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Brisson V, Fournier C, Pelletier A, Joyal M, Defoy L, Tremblay P. Vocal Health and Vocal Health Knowledge Among Occupational Voice Users in the Province of Quebec. J Voice 2024; 38:799.e15-799.e27. [PMID: 35082049 DOI: 10.1016/j.jvoice.2021.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/22/2021] [Accepted: 12/27/2021] [Indexed: 11/27/2022]
Abstract
Voice disorders are frequent among occupational voice users such as teachers. Although these disorders can have serious personal and professional consequences, they are not often recognized as occupational diseases and little attention is paid to their prevention. This study aimed to provide a portrait of the self-reported vocal health and vocal health knowledge of occupational voice users in Quebec, Canada, and to identify risk factors associated with voice disorder symptoms. We conducted an online survey targeting occupational voice users in the province of Quebec, Canada, with a focus on those involved in teaching or training. The final sample, after excluding incomplete surveys, included 808 respondents (665 women, M = 41.5 ± 10.4 years old). The survey responses were analyzed using descriptive and inferential statistics. Results indicated that 9.8% of the respondents had a history of a diagnosed voice disorder and 68.8% of the respondents experienced at least one voice symptom on a regular basis. Ordinal logistic regressions revealed that several personal and environmental factors are associated with an increased risk of developing voice disorders symptoms: being a woman, suffering from a breathing disorder, allergies, acid reflux and/or hearing impairment, having less work experience, working with elementary school children and/or with continuous or speech noise in the background. Most of the respondents (94.6%) had never received information regarding voice disorders during their academic training and less than half of them (47.7%) knew which professionals can treat voice disorders. These findings highlight the need for formal vocal health education among both occupational voice users and their employers to improve prevention and treatment for voice disorders in an at-risk population.
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Affiliation(s)
- Valérie Brisson
- Université Laval, Faculté de Médecine, Département de Réadaptation, Quebec City, Canada; CERVO Brain Research Center, Quebec City, Canada
| | - Constance Fournier
- Université Laval, Faculté de Médecine, Département de Réadaptation, Quebec City, Canada
| | - Alicia Pelletier
- Université Laval, Faculté de Médecine, Département de Réadaptation, Quebec City, Canada
| | | | - Lyne Defoy
- CHU de Quebec-Université Laval, Hôpital St-François d'Assise, Quebec City, Canada
| | - Pascale Tremblay
- Université Laval, Faculté de Médecine, Département de Réadaptation, Quebec City, Canada; CERVO Brain Research Center, Quebec City, Canada.
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García-Real TJ, Díaz-Román TM, Mendiri P. Vocal Problems and Burnout Syndrome in Nonuniversity Teachers in Galicia, Spain. Folia Phoniatr Logop 2023; 76:68-76. [PMID: 37487470 DOI: 10.1159/000531982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/11/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION Voice disorders and burnout syndrome are common among teachers. This study aimed to explore the relationship among vocal problems, burnout syndrome, and some personal work factors. METHODS This cross-sectional descriptive study enrolled 90 nonuniversity teachers who completed the Multidimensional Vocal Scale for Teachers (EVM-D) to evaluate vocal problems and an adapted Spanish version of the Maslach Burnout Inventory-Educators Survey (MBI-ES) to detect burnout syndrome. RESULTS Overall, 16% of teachers expressed symptoms compatible with burnout, and 60% of them were in the interval above the 75th percentile of the EVM-D, i.e., they had a high risk of vocal problems. An association between burnout and more vocal problems was established among teachers, particularly between the vocal symptoms and vocal abuse dimensions with the emotional exhaustion subscale of the MBI-ES. A history of anxiety/depression and fewer years of professional experience were associated with more vocal problems. The burnout group perceived more "loss of vocal power," "vocal fatigue," "vocal effort," and "hoarseness." Vocal abuse items received the highest scores of EVM-D. However, only "shouting" in the classroom was significantly different between the groups with and without burnout. CONCLUSION Emotional exhaustion of burnout syndrome, history of anxiety/depression, and a shorter professional experience were associated with vocal problems, which could limit the performance of teachers. Reducing classroom noise, establishing strategies to avoid shouting, or strengthening personal accomplishments in teachers could be useful in breaking the cycle of vocal problems and emotional exhaustion, particularly at the beginning of their professional experience.
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Affiliation(s)
- Teresa J García-Real
- Department of Specific Didactics and Research Methods and Diagnosis in Education, Faculty of Educational Sciences, University of La Coruña, La Coruña, Spain
| | | | - Paula Mendiri
- Department of Specific Didactics and Research Methods and Diagnosis in Education, Faculty of Educational Sciences, University of La Coruña, La Coruña, Spain
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de Magalhães TA, Ferreira ED, de Souza JEM, Santos VM, Rossi-Barbosa LAR, Nascimento JE, Silveira MF, Sant'Ana Haikal D. Voice Disorders and Mental health of Basic Education Teachers in a Brazilian Municipality. J Voice 2023:S0892-1997(23)00043-7. [PMID: 37055328 DOI: 10.1016/j.jvoice.2023.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 04/15/2023]
Abstract
OBJECTIVE To identify associations with voice disorders in elementary school teachers of a Brazilian municipality STUDY DESIGN: This was a quantitative cross-sectional and analytical study with probability sampling carried out in the 2016 school year METHOD: Self-report of vocal complaints was used for the dependent variable vocal disorder. The independent variables were sociodemographic and occupational characteristics, working conditions that generate discomfort, habits and behaviors, mental health and self-perception of health. For the evaluation of the Burnout Syndrome (BS), the questionnaire Cuestionário para la Evaluación del Syndrome de Quemarse por el Trabajo (CESQT) was used and, for depression, the Beck Depression Inventory (BDI) scale instrument. Multiple fit models were used applying the Binary Logistic Regression RESULTS: A total of 634 teachers participated in this study. There was a predominance of women (85.3%) with mean age 40.6 years (SD ±9.5); 62.1% were married, 70.2% had children and a mean teaching time of 12.9 years (SD ±8.4); 19.3% had voice disorders; 14.5% experienced BS and 24.0% depression. Voice disorders were associated with women (OR=2.30) working longer weekly hours (OR=1.75), with psycho-emotional problems, with burnout (OR=1.95) and depressive symptoms (OR=1.70), and were also associated with women who reported negative self-perception of health (OR= 1.97) CONCLUSION: Voice disorders appear to be strongly associated with mental health problems, mainly in women, in those with a longer working week and those who reported a negative perception of health. Public policies are required to prevent psycho-emotional problems and for vocal health promotion of the teaching category.
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Affiliation(s)
- Tatiana Almeida de Magalhães
- Universidade Estadual de Montes Claros-Unimontes, Programa de Pós-Graduação em Ciências da Saúde -PPGCS, Montes Claros, Minas Gerais, Brasil.
| | | | - Joyce Elen Murça de Souza
- Universidade Estadual de Montes Claros-Unimontes, Programa de Pós-Graduação Stricto Sensu em Cuidados Primários em Saúde -PPGCPS, Montes Claros, Minas Gerais, Brasil
| | - Viviane Maia Santos
- Centro Universitário FIPMoc departamento de Medicina, Montes Claros, Minas Gerais, Brasil
| | - Luiza Augusta Rosa Rossi-Barbosa
- Universidade Estadual de Montes Claros-Unimontes, Programa de Pós-Graduação Stricto Sensu em Cuidados Primários em Saúde -PPGCPS, Montes Claros, Minas Gerais, Brasil
| | | | - Marise Fagundes Silveira
- Universidade Estadual de Montes Claros-Unimontes, Programa de Pós-Graduação em Ciências da Saúde-PPGCS, Montes Claros, Minas Gerais, Brasil
| | - Desirée Sant'Ana Haikal
- Universidade Estadual de Montes Claros-Unimontes, Programa de Pós-Graduação em Ciências da Saúde-PPGCS, Montes Claros, Minas Gerais, Brasil
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de Oliveira Lemos I, Picanço Marchand DL, Oliveira Cunha E, Alves Silvério KC, Cassol M. What are the Symptoms that Characterize the Clinical Condition of Vocal Fatigue? A Scoping Review and Meta-Analysis. J Voice 2023:S0892-1997(22)00419-2. [PMID: 36737268 DOI: 10.1016/j.jvoice.2022.12.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Vocal fatigue is a clinical manifestation associated with a perception of negative vocal adjustment. It is related to the increase in the sensation of excessive effort when speaking and the lack of conditioning of the muscles and structures that involve vocal production. Because it has a complex and multifactorial diagnosis, there is still no consensus on the symptoms most commonly found in this clinical condition. OBJECTIVE To review and analyze the symptoms that characterize the clinical condition of vocal fatigue. METHODS This study consists of a scoping review carried out in the Cochrane Library, Embase, Lilacs, and Medline databases. Observational studies or clinical trials from the last 10 years. Studies with participants younger than 18 years of age were excluded; as well as research that did not describe symptoms of vocal fatigue or that presented vocal fatigue as a symptom; studies with patients with neurological, psychiatric, syndromic conditions, or head and neck cancer. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies NHLBI-NIH scale was used to assess the methodological quality of selected observational studies and the PEDro scale for the analysis of experimental studies. The steps were performed by three blinded evaluators. Subsequently, meta-analyses of global means were executed for each factor under study; a comparison of the difference in the mean score for each factor between exposed and unexposed; a comparison of the difference in the average score, among non-professional voice users, for each factor between exposed and unexposed. RESULTS In the searches performed, 956 articles were found and 29 articles were selected according to the eligibility criteria. Of these, 93.11% of the studies were observational and 6.89% were clinical trials. Regarding the gender and age group of the study samples, women aged between 30 and 45 years were predominant. As for the occupational use of voice, 68.97% of the samples were composed of professional voice users and 31.03% of non-professional voice users, with most professional voice users being teachers and non-professional voice users, individuals with dysphonia or vocal complaint. To assess vocal fatigue symptoms, 28 studies used the Vocal Fatigue Index (VFI) protocol, and only one study used another assessment protocol, Self-Administered Voice Rating. All studies were classified as regular, according to the scale used. As for the meta-analyses performed, the mean scores of the VFI factors were higher among professional voice users when compared to non-professional voice users and higher in dysphonic individuals compared to non-dysphonic individuals. CONCLUSION The vocal fatigue symptoms found in this review were common in the populations of professional voice users and non-professional voice users and dysphonic and non-dysphonic individuals. These symptoms were related to vocal recovery after rest, physical discomfort, and restricted vocal use.
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Affiliation(s)
- Isadora de Oliveira Lemos
- Rehabilitation Sciences Program, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Daniel Lucas Picanço Marchand
- Rehabilitation Sciences Program, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Eduarda Oliveira Cunha
- Health Sciences Program, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Kelly Cristina Alves Silvério
- Speech-Language Pathology and Audiology Department, Bauru School of Dentistry, São Paulo College, Bauru, São Paulo, Brazil.
| | - Mauriceia Cassol
- Rehabilitation Sciences Program And Speech, Language, and Hearing Sciences Department. Federal University of Health Sciences of Porto Alegre, Porto alegre, Rio Grande do Sul, Brazil.
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Rezende BA, Abreu MNS, Assunção AÁ, de Medeiros AM. Factors Associated With the Limitation at Work Because of the Voice: Study With Teachers of Basic Education In Brazil. J Voice 2023; 37:79-91. [PMID: 33214005 DOI: 10.1016/j.jvoice.2020.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 11/02/2020] [Accepted: 11/02/2020] [Indexed: 01/11/2023]
Abstract
INTRODUCTION The voice disorder can cause limitations at work, as it affects the communication and the performance of the teaching function. OBJECTIVE To analyze the limitation at work because of the voice and to examine possible associations with sociodemographic characteristics, life and health habits and work conditions among Basic Education teachers in Brazil. METHODS Cross-sectional epidemiological study, with a representative sample, carried out between October 2015 and March 2016, with 6,324 teachers working in Basic Education in Brazil. Data collection was carried out through the application of a questionnaire via telephone with questions regarding health and working conditions. The "limitation at work because of the voice" was considered a dependent variable, whose response options were a scale with four Likert items that varied from frequently to never. The independent variables were grouped in blocks for ordinal logistic regression analysis with hierarchical entry. The magnitude of the association was assessed by the Odds Ratio (OR) with the respective confidence intervals (95% CI). RESULTS One third of Brazilian teachers (32.7%) reported some frequency of limitation at work (sometimes; rarely, frequently) because of the voice at some moment in the month before the survey and, of these, 5% declared high frequency. The factors that increased the chance of a greater frequency of limitation at work because of the voice were: being female (OR = 1.32; 95% CI = 1.15-1.51); teaching for elementary school (OR = 1.35; 95% CI = 1.02-1.78); use anxiolytic or antidepressant medications (OR = 1.46; 95% CI = 1.20-1.78); losing sleep due to concerns (OR = 1.69; CI = 95% = 1.46-1.95); high noise at school (OR = 2.09; 95% CI = 1.78-2.46); agitated environment by students' indiscipline (OR = 1.37; 95% CI =1.15-1.63); high demands at work (OR = 1.18; 95% CI = 1.02-1.36); not having social support (OR = 1.19; 95% CI = 1.04-1.38); having suffered verbal violence by the students (OR = 1.43; 95% CI = 1.23-1.67). On the other hand, the practice of regular physical activity (OR = 0.86; 95% CI = 0.75-1.00) and the fact of having enough time to complete work tasks (OR = 0.71; 95% CI = 0,62-0.82) decreased the chance of a higher frequency of limitation at work due to vocal problems. The perception that the work limits the teaching performance because of the voice was more frequent among teachers in the North (OR=1.41; 95% CI = 1.17-1.71) and Northeast (OR=1.46; 95% CI = 1.22-1.76) compared to the Southeast region. CONCLUSION Factors associated with an increase in the chance of higher frequency of reporting work limitations due to the voice: being female, lack of physical activity, losing sleep due to concern, using anxiolytic or antidepressant medication, school location in the North and Northeast, teaching for the elementary school stage, high noise at school and psychosocial aspects of work organization. The Brazilian educational sector needs public policies that take into account regional inequalities and the health and work conditions of teachers.
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Affiliation(s)
- Bárbara Antunes Rezende
- Graduate Program in Public Health, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Mery Natali Silva Abreu
- Department of Applied Nursing, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ada Ávila Assunção
- Graduate Program in Public Health, Department of Preventive and Social Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Adriane Mesquita de Medeiros
- Graduate Program in Speech-Language Sciences, Department of Speech Therapy, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Oliveira P, Ribeiro VV, Constantini AC, Cavalcante MEDOB, Sousa MDS, da Silva K. Prevalence of Work-Related Voice Disorders in Voice Professionals: Systematic Review and Meta-Analysis. J Voice 2022:S0892-1997(22)00232-6. [PMID: 36057482 DOI: 10.1016/j.jvoice.2022.07.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To analyze the prevalence of work-related voice disorders (WRVD) among the voice professionals. METHODS The study protocol was registered in PROSPERO (CRD42021250121). The search was performed in the Embase, Lilacs, Medline, SCOPUS, and Web of Sciences databases. There were no limitations to the year of publication and the search included observational studies which reported data on the prevalence of dysphonia in voice professionals measured through vocal complaints, vocal self-assessment, the auditory-perceptual judgment of the voice, and laryngoscopy examinations. The critical appraisal instrument for studies reporting prevalence data was used to analyze the risk of bias of the studies. Data analysis was performed using Jamovi and R software with a significance level of 5%. RESULTS The initial search identified 561 articles, 73 of which were finally included and analyzed. The total number of participants was 63,126. Dysphonia was diagnosed in 45,996 participants based on a vocal complaint, 12,843 using vocal self-assessment, 1,254 using the auditory-perceptual judgment, and 1,683 using laryngoscopies. The prevalence of total dysphonia was 44.0 (95% CI 38.47; 49.69). The prevalence of vocal complaints was 43.9% (95% CI 37.37; 50.52), 42.5% (95% CI 28.57; 57.08) for self-assessment, 53.0% (95% CI 29.87; 77.19) for auditory-perceptual judgment, and 36.9% (95% CI 18.62; 57.08) for laryngoscopic examination. In the auditory-perceptual judgment, voice professionals in class 3 (moderate quality, high demand) had a higher prevalence of dysphonia than those in class 4 (moderate quality, moderate demand) (P = 0.04). In the auditory-perceptual judgment (P = 0.04), there was a higher prevalence of dysphonia in teachers than among other voice professionals non-teachers, and in the laryngeal evaluation, no differences were found between professionals (P = 0.8). CONCLUSION There was a high prevalence of dysphonia in voice professionals, especially in the detection by auditory-perceptual judgment. High vocal demand and being a teacher influenced the increase in the prevalence of WRVD.
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Affiliation(s)
- Priscila Oliveira
- Department of Speech Therapy, Universidade Federal da Paraíba - UFPB, João Pessoa, Paraiba, Brazil.
| | - Vanessa Veis Ribeiro
- Speech-Language Pathology Course, Faculdade de Ceilândia, Universidade de Brasília - UnB, Brasília, Federal District, Brazil
| | - Ana Carolina Constantini
- Department of Human Development and Rehabilitation, Speech-Language Pathology Course, Faculdade de Ciências Médicas - FCM, Universidade Estadual de Campinas - Unicamp, Campinas, São Paulo, Brazil
| | | | - Maiara Dos Santos Sousa
- Department of Speech Therapy, Universidade Federal da Paraíba - UFPB, João Pessoa, Paraiba, Brazil
| | - Kelly da Silva
- Speech-Language Pathology Course, Campus Lagarto, Universidade Federal de Sergipe - UFS, Lagarto, Sergipe, Brazil
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de Brito Mota AF, Giannini SPP, de Oliveira IB, Paparelli R, Dornelas R, Ferreira LP. Voice Disorder and Burnout Syndrome in Teachers. J Voice 2018; 33:581.e7-581.e16. [PMID: 30220529 DOI: 10.1016/j.jvoice.2018.01.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 01/25/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The objective of this study was to assess the association between burnout syndrome and the likely presence of voice disorders among teachers from a public elementary school in the country town of Sergipe. METHODS This is a cross-sectional study in which 208 teachers completed the following questionnaires: the Condition of Vocal Production-Teacher (CPV-P), the Screening Index for Voice Disorder (SIVD), and the Burnout Syndrome Evaluation Questionnaire (CESQT). RESULTS Of the 208 teachers, 76.9% were women, 77.9% came from rural areas, and 64.4% were likely to have a voice disorder. Teachers with a career length of over 15 years were almost twice as likely to have a voice disorder. Of the symptoms listed in the SIVD, the following were most prevalent: dry throat (88.1%), hoarseness (84.4%), and fatigue when speaking (82.1%). Among the burnout subscales, psychic exhaustion was the most common (30.3%). Analyses revealed that probable voice disorder was associated with psychic exhaustion with an odds ratio of 1.78 (P < 0.001, χ2 = 84.1%). Teachers with positive scores on two to four burnout subscales had an odds ratio of 4.01 (P = 0.013, χ2 = 86.2%) for a probable voice disorder compared with those with positive scores on zero to one subscale. CONCLUSIONS The present results confirmed that burnout syndrome was associated with the presence of a probable voice disorder.
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Affiliation(s)
| | | | - Iara Bittante de Oliveira
- Speech Language Pathology College, Pontifical Catholic University of Campinas, Campinas, São Paulo, Brazil
| | - Renata Paparelli
- Workers' Health Department, PUC-SP, São Paulo, São Paulo, Brazil
| | - Rodrigo Dornelas
- Speech Language Pathology Department, Federal University of Sergipe, Sergipe, Brazil
| | - Léslie Piccolotto Ferreira
- Speech Language Pathology and Physiotherapy Foundations Department, PUC-SP, São Paulo, São Paulo, Brazil
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