Vocal Fatigue Symptoms and Laryngeal Status in Relation to Vocal Activity Limitation and Participation Restriction

Cross-Cultural Adaptation and Validation of the Vocal Fatigue Index (VFI) to Danish

OBJECTIVES

The aim was to cross-culturally adapt and validate the Vocal Fatigue Index (VFI) to Danish (DK-VFI).

STUDY DESIGN

Cross-sectional design.

METHODS

The original American English VFI was cross-culturally adapted to Danish using a forward-backward translation procedure combined with focus group interviews. The DK-VFI was distributed to 26 patients with vocal fatigue (VF) and 103 vocally healthy controls. A matched subsample based on age and sex of the control group was included. Internal consistency was determined using Cronbach's alpha and test-retest reliability was determined using Spearman's Rho as well as Wilcoxon signed-rank tests. Validity was confirmed using the Wilcoxon rank-sum test. Sensitivity and specificity were assessed using the Receiver Operating Characteristics test and the discriminative ability was determined using the Area Under the Curve (AUC) test. The original VFI consists of three factors, and cutoff values were calculated for each separate factor in the DK-VFI.

RESULTS

Minor changes were made in the phrasing of specific questions in order to appropriate the VFI to the Danish language. The internal consistency for the DK-VFI was high, with a Cronbach's alpha of α = 0.95. The results showed statistically significant differences (P < 0.05) in mean scores of the DK-VFI between patients and controls. The cutoff values between patients and controls for each separate factor were ≥11.5 for factor 1, ≥2.5 for factor 2, and ≤5.5 for factor 3. The results of the AUC analysis showed that the DK-VFI has discriminative abilities of 0.94 for factor 1, 0.92 for factor 2, and 0.82 for factor 3. Analysis of test-retest reliability showed strong reliability for the patient group and acceptable reliability for the control group.

CONCLUSION

The DK-VFI is a valid and reliable tool for identifying symptoms of VF and can sensitively discriminate people with VF from vocally healthy controls.

Measuring Vocal Fatigability in Teachers: The Vocal Fatigability Scale for Teachers (VFS-T)

OBJECTIVES

This study focuses on the distinction between vocal fatigability and vocal fatigue (VF), highlighting the importance of vocal fatigability when assessing teachers' quality of life. Vocal fatigability is more critical for quality of life than performance or perceived VF because it considers the accumulation and chronicity of fatigue over isolated tasks. The objectives are to develop and validate the Vocal Fatigability Scale for Teachers (VFS-T), to assess teachers' levels of vocal fatigability, and to analyze variations based on personal and occupational traits. The VFS-T construct encompasses items related to vocal sensations and performance, their connection to accumulated demanding vocal activity, descriptions of recovery strategies, necessary rest periods, and the impact of VF on daily activities.

STUDY DESIGN

A single cross-sectional study with an ex post facto design was conducted.

METHODS

The sample consisted of 184 active teachers with various vocal conditions. They completed the VFS-T questionnaire, provided personal and occupational data, and completed the VHI-10 questionnaire. The data collected were analyzed for item refinement, internal structure, reliability, validity, diagnostic capacity, cutoff values, and group differences.

RESULTS

The item refinement and internal structure analysis revealed a scale comprising 17 items grouped into two factors. The VFS-T shows good reliability and validity, with cutoffs at <15 for no fatigability, 15-27 for moderate fatigability, and >28 for high fatigability. Most teachers fall into the moderate fatigability range, with 72% experiencing vocal fatigability.

CONCLUSIONS

The VFS-T is a reliable tool for detecting vocal fatigability in teachers. This scale focuses on the construct of vocal fatigability, which is related to chronicity of VF and limitations in daily activities in teachers.

Cross-Cultural Adaptation, Validation, and Diagnostic Accuracy of the Voice Fatigue Handicap Questionnaire-Persian Version

OBJECTIVE

The current study aimed to determine the psychometric characteristics of a translated version of the Voice Fatigue Handicap Questionnaire in Persian by examining the validity, reliability, and diagnostic accuracy using data collected from people with and without dysphonia.

STUDY DESIGN

Cross-sectional study.

METHOD

The original questionnaire was translated from Italian to Persian using the International Quality of Life Assessment criteria. The translated version was completed by 122 people with dysphonia and 49 people without dysphonia. The validity, reliability, and diagnostic accuracy of the Voice Fatigue Handicap Questionnaire Persian-version were evaluated. A panel of five voice-specializing Speech and Language Pathologists and 20 native Persian speakers (with dysphonia) in a pilot study confirmed the translated version for content and face validity, respectively. The internal consistency was evaluated by Cronbach's alpha and McDonald omega coefficients. The intraclass correlation coefficient was used to examine the test-retest reliability. For discriminant validity, the mean total and subscale scores of respondents with and without dysphonia were compared through independent t tests. Finally, sensitivity, specificity, and ideal cut-off value were determined using the receiver-operating characteristic curve.

RESULTS

Cronbach's alpha coefficient was 0.965 for the total score (functional: α = 0.883, emotional: α = 0.944, physical: α = 0.917). Also, the McDonald omega coefficient was 0.966 for the total score (functional: ω = 0.889, emotional: ω = 0.933, physical: ω = 0.920). The intraclass correlation coefficient for measuring the test-retest reliability was 0.971 for the total score (functional: ICC=0.937, emotional: ICC=0.954, physical ICC=0.976). The results of the independent samples t tests indicated that the dysphonia group obtained significantly higher mean scores (total and subscale scores) than the group without dysphonia. The cutoff value of 13.5 was determined based on the optimal balance of sensitivity (0.992) and specificity (0.918).

CONCLUSION

The Voice Fatigue Handicap Questionnaire-Persian version is a valid and reliable questionnaire to identify individuals at high risk of vocal fatigue and subsequent dysphonia.

Vocal Sensory Symptoms, Vocal Fatigue and Vocal Habits in University Professors

PURPOSE

To identify vocal sensory symptoms, vocal fatigue, and vocal habits, compare and correlate them in university professors who have passed or failed a screening related to vocal symptoms.

STUDY DESIGN

Cross-sectional, quantitative, non-randomized study.

METHODS

The professors responded to four vocal self-assessment Patient-Reported Outcome Measures (PROM): the Brazilian validated version of the Voice Symptom Scale (VoiSS), the Brazilian version (not validated) of the Vocal Tract Discomfort Scale, the Brazilian validated version of the Vocal Fatigue Index and the validated version of the Vocal Health and Hygiene Questionnaire ("Questionário de Saúde e Higiene Vocal - QSHV," in Portuguese). After the PROM's application, the professors were divided into two groups from the VoiSS cutoff point. G1 was formed by professors who passed in the VoiSS screening, that is, those who achieved a total score below 16 points, and G2, formed by professors who failed, that is, those who achieved 16 points or more. The Mann-Whitney U test was used to compare the values of PROM between G1 and G2 groups, and the Spearman correlation test was used to correlate the PROM with one another.

RESULTS

One hundred and two professors filled in the PROM, 23 from G1 and 79 from G2. Results showed that the total scores of all PROM used exceeded their cutoff scores in the overall sample. It was also observed that professors who failed the screening through VoiSS presented higher scores of vocal sensory symptoms and vocal fatigue, however no differences regarding knowledge on vocal health and hygiene were noticed. In G1, the protocols showed significant correlations ranging from moderate to very strong with one another, but the QSHV showed no correlation with any of the instruments. In G2, the protocols presented weak to strong correlation ratios, and the QSHV reported correlation with all protocols, except for Vocal Fatigue Index.

CONCLUSION

University professors presented scores higher than the cut-off point suggested by the literature for vocal sensory symptoms, vocal fatigue and knowledge on vocal health and hygiene. Professors who failed the screening performed through VoiSS achieved higher scores of vocal discomfort and fatigue, but also presented a high score for knowledge on vocal hygiene. There was a moderate to very strong statistical correlation among the vocal symptoms, discomforts, vocal fatigue and vocal habits in professors who failed the screening through VoiSS, however among those professors who passed the screening, knowledge on vocal health and hygiene showed no correlation with the PROM analyzed.

Examination of Voice Perception and Voice Fatigue in Call Center Employees

OBJECTIVES

Call center employees are professional voice users and use their voices extensively while performing their professional functions. The purpose of this study is to examine whether a higher occupational voice burden among call center employees affects voice fatigue and perception.

METHODS

A total of 114 adult individuals working in call centers who were not diagnosed with any voice disorder (study group, n = 57) and who were not professional voice users (control group, n = 57) were included in this study. Demographic information, the Voice Fatigue Index (VFI), and the Voice Handicap Index-10 (VHI-10) were administered to all participants. Sub-factors of the VFI, such as tiredness and avoidance of voice use (factor 1), physical discomfort after voice use (factor 2), and improvement in symptoms with rest (factor 3), were also examined.

RESULTS

Each group included 71.9% females (n = 41) and 28.1% men (n = 16). The scores of VFI factor 1, VFI factor 2, 3, VFITOTAL, and VHI-10 in the study group were statistically higher than those in the control group. The average VFI factor 2, VFI factor 3, and VFITOTAL scores of females in the study group were considerably greater than the average scores of men. The VFI and its sub-factors, as well as the VHI-10 scores of the study group whose daily working hours were 8 hours or less and 8 hours or more, did not vary significantly.

CONCLUSIONS

It has been observed that call center employees experience voice fatigue, which has an impact on voice perception in their professional functions. As a result of their heavy vocal load, contact center workers may be at a higher risk of acquiring voice disorders. Voice fatigue must be taken into account in the assessment and intervention of contact center employees by professionals and therapists working in the field of voice.

Psychometric Properties of the Vocal Fatigue Handicap Questionnaire in Kannada Among Teachers

BACKGROUND

As the literature review suggests, most professional voice users, such as teachers and singers, are prone to vocal abuse or misuse and frequently experience vocal fatigue. Therefore, validating the Vocal Fatigue Handicap Questionnaire among professional voice users with and without the symptoms of vocal fatigue might provide appropriate external validity of the questionnaire.

OBJECTIVE

The objective of the study was to validate the Kannada version of the Vocal Fatigue Handicap Questionnaire (VFHQ-K) among a cohort of Kannada-speaking primary and secondary school teachers with and without self-reported vocal fatigue symptoms.

STUDY DESIGN

This was a validation study.

METHOD

The study consisted of two groups of participants. Group 1 included 40 teachers with self-reported vocal fatigue symptoms, and Group 2 included 57 teachers without self-reported vocal fatigue symptoms. The VFHQ-K was administered to each participant after obtaining informed consent. The questionnaire was again readministered between 1 and 2 weeks to assess the test-retest reliability. All the responses that were obtained were tabulated for analysis.

RESULTS

The VFHQ-K demonstrated good test-retest reliability, internal consistency, and acceptable discriminant validity. The cutoff value of VFHQ-K obtained in the present study between the teachers with and without self-reported symptoms of vocal fatigue was much less than the cutoff values reported by the earlier version of VFHQ-K.

CONCLUSION

The VFHQ-K can be a helpful tool in the early identification of teachers with vocal fatigue and in improving the vocal health of professional voice users.

Preliminary Perceptual Findings of Singing After Flow Phonation Voice Exercises for Singers in Training

INTRODUCTION

Goals of voice therapy and vocal pedagogy share similar principles and therefore, therapy approaches designed to improve the disordered voice may be equally effective when used to enhance healthy voice and vice versa. The purpose of this study was to investigate the effects of flow phonation voice exercises on vocal characteristics of students in undergraduate vocal music training programs and examine their potential use in vocal pedagogy.

METHODS

A total of 10 cis females were recruited and were randomized into two groups: an experimental group (group 1, n = 6) receiving five sessions of flow phonation intervention across 5 weeks; and a control group (group 2, n = 4) that did not receive any direct intervention other than vocal hygiene education. Participants provided data pertaining to auditory perception, subjective respiratory measures, voice-related quality of life, and vocal fatigue before and after 5 weeks. Flow phonation exercises consisted of cup bubble blowing, gargling, and stretch and flow. Wilcoxon signed ranks test was administered to compare outcomes across time points and between groups.

RESULTS

Data indicate statistically significant changes in auditory perception of the singing voice, and voice-related quality of life for the group that received flow phonation exercises alone. No other measures showed statistical significance.

DISCUSSION AND CONCLUSION

Overall, this study indicates that the use of flow phonation voice exercises has the potential to improve voice instruction within the voice studio. While our target enrollments were not met to achieve optimal statistical power, our hypotheses were at least partially supported. In particular, positive intervention-related changes were observed in self-perceived voice handicap, and auditory perception of singing which were not observed in the control group.

Cross-Linguistic Adaptation of Vocal Fatigue Handicap Questionnaire into Kannada (VFHQ-K)

BACKGROUND

It is often considered appropriate to assess vocal fatigue using a self-reported tool or a subjective measure, as vocal fatigue is primarily described through self-reported symptoms. The vocal fatigue handicap questionnaire (VFHQ) is a self-rated questionnaire that addresses the concern of vocal fatigue in persons with voice disorders. Adapting and validating this questionnaire into the Kannada language can be helpful in assessing the physical, emotional, and functional effects of vocal fatigue among Kannada-speaking individuals.

OBJECTIVE

Adaptation and Validation of the VFHQ into the Kannada language.

STUDY DESIGN

A validation study.

METHOD

Initially, the VFHQ was translated into Kannada. The translated questionnaire was given to two SLPs and two Linguists for content validation and to assess the cultural and linguistic equivalency. 65 participants (34 males and 31 females) were diagnosed with voice disorders, and 65 participants who were age and gender-matched and had healthy voices were administered the Kannada version of VFHQ (VFHQ-K).

RESULTS

The results showed that the VFHQ-K had good test-retest reliability, internal consistency, and known groups' discriminative validity. The cut-off point of the VFHQ-K was equal to 26.50, indicating that the VFHQ-K had acceptable discrimination between the patients with and without dysphonia.

CONCLUSION

VFHQ-K is a valid, reliable, and sensitive questionnaire to assess the emotional, physical, and functional effects of vocal fatigue in the Kannada-speaking population.

Comprehensive Index of Vocal Fatigue (CIVF): Development and Clinical Validation

OBJECTIVES

In this study, we sought to investigate whether auditory-perceptual and acoustic measures change after a passage-reading task and to develop a multidimensional index of performance fatigue in voice disorders. The clinical usefulness and cut-off scores of the newly developed index were also explored.

METHODS

A total of 150 patients (age = 35.65 ± 11.44 years) with voice disorders and 100 healthy controls (age = 35.04 ± 11.26 years) were enrolled in the study. Overall severity (OS) and acoustic measures of sentence samples were obtained before and after a passage-reading task and compared between the two positions. Acoustic features included cepstral peak prominence (CPP), σCPP, L/H spectral ratio (SR), and σSR. Using the changes (Δ) in those acoustic measures and the scores of the Vocal Fatigue Index (VFI), a predictive model of the ΔOS was established. The clinical cut-off point of the index was also identified.

RESULTS

For the patient group, OS was higher, but CPP and σCPP were lower for the rear position (after reading the passage) compared to the front position (before reading the passage). A significant portion (adjusted R² = 77.7%) of the ΔOS was predicted by ΔCPP, tiredness score of the VFI, ΔσCPP, ΔσSR, and ΔSR. The area under the curve of the newly developed index was .864 (sensitivity, 78.67%; specificity, 78.00%), and the index's criterion was >2.6489.

CONCLUSIONS

The newly developed Comprehensive Index of Vocal Fatigue (CIVF) can quantify vocal fatigue in voice disorders, reflecting both acoustic and auditory perceptual changes after a passage-reading task. Further studies should explore the responsiveness of the CIVF and the impact of related factors on the CIVF in various voice disorders.

Fatigue-Related Change in Surface Electromyographic Activities of the Perilaryngeal Muscles

PURPOSE

This study set out to quantify the fatigue-related changes in surface electromyographic (sEMG) activities of the perilaryngeal muscles following a vocal loading task.

METHOD

Thirty-six young healthy participants (M _age = 22.4 years) with normal voice performed karaoke singing for at least 100 min. Before the singing task, all participants underwent the sEMG measure and completed a Perceived Vocal Fatigue Score (P-VFS) questionnaire. After the singing task, all participants were immediately measured with the P-VFS again. Half of the participants were then measured for their sEMG immediately after their karaoke singing task, and the other half were given 20 min of rest before undertaking the sEMG measure. The P-VFS and the median frequency (MDF) of the sEMG signals collected from the suprahyoid, infrahyoid, and sternocleidomastoid muscles before and after the singing task were compared using a linear mixed-effects model.

RESULTS

All participants reported a perceived vocal fatigue after singing, with a significantly increased P-VFS. Compared with the presinging baseline, the MDF of the sEMG signals in perilaryngeal muscles was significantly lower immediately after the singing task. Such a significant difference was also found after 20 min following the singing task.

CONCLUSIONS

The MDF analysis of the sEMG signals could identify and quantify the performance vocal fatigue contributed by perilaryngeal muscles following a vocal loading task. The findings also showed that such fatigue in perilaryngeal muscles, as far as sEMG activities are concerned, can last for at least 20 min.

[Vocal fatigue as an indicator of complex voice disorders-a diagnostic and therapeutic challenge]

Vocal fatigue is increasingly observed among professional voice users (e.g., teachers). This pathologic state is associated with restrictions in everyday life and is considered to be an indicator of complex voice disorders. Since there are few systematic studies on the phenomenon, there is currently no uniform definition or diagnostic workup. Based on the case study of a professional speaker, possibilities for a structured vocal fatigue assessment are presented. These are discussed with regard to their laryngoscopic, instrumental acoustic ("performance fatigue") and subjective symptom-related characteristics ("perceived fatigue"). In addition, a differentiation from the vocal effort, vocal demand, and vocal demand response models according to Hunter et al. (2020) is made.

Listening to Video Game Voices: A Call for Action for Research into the Vocal Health of Video Game Voice Actors

Video game voice actors (VGVAs) are a professional voice user (PVU) population whose occupation relies on their ability to reliably deliver extremes in vocal performance. In their work VGVAs are required to perform solo for extended durations, producing highly complex character performances that not only include extremes of vocal parameters and qualities but also highly demanding vocal acts (ie, screaming, singing) within those voice archetypes. Based on the vocal demands of their work and current understandings of occupational voice disorder, it is reasonable to consider that VGVAs may be at increased risk of vocal fatigue, injury, and disorder, as manifestations of occupational disease. This risk is of primary concern to VGVAs who recently organized industrial action to highlight their concerns regarding vocal health within their industry. As a group that is not well represented within voice research, there is little literature currently available to inform clinical support of the population. Due to the unique nature of VGVA work and the highly specific nature of occupational voice use among PVUs, we cannot necessarily generalize research from other populations to VGVAs. As such, research utilising frameworks designed to capture the complexity of voice use, demands on the voice, and experiences of its use are required to support the concerns of the population. This paper introduces VGVAs as an emerging PVU population, describes the concerns of this population within the context of current understandings of vocal fatigue, occupational voice problems and PVU populations, and details the approaches required in the development of research into the population.

Cross-Cultural Adaptation and Validation of the Hong Kong-Chinese Version of Vocal Fatigue Index (VFI(HK))

PURPOSE

This study aimed to cross-culturally adapt and validate the Hong Kong-Chinese version of the Vocal fatigue index (VFI(HK)).

METHOD

The original English version of the Vocal fatigue index (VFI) was translated and adapted to the VFI(HK). A total of 206 subjects (87 in the Fatigue group and 119 in the Control group) completed the VFI(HK) and validity, reliability and receiver operating characteristic (ROC) were analysed.

RESULT

The VFI(HK) exhibited satisfactory psychometric properties. It showed good content validity (scale-level content validity indices ≥ 0.842) and excellent internal consistency (Part 1: α = 0.945, Part 2: α = 0.914, Part 3: α = 0.951). Parts 1 and 2 of the questionnaire showed good construct validity (Part 1: t(204) = 5.743, P < 0.001; Part 2: t(204) = 5.049, P < 0.001). Test-retest reliability ranged from acceptable (Part 3: Ρ = 0.702) to good (Part 1: Ρ = 0.885, Part 2: Ρ = 0.827). ROC curves showed acceptable and close-to-acceptable intrinsic accuracies for Parts 1 (Aera under curve (AUC) = 0.712) and 2 (AUC = 0.694) respectively. Cutoff scores of 25 and 10 are suggested for Parts 1 and 2 respectively.

CONCLUSION

The VFI(HK) is a valid and sensitive assessment tool. It may be adopted to identify individuals with vocal fatigue in the Hong Kong-Chinese population.

The German Restructured Vocal Fatigue Index and Characteristics of Dysphonic and Vocally Healthy Populations

OBJECTIVE

The Vocal Fatigue Index (VFI), a 19-item psychometric self-report questionnaire, enables individuals with vocal fatigue (VF) to be identified and their complaints to be characterized. The purpose of this study was to improve the German-language version (VFI-G) and to evaluate further vocal fatigue-related characteristics of dysphonic and control populations.

METHODS

The VFI-G was restructured by replacing the three factors that structured the original: (1) tiredness of voice and voice avoidance; (2) physical discomfort; and (3) improvement of symptoms with rest, with two clusters developed on the basis of the results of a factor analysis by Nanjundeswaran et al. (2019). The two new clusters are: (1) tiredness and avoidance plus physical discomfort; and (2) symptom improvement through rest. One hundred one (101) individuals with voice disorders and 100 vocally healthy controls from a previous study that cross-validated the VFI-G participated in this study. In order to assess the validity of our newly adjusted VFI-G, independent samples t test, receiver operating characteristic curve, likelihood ratios and the Youden Index were calculated. The association of the two VF clusters with subject characteristics such as age, sex, type of voice disorder, and level of vocal usage was also analyzed using either a Pearson correlation or a one-way ANOVA for each of the two populations.

RESULTS

Significantly higher scores were obtained in voice-disordered subjects in both clusters (all P values < 0.001) than in healthy-voice subjects. The threshold for cluster 1 of the VFI-G was determined as ≥17.5 (74.3% sensitivity and 88.0% specificity). The results of cluster 2 are identical to that of factor 3 of the previous cross-validation study of the VFI-G. Most subject characteristics show no significant association with cluster 1 of the VFI-G, but cluster 2 seems to be moderately associated with age, type of voice disorder and level of vocal usage in the dysphonic population.

CONCLUSIONS

The restructured VFI-G showed improved validity and can be recommended for use in the assessment of VF. Cluster 2 is also moderately associated with several vocal fatigue-related subject characteristics of the dysphonic population.

Relationship Between Work Engagement and Voice Complaints Among Elementary School Teachers

INTRODUCTION

Engaged teachers feel rewarded at work, complete assignments in a positive manner and, often immerse themselves in their work. However, voice complaints are more common for teachers than other professionals which may negatively affect their engagement. This study aims to determine the relationship between work engagement and voice complaints for elementary school teachers.

METHOD

This descriptive-analytical, cross-sectional study was conducted on 300 elementary school teachers in 2018. To study voice complaints, the researchers used the self-reporting question "Have you complained about your voice during the past year or so?" Work engagement was measured by the Utrecht Work Engagement Scale (UWES). To analyze the data, descriptive and analytical statistical methods, including two-way ANOVA, were used.

RESULTS

A total of 55.67% (n = 167) of the teachers had voice complaints, and 44.33% (n = 133) had no voice complaints. After controlling for gender, the results of the study showed that there is a statistically significant relationship between voice complaints and work engagement (P < 0.001) and its three dimensions, including: vigor (P ≤ 0.001), dedication (P ≤ 0.001), and absorption (P ≤ 0.001).

CONCLUSION

The results of the present study showed that teachers with voice complaints have lower work engagement than those without. Given the central importance of work engagement in organizational, social, and financial systems, undivided attention should be given to treatment of voice disorders among teachers.

Cultural and Linguistic Adaptation of Vocal Fatigue Index for Tamil-Speaking Population (VFI-T)

OBJECTIVE

To adapt the vocal fatigue index (VFI) for the Tamil-speaking population.

STUDY DESIGN

Cross-sectional research design METHOD: VFI developed originally in English was translated in the Tamil language, a South Indian Dravidian language. Content validity and reverse translation of VFI in Tamil [VFI-T] was done. The final of VFI-T was administered on 251 subjects with voice concerns/ problems and on 100 individuals with perceptually normal voice for validity and reliability measures.

RESULTS

Factor analysis of VFI-T yielded four factors as opposed to three factors in the English version of VFI. The four factors were extracted based on Eigenvalue and variance contributed by each factor namely, I-physical discomfort; II-tiredness of voice and avoidance of voice use; III-increased effort and its effect on voice quality, and IV-Improvement of symptoms with rest. Varimax rotation and factor loading values for individual items identified five items under factor I; seven items under factor II; four items under factor III, and three items were preserved under factor IV. Overall Cronbach's alpha coefficient was 0.91 and alpha values for four factors ranged from 0.75 to 0.85. Item-to-total correlation revealed good internal consistency between the items. The median and interquartile range of VFI-T for cases and controls were viz., I-6.00 (10.00); 0.00 (1.00), factor II-12.00 (11.00); 1.00 (3.00), factor III-7.00 (8.00); 1.00 (2.00), and factor IV-6.00 (6.00); 1.00 (3.00), respectively. Mann-Whitney U test revealed a significant difference between the scores of cases and controls (P < 0.00). Logistic regression suggested sensitivity of 96% and a specificity of 79% for the inventory in the Tamil language.

CONCLUSION

VFI-T identified and documented vocal fatigue under four factors in subjects with voice disorders.

Vocal Symptoms in Brazilian Professors: Self-Perception and Relationship Factors

OBJECTIVE

This study aimed to investigate the self-perception of vocal symptoms and relationship factors in Brazilian academic teacher.

METHODS

This was a cross-sectional study. The study sample consisted of 235 Brazilian academic teachers, of whom 103 were men and 132 women, aged between 26 and 67 years, and employed at 39 institutions. All participants filled out a questionnaire detailing the presence of vocal complaints, and occupation and sociodemographic information. The vocal symptoms were investigated using voice symptom scale.

RESULTS

Academic teacher with vocal complaints showed a higher perception of vocal symptoms in all domains (P < 0.001 for all). Other factors did not result in any significant difference.

CONCLUSION

The only factor that influences the self-perception of vocal symptoms in Brazilian academic teachers is the presence of vocal complaints.