innov. Cienc. Salud. 2021;3(1):116-24. https://doi.org/10.46634/riics

4. Crisosto J, Flores A. Estructura de los objetivos terapéuticos en la intervención fonoaudiológica de usuarios con necesidades vocales: una revisión sistemática exploratoria. Rev. Chil. Fonoaudiol. 2022;21(1):1-20. https://doi.org/10.5354/0719-4692.2022.64698

5. Steiner W, Ryser L, Huber E, Uebelhart D, Aeschlimann A, Stucki G. Use of the ICF Model as a Clinical Problem-Solving Tool in physical therapy and rehabilitation medicine. Phys Ther. 2002;82(11):1098-107. https://doi.org/10.1093/ptj/82.11.1098 PMID: 12405874.

6. Schut H, Stam H. Goals in rehabilitation teamwork. Disabil. Rehabil. 1994;16(4):223-6. https://doi.org/10.3109/09638289409166616 PMID: 7812023.

7. Valaas HL, Klokkerudb M, Hildeskårc J, Haglandd A, Kjønlie E, Mjøsundf K et al. Rehabilitation goals described by patients with rheumatic and musculoskeletal diseases: Content and attainment during the first year after rehabilitation. Disabil. Rehabil. 2022;44(25):7947-57. https://doi.org/10.1080/09638288.2021.2003879 PMID: 34854330.

8. Plewnia A, Bengel J, Körner M. Patient-centeredness and its impact on patient satisfaction and treatment outcomes in medical rehabilitation. Patient Educ. Couns. 2016;99(12):2063-70. https://doi.org/10.1016/j.pec.2016.07.018 PMID: 27503286.

9. Wade D. Goal setting in rehabilitation: An overview of what, why and how. Clin. Rehabil. 2009;23(4)291-5. https://doi.org/10.1177/0269215509103551 PMID: 19293289.

10. American Speech-Language-Hearing Association. American Speech-Language-Hearing Association [Webpage on the internet]. 2023. [accessed 2023 may 25]. Available at: https://www.asha.org/

11. Landis K, Vander J, Jongsma A. The Speech-Language Pathology Treatment Planner. New Jersey: John Wiley & Sons, Inc. 2004.

12. Hart T, Dijkers MP, Whyte J, Turkstra LS, Zanca JM, Packel A et al. A Theory-Driven System for the specification of rehabilitation treatments. Arch Phys Med Rehabil. 2019;100(1):172-80. https://doi.org/10.1016/j.apmr.2018.09.109 PMID: 30267669.

13. Van Stan JH, Dijkers MP, Whyte J, Hart T, Turkstra LS, Zanca JM et al. The Rehabilitation Treatment Specification System: Implications for improvements in research design, reporting, replication, and synthesis. Arch Phys Med Rehabil. 2019;100(1):146-55. https://doi.org/10.1016/j.apmr.2018.09.112 PMID: 30267666.

14. Crisosto J. Theoretical proposal for therapy planning in vocal practice: An ICF model. Rev. Chil. Fonoaudiol. 2021;20:1-18. https://doi.org/10.5354/0719-4692.2021.58315

15. González R, Donoso A. Programa de rehabilitación fonoaudiológica para pacientes afásicos. Rev. Chil. Fonoaudiol. 2000;2(3):35-48.

16. Lignugaris/Kraft B, Marchand-Martella N, Martella RC. Writing better goals and short-term objectives or benchmarks. Teach. Except. Child. 2001;34(1):52-9. https://doi.org/10.1177/004005990103400107

17. Chacon JEA. Metodología de Planificación Operacional. Revista Electrónica de Trabajo Social de la Universidad de Concepción. 2015 Nov;12:82-102.

18. Ogbeiwi O. General concepts of goals and goal-setting in healthcare: A narrative review. J. Manag. Organ. 2018;27(2):324-41. https://doi.org/10.1017/jmo.2018.11

19. Ogbeiwi O. Why written objectives need to be really SMART. Br. J. Health Care Manag. 2017;23(7):324-36. https://doi.org/10.12968/bjhc.2017.23.7.324

20. Levack W, Siegert R. Challenges in theory, practice and evidence. In: Siegert RLW, editor. Rehabilitation goal setting: Theory, practice and evidence. Florida: Taylor & Francis Group; 2015. p. 3-20. https://doi.org/10.1201/b17166

21. Doran GT. There's a SMART way to write management's goals and objectives. Manag. Rev. 1981;70(11):35-6.

22. Hersh D, Sherratt S, Howe T, Worrall L, Davidson B, Ferguson A. An analysis of the "goal" in aphasia rehabilitation. Aphasiology. 2012;26(8)971-84. https://doi.org/10.1080/02687038.2012.684339

23. Clarke SP, Crowe TP, Oades LG, Deane FP. Do goal-setting interventions improve the quality of goals in mental health services? Psychiatr. Rehabil. J. 2009;32(4):292-9. https://psycnet.apa.org/doi/10.2975/32.4.2009.292.299 PMID: 19346208.

24. Day T, Tosey T. Beyond SMART? A new framework for goal setting. Curric. J. 2011;22(4):515-34. https://doi.org/10.1080/09585176.2011.627213

25. Hersh D, Worrall L, Howe T, Sherratt S, Davidson B. SMARTER goal setting in aphasia rehabilitation. Aphasiology. 2012;26(2):220-33. https://doi.org/10.1080/02687038.2011.640392

26. Worrall L, Sherratt S, Rogers P, Howe T, Hersh D, Ferguson A et al. What people with aphasia want: Their goals according to the ICF. Aphasiology. 2011;25(3):309-22. https://doi.org/10.1080/02687038.2010.508530

27. McPherson K, Kayes NM, Kersten P. MEANING as a smarter approach to goals in rehabilitation. In: Siegert RJ, Levack WMM, editors. Rehabilitation goal setting theory, practice and evidence. Florida: Taylor and Francis Group; 2015. p.105-22. https://doi.org/10.1201/b17166

28. Krasny-Pacini A, Hiebel J, Pauly F, Godon S, Chevignard M. Goal attainment scaling in rehabilitation: A literature-based update. Ann. Phys. Rehabil. Med. 2013;56(3)212-30. https://doi.org/10.1016/j.rehab.2013.02.002 PMID: 23562111.

29. Turner-Stokes L. Goal attainment scaling (GAS) in rehabilitation: A practical guide. Clin. Rehabil. 2009;23(4):362-70. https://doi.org/10.1177/0269215508101742 PMID: 19179355. https://doi.org/10.1177/0269215508101742 PMID: 19179355.

30. Ma PM, Yiu ML, Verdolini K. Application of the ICF in voice disorders. Semin. Speech Lang. 2007;28(4):343-50. https://doi.org/10.1055/s-2007-986531 PMID: 17935019.

31. World Health Organization (WHO). World Health Organization [Webpage on the internet]. 2001. [accessed 2023 may 25]. Available at: https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health

32. Van Stan JH, Roy N, Awan S, Stemple J, Hillman RE. A taxonomy of voice therapy. Am J Speech Lang Pathol. 2015;24(2):101-25. https://doi.org/10.1044/2015_AJSLP-14-0030 PMID: 25763678.

33. Castillo-Allendes A, Fouillioux C. Objetivos de intervención en voz: Una propuesta para su análisis y redacción. Rev. Investig. Innov. Cienc. Salud. 2021;82(11):125-39. http://dx.doi.org/10.46634/riics.56

34. Van Stan JH, Whyte J, Duffy JR, Barkmeier-Kraemer J, Doyle P, Gherson S et al. Voice therapy according to the Rehabilitation Treatment Specification System: Expert consensus ingredients and targets. Am J Speech Lang Pathol. 2021;30(5):2169-201. https://doi.org/10.1044/2021_AJSLP-21-00076 PMID: 34464550.

35. Walsh K. Documentary research and evaluation in medical education. J Educ Eval Health Prof. 2014;18. https://doi.org/10.3352/jeehp.2014.11.18 PMID: 25112446.

36. Díaz C. Investigación cualitativa y análisis de contenido temático. Orientación intelectual de revista Universum. Rev. Gen. Inf. Doc. 2018;28(1):119-42. https://doi.org/10.5209/RGID.60813

37. Manchado R, Tamames S, López M, Mohedano L, D'Agostino M, Veiga de Cabo J. Revisiones sistemáticas exploratorias. Medicina y Seguridad del Trabajo. 2009;55(216):12-9.

38. Romero L, León H, Villanueva P. Estudio de las características vocales en un grupo de profesores con y sin antecedentes de trastorno vocal. Rev. Chil. Fonoaudiol. 1999;1(1):14-22. https://doi.org/10.5354/0719-4692.1999.57972

39. Jabbour Z, Tran M. Can students develop clinical competency in treatment planning remotely through flipped collaborative case discussion? Eur J Dent Educ. 2023;27(1):69-77. https://doi.org/10.1111/eje.12778 PMID: 35103367.

40. Bovend'Eerdt TJ, Botell RE, Wade DT. Writing SMART rehabilitation goals and achieving goal attainment scaling: A practical guide. Clin. Rehabil. 2009;23(4):352-61. https://doi.org/10.1177/0269215508101741 PMID: 19237435.
 

Submitted date:
01/12/2023

Accepted date:
08/02/2024

663d3087a9539557bc2db7f3 cefac Articles
1982-0216 (Electrónico) 1516-1846 (Impreso)
Revista CEFAC ©2024 Todos los derechos reservados.

Revista CEFAC

Share this page
Page Sections