Urica-VV Scale: A New Research Perspective of The Stage of Readiness for Treatment in Patients with Dysphonia.

OBJECTIVE: To obtain evidence of validity for the URICA-V scale and estimate the psychometric properties of its items based on item response theory (IRT). METHOD: A total of 658 individuals of both sexes over 18 years of age were allocated into two groups: with dysphonia group (WDG) and vocally healthy group (VHG). A digital database was constructed with personal and professional data and item-by-item responses on the URICA-V scale. Subsequently, Cronbach's alpha, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), application of IRT using Samejima's model and ROC curve analysis were used to obtain the cutoff point for the URICA-V scale. RESULTS: A different version of the original URICA-V scale was obtained. Of the 32 items from the original protocol, 25 better explained the instrument and were regrouped into two domains: contemplation and maintenance. It was possible to identify which items generated higher difficulty (b) and discrimination (a) values and which contributed to the presentation of a calculation based on the theta of each participant. The ROC curve was analyzed, and a cutoff point of -0.236 was established; establishing a cutoff point facilitates the decision of which individuals are in a state of readiness for voice treatment. CONCLUSION: The present study provided evidence that allows us to propose the URICA-Voice validated (URICA-VV) scale within a more contemporary perspective and with a reduced number of items and domains. In addition, a cutoff point was obtained based on IRT to measure, with greater accuracy, sensitivity and specificity, the stage of readiness and to differentiate individuals who have an indication for speech therapy.

Stages of Readiness in Patients With Dysphonia: A Proposal Based on Factor Analysis Using the URICA-V Scale.

INTRODUCTION: In terms of treatment results, the readiness stage presents the best conditions for adherence to a therapeutic proposal, and it allows for an estimated disease prognosis and assistance with treatment monitoring. Patients with dysphonia who are treated using vocal rehabilitation (basically a behavioral program), regardless of disease etiology, can optimize their treatment by understanding the stages of behavioral change. OBJECTIVES: To evaluate the accuracy of the components constituting the stages of readiness to change on the University of Rhode Island Change Assessment-Voice (URICA-V) scale using confirmatory factor analysis and internal consistency indices. METHODS: This documentary study evaluated the records of 488 patients with dysphonia collected from a voice laboratory database. Most of the patients were Brazilian women with higher education who were single, nonprofessional voice users. The results of the URICA-V self-assessment questionnaire were analyzed to determine the patients' stage of readiness to change when vocal rehabilitation was proposed as a treatment. A descriptive and inferential statistical analysis was conducted using confirmatory factor analysis to determine the correlation between the questionnaire items and the stages of readiness. RESULTS: Of the eight items in the precontemplation stage, only four presented significant factor loading within that stage. Three items in the action stage did not present significant factor loading during that stage. The items in the contemplation and maintenance stages presented significant factor loadings within their respective stages. CONCLUSIONS: The results of a confirmatory factor analysis allowed us to propose an adjustment to the URICA-V scale. The objective of the adjusted scale is to improve the instrument's ability to make evaluations prethrepy and posttherapy and to more reliably assess readiness in patients undergoing voice therapy.