Thomas George, de Jong Felix I C R S, Cremers Cor W R J, Kooijman Piet G C
Department of ORL, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Folia Phoniatr Logop. 2006;58(2):65-84. doi: 10.1159/000089609.
A cross-sectional questionnaire survey was done among 457 female student teachers and 144 females in the general population. The conclusions are based on the opinions of student teachers and the general population. The results of this study show that 39.6% of the student teachers and 32.6% of the general population reported voice complaints at the moment and/or over the past year (p=0.198). The association between various risk factors (vocal loading factors, physical factors, environmental factors and psycho-emotional factors) and voice complaints were examined. Vocal load was reported in both the student teachers and the general population (p=0.322). Among the subjects with voice complaints, the student teachers were significantly more of the opinion than the general population that environmental irritants in the classroom (p=0.001) and the composition of the group they communicate with (p=0.033) have a negative influence on their voice. In the groups with voice complaints, the student teachers reported significantly less than the general population that stress (p=0.004) and the deterioration of their general physical condition (p=0.003) have a negative influence on their voice. Remarkably, over a third of the student teachers and one fifth of the general population with voice complaints were of the opinion that decrease of hearing has a negative influence on their voices (p=0.113). There was no significant difference in Voice Handicap Index (VHI) scores (p=0.284) and impact of voice complaints among student teachers and the general population. Over 15% of the student teachers and the general population with voice complaints reported being or having been disabled due to the voice problem, probably reflecting the severity of the voice problem (p=0.838). The groups reporting voice complaints and disability in relation to their voice complaints have significantly higher VHI scores than those without voice complaints and disability, which indicates a higher psychosocial impact of voice complaints. Only around a third of the student teachers and the general population with voice complaints sought paramedical care (p=0.656)/treatment (p=0.361) for their voice complaint. Only a minority of student teachers (18.6%) and the general population (29.5%) with voice complaints were of the opinion that the number of people they communicate with has a negative influence on their voice (p=0.120). Only around a third of the student teachers and less than a tenth of the general population with voice complaints were of the view that they would develop a voice complaint due to their profession (p=0.003). Less than half of the student teachers and less than one fifth of the general population with voice complaints were aware of the potential risks of their profession on their voice (p=0.002). Voice complaints appear to have a multifactorial genesis. The student teachers are not sufficiently aware of the impact of the various risk factors on their voice. Furthermore, they are not aware of the potential risk that future teaching may have on their voice. This apparent lack of awareness in student teachers may be considered a risk factor for voice complaints.
对457名女学生教师和144名普通女性人群进行了横断面问卷调查。研究结论基于学生教师和普通人群的意见。本研究结果显示,39.6%的学生教师和32.6%的普通人群报告目前和/或过去一年有嗓音问题(p = 0.198)。研究了各种危险因素(嗓音负荷因素、身体因素、环境因素和心理情绪因素)与嗓音问题之间的关联。学生教师和普通人群均报告有嗓音负荷(p = 0.322)。在有嗓音问题的受试者中,学生教师比普通人群更明显地认为课堂中的环境刺激物(p = 0.001)以及他们交流对象的构成(p = 0.033)对其嗓音有负面影响。在有嗓音问题的人群中,学生教师报告压力(p = 0.004)和总体身体状况恶化(p = 0.003)对其嗓音有负面影响的比例显著低于普通人群。值得注意的是,超过三分之一有嗓音问题的学生教师和五分之一有嗓音问题的普通人群认为听力下降对其嗓音有负面影响(p = 0.113)。学生教师和普通人群在嗓音障碍指数(VHI)得分(p = 0.284)以及嗓音问题的影响方面没有显著差异。超过15%有嗓音问题的学生教师和普通人群报告因嗓音问题导致或曾经导致残疾,这可能反映了嗓音问题的严重程度(p = 0.838)。报告有嗓音问题及与嗓音问题相关残疾的人群的VHI得分显著高于无嗓音问题及残疾的人群,这表明嗓音问题对心理社会有更高的影响。只有约三分之一有嗓音问题的学生教师和普通人群因嗓音问题寻求辅助医疗护理(p = 0.656)/治疗(p = 0.361)。只有少数有嗓音问题的学生教师(18.6%)和普通人群(29.5%)认为他们交流的人数对其嗓音有负面影响(p = 0.120)。只有约三分之一有嗓音问题的学生教师和不到十分之一有嗓音问题的普通人群认为他们会因职业而出现嗓音问题(p = 0.003)。不到一半有嗓音问题的学生教师和不到五分之一有嗓音问题的普通人群意识到其职业对嗓音的潜在风险(p = 0.002)。嗓音问题似乎有多种成因。学生教师对各种危险因素对其嗓音的影响认识不足。此外,他们没有意识到未来教学可能对其嗓音产生的潜在风险。学生教师中这种明显的认识不足可能被视为嗓音问题的一个危险因素。