Kvalitet komunikacije osoba sa spastičnom dizartrijom

Abstract

Spastična dizartrija nastaje usled povećanog tonusa mišića i smanjenja opsega voljnih pokreta mišića koji učestvuju u govornoj produkciji. Osnovne karakteristike govora osoba sa spastičnom dizartrijom su: neprecizna artikulacija, napeta fonacija, hrapav glas, jednolična visina glasa, hipernazalanost i izarazito spor govor. Navedene karakteristike utiču na razumljivost govora kao i kvalitet komunikacije koju ostvaruju ove osobe. Cilj istraživanja se odnosio na utvrđivanje kvaliteta komunikacije osoba sa spastičnom dizartrijom. Ispitanici su sami vrednovali uticaj govornog poremećaja na različite komunikacione situacije. U istraživanju je učestvovao 31 ispitanik sa spastičnom dizartrijom, od čega 17 osoba muškog i 14 osoba ženskog pola, starosti od 22 do 83 godine (AS = 63). Ispitanici su imali zadatak da odgovore na 30 pitanja skale pod nazivom „Indeks glasovnog oštećenja“, a koja se sastoji iz tri subskale: fizičke, emocionalne i funkcionalne. Rezultati celokupne skale su pokazali da blag poremećaj ima 48,4% ispitanika, umeren 22,6% i težak 29,0% ispitanika. Na funkcionalnoj subskali 48,4% ispitanika smatra da ima blag poremećaj, dok 51,6% smatra da ima težak poremećaj. Nije bilo ispitanika koji su na ovoj subskali svoj poremećaj vrednovali kao umeren. Blag poremećaj na fizičkoj subskali zabeležen je kod 54,8% ispitanika, umeren kod 12,9% i težak kod 32,3% ispitanika. Na emocionalnoj subskali 58,1% ispitanika smatralo je da ima blag poremećaj, 16,1% umeren i 25,8% ispitanika težak poremećaj. Potrebno je istaći da su dobijene vrednosti na osnovu samoprocene pacijenata sa spastičnom dizartrijom veoma korisne za sprovođenje adekvatnog tretmana, kao i evaluaciju tretmana i da ti podaci omogućavaju da se utvrdi uticaj poremećaja glasa i govora na svakodnevno komunikaciono funkcionisanj

Spastic dysarthria is caused by increased muscle tone and limited range of the voluntary muscles movements engaged in speech production. Most prominent perceptible speech deviations associated with spastic dysarthria are: inaccurate speech production of consonants, distorted vowels, monopitch, reduced stress, harsh voice quality, monoloudness, hypernasality and slow speech rate. These characteristics can affect the intelligibility of speech and the quality of communication of these people. The aim of this study was to determine the quality of communication in people with spastic dysarthria. The participants themselves evaluated the impact of speech disorder on different communicative situations. The sample consisted of 31 participants with spastic dysarthria, 17 men and 14 women, 22 to 83 years of age (M = 63). The participants had to complete the task of answering 30 questions within the scale “Voice Handicap Index”. The scale consists of three subscales: physical, emotional and functional. The overall scale scores showed that 48.4% participants had mild, 22.6% moderate, while 29.0% of participants had a severe form communication impairment. Functional subscale scores showed that 48.4% of participants had a mild form of impairment, while 51.6% of participants had a severe form of impairment. In the physical domain of the scale, a mild form of impairment was observed in 54.8%, moderate in 12.9% and severe in 32.3% of participants. Scores on emotional subscale showed that 58.1% of participants considered that they had a mild impairment, 16.1% moderate and 25.8% of participants thought that they had severe impairment in emotional domain. It should be pointed out that the obtained values based on the self-assessment of patients with spastic dysarthria are very useful for the implementation of adequate treatment techniques, as well as for treatment evaluation, and that these data enable the determination of voice and speech disorder influence on communication in daily life.