Workplace productivity and voice disorders: a cognitive interviewing study on presenteeism in individuals with spasmodic dysphonia

J Voice. 2014 Nov;28(6):700-10. doi: 10.1016/j.jvoice.2014.03.017. Epub 2014 Jun 24.


Objective: The objective of this study was to obtain initial reactions and suggested modifications to two existing presenteeism scales: the Stanford Presenteeism Scale 6 (SPS-6) and the Work Productivity and Activity Impairment Questionnaire-Specific Health Problem (WPAI-SHP) among a cohort of employed individuals with a focal laryngeal dystonia, spasmodic dysphonia (SD).

Study design: The study design is a qualitative study.

Methods: Nine speakers with SD underwent cognitive interviews, during which they were asked to evaluate the relevance of statements and clarity of wording on the SPS-6, the WPAI-SHP, and an additional set of voice-related statements designed by the researchers. Participants were asked to complete the scales, rank order statements in terms of perceived importance, and suggest additional statements of relevance.

Results: Although all participants noted that their SD did have an effect on their jobs, there were suggestions for modifying both the WPAI-SHP and the SPS-6. Participants regarded specific voice-related statements that were generated by the researchers to be of greater importance than the majority of the statements on the SPS-6. Minor changes in the wording of the instructions on the WPAI-SHP were recommended.

Conclusions: Presenteeism is an important construct to measure in individuals with a chronic voice disorder such as SD. However, existing presenteeism scales might best be administered in conjunction with additional statements that are more voice related so that clinicians can be made aware of specific difficulties encountered in the workplace.

Keywords: Presenteeism; Spasmodic dysphonia; Workplace productivity.

MeSH terms

  • Absenteeism
  • Adult
  • Aged
  • Botulinum Toxins, Type A / therapeutic use
  • Cognition*
  • Cost of Illness
  • Dysphonia / diagnosis
  • Dysphonia / drug therapy
  • Dysphonia / physiopathology
  • Dysphonia / psychology*
  • Efficiency*
  • Female
  • Humans
  • Interviews as Topic*
  • Male
  • Middle Aged
  • Neuromuscular Agents / therapeutic use
  • Occupational Health*
  • Perception
  • Phonation* / drug effects
  • Qualitative Research
  • Sick Leave
  • Surveys and Questionnaires
  • Time Factors
  • Voice Quality* / drug effects
  • Workplace*


  • Neuromuscular Agents
  • Botulinum Toxins, Type A