嗓音障碍的小学教师嗓音放大：一项随机临床试验。

Voice amplification for primary school teachers with voice disorders: a randomized clinical trial.

机构信息

Operative Unit of Otolaryngology and Otosurgery, Padua University, Padua, Italy,

出版信息

Int J Occup Med Environ Health. 2013 Jun;26(3):363-72. doi: 10.2478/s13382-013-0115-1. Epub 2013 Jul 1.

DOI:10.2478/s13382-013-0115-1

PMID:23817868

Abstract

OBJECTIVES

Several studies have demonstrated a high prevalence of voice disorders in teachers, together with the personal, professional and economical consequences of the problem. Good primary prevention should be based on 3 aspects: 1) amelioration of classroom acoustics, 2) voice care programs for future professional voice users, including teachers and 3) classroom or portable amplification systems. The aim of the study was to assess the benefit obtained from the use of portable amplification systems by female primary school teachers in their occupational setting.

MATERIALS AND METHODS

Forty female primary school teachers attended a course about professional voice care, which comprised two theoretical lectures, each 60 min long. Thereafter, they were randomized into 2 groups: the teachers of the first group were asked to use a portable vocal amplifier for 3 months, till the end of school-year. The other 20 teachers were part of the control group, matched for age and years of employment. All subjects had a grade 1 of dysphonia with no significant organic lesion of the vocal folds.

RESULTS

Most teachers of the experimental group used the amplifier consistently for the whole duration of the experiment and found it very useful in reducing the symptoms of vocal fatigue. In fact, after 3 months, Voice Handicap Index (VHI) scores in "course + amplifier" group demonstrated a significant amelioration (p = 0.003). The perceptual grade of dysphonia also improved significantly (p = 0.0005). The same parameters changed favourably also in the "course only" group, but the results were not statistically significant (p = 0.4 for VHI and p = 0.03 for perceptual grade).

CONCLUSIONS

In teachers, and particularly in those with a constitutional weak voice and/or those who are prone to vocal fold pathology, vocal amplifiers may be an effective and low-cost intervention to decrease potentially damaging vocal loads and may represent a necessary form of prevention.

摘要

目的

多项研究表明，教师中存在较高比例的嗓音障碍，该问题不仅给患者本人带来个人和职业方面的负面影响，也造成了巨大的经济损失。良好的初级预防应基于以下 3 个方面：1）改善教室声学环境，2）针对未来专业用嗓人群（包括教师）开展嗓音保健计划，3）采用教室或便携式扩音系统。本研究旨在评估女性小学教师在职业环境中使用便携式扩音系统的获益。

材料与方法

40 名女性小学教师参加了为期 3 个月的职业嗓音保健课程，包括 2 次各 60 分钟的理论讲座。此后，她们被随机分为两组：第 1 组教师被要求使用便携式嗓音放大器，直至学年结束；第 2 组为对照组，与第 1 组年龄和工龄匹配。所有受试者均存在 1 级嗓音障碍，声带无明显器质性病变。

结果

实验组大多数教师在整个实验过程中持续使用扩音器，并发现其在减轻嗓音疲劳症状方面非常有效。事实上，3 个月后，“课程+放大器”组的嗓音障碍指数（VHI）评分显著改善（p=0.003）。嗓音障碍的听觉评分也显著改善（p=0.0005）。仅课程组的这些参数也有良好的变化，但结果无统计学意义（VHI 为 p=0.4，听觉评分 p=0.03）。