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与因嗓音导致工作受限相关的因素:巴西基础教育教师的研究

Factors Associated With the Limitation at Work Because of the Voice: Study With Teachers of Basic Education In Brazil.

作者信息

Rezende Bárbara Antunes, Abreu Mery Natali Silva, Assunção Ada Ávila, de Medeiros Adriane Mesquita

机构信息

Graduate Program in Public Health, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.

Department of Applied Nursing, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

J Voice. 2023 Jan;37(1):79-91. doi: 10.1016/j.jvoice.2020.11.003. Epub 2020 Nov 17.

DOI:10.1016/j.jvoice.2020.11.003
PMID:33214005
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.

摘要

引言

嗓音障碍会导致工作受限,因为它会影响沟通和教学功能的发挥。

目的

分析因嗓音导致的工作受限情况,并研究巴西基础教育教师的社会人口学特征、生活与健康习惯及工作条件之间可能存在的关联。

方法

2015年10月至2016年3月期间开展了一项具有代表性样本的横断面流行病学研究,研究对象为巴西6324名基础教育教师。通过电话问卷的方式收集数据,问卷包含有关健康和工作条件的问题。“因嗓音导致的工作受限”被视为因变量,其回答选项是一个包含四个李克特量表项目的量表,范围从频繁到从不。自变量被分组用于有序逻辑回归分析,并采用分层进入法。关联强度通过比值比(OR)及其相应的置信区间(95%CI)进行评估。

结果

三分之一的巴西教师(32.7%)报告在调查前一个月的某个时刻因嗓音出现过某种程度的工作受限(有时;很少;频繁),其中5%表示受限频繁。增加因嗓音导致更高频率工作受限可能性的因素有:女性(OR = 1.32;95%CI = 1.15 - 1.51);教授小学课程(OR = 1.35;95%CI = 1.02 - 1.78);使用抗焦虑或抗抑郁药物(OR = 1.46;95%CI = 1.20 - 1.78);因担忧而失眠(OR = 1.69;CI = 95% = 1.46 - 1.95);学校噪音大(OR = 2.09;95%CI = 1.78 - 2.46);学生违纪导致环境嘈杂(OR = 1.37;95%CI = 1.15 - 1.63);工作要求高(OR = 1.18;95%CI = 1.02 - 1.36);缺乏社会支持(OR = 1.19;95%CI = 1.04 - 1.38);遭受学生言语暴力(OR = 1.43;95%CI = 1.23 - 1.67)。另一方面,定期进行体育锻炼(OR = 0.86;95%CI = 0.75 - 1.00)以及有足够时间完成工作任务(OR = 0.71;95%CI = 0.62 - 0.82)会降低因嗓音问题导致更高频率工作受限的可能性。与东南部地区相比,北部(OR = 1.41;95%CI = 1.17 - 1.71)和东北部(OR = 1.46;95%CI = 1.22 - 1.76)的教师更频繁地认为工作因嗓音而限制了教学表现。

结论

与因嗓音导致更高频率报告工作受限可能性增加相关的因素包括:女性、缺乏体育锻炼、因担忧而失眠、使用抗焦虑或抗抑郁药物、学校位于北部和东北部、教授小学阶段课程、学校噪音大以及工作组织的社会心理方面。巴西教育部门需要制定考虑到地区不平等以及教师健康和工作条件的公共政策。

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