A Qualitative Exploration of Voice Oriented Quality of Life in Iranian Patients: A Cultural Explanation.

PURPOSE: The phrase "health-related quality of life" (HRQOL) refers to patients' perceptions of the influence of disease and treatment on their physical, psychological, and social function. Also, cultural aspects should be taken into account when evaluating quality of life and should be considered in related surveys.  In the current study, the most prominent voice-related QOL dimensions, including culture-based items in Iranian individuals was examined.

METHODS: A convenience sample (n= 23) of adults was interviewed addressing voice related quality of life areas. Participants consisted of 15 people (13 men and 2 women) over 18 years with voice disorders lasting at least 6 months with mean age 41.46±16.06, 3 people (2 men and 1 woman) with mean age 47.66±6.65 who worked as radio broadcasters with over 20 years of experience in the field, and 5 experienced specialists in voice disorders (3 speech therapists and 2 otolaryngologists). A semi-structured interview method was used. The components of voice quality of life based on the interviews were extracted by a fourteen stage process content analysis.

RESULTS: Many of the extracted components were common to both the interviews and those found in the relevant literature and some of them are new. Some of the new components appear to fit best under the category of "cultural". Eleven cultural elements are "religious beliefs in disease tolerance and promotion of quality of life", "More support expectation from family", "Fear about pain and thinking about serious problems (such as Cancer)",  "Throat strain results in more disappointment " "Fatalism in coping with problem and promotion of Quality of life", "Traditional home remediation", "Hope for spontaneous recovery", "Discrimination because of sound problems", "Pain and globus sensation as a factor in finding remediation more quickly", "Negative judgments", "Negative thoughts about people with voice disorders". These elements appear to have a potentially strong effect on health quality of life especially in the voice domain.

CONCLUSIONS: Relative to the development of a Quality of Life questionnaire for voice, important cultural components of Iranian patients were identified in the current study. Identifying these components may help Iranian voice clinicians obtain a more accurate understanding of health-related quality of life aspects within the Iranian culture. This may lead to more effective remediation for voice patients.