Fabiana Zambon1, Felipe Moreti2, Mara Behlau2. 1. Department of Speech-Language Pathology and Audiology, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil; Sao Paulo Teachers Union - Sindicato dos Professores de São Paulo - SINPRO/SP, São Paulo, Brazil. Electronic address: fabianazambon@hotmail.com. 2. Department of Speech-Language Pathology and Audiology, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil.
Abstract
OBJECTIVES: To understand the coping strategies used by teachers with vocal complaints, compare the differences between those who seek and those who do not seek voice therapy, and investigate the relationships among coping and voice perceptual analysis, coping and signs and symptoms of voice, and coping and participation restrictions and limitations in vocal activities. STUDY DESIGN: Cross-sectional nonrandomized prospective study with control group. METHODS: Ninety female teachers participated in the study, of similar ages, divided into three groups: group 1 (G1) comprised 30 teachers with vocal complaints who sought voice therapy, group 2 (G2) comprised 30 teachers with vocal complaints who never sought voice therapy, and group 3 (G3) comprised 30 teachers without vocal complaints. The following analysis were conducted: identification and characterization questionnaire, addressing personal and occupational description, recording speech material for voice perceptual analysis, Voice Signs and Symptoms Questionnaire, Voice Activity and Participation Profile (VAPP), and Voice Disability Coping Questionnaire (VDCQ)-Brazilian Version. RESULTS: In relation to the voice perceptual analysis, there was statistically significant difference between the groups with vocal complaint (G1+G2), which had showed voices with mild-to-moderate deviation, and the group without vocal complaint (G1), which showed voices within the normal variability of voice quality (mean for G1 = 49.9, G2 = 43.7, and G3 = 32.3, P < 0.001). G1 had higher mean of voice signs and symptoms (G1 = 8.6, G2 = 6.6, and G3 = 2.0, P < 0.001) and higher scores in almost all dimensions of VAPP (P < 0.001), except for the aspects effect on job and effect on social communication. Individuals with vocal complaints who looked for voice therapy (G1) tended to use more problem-focused strategies and had higher scores in VDCQ (G1 = 45.4, G2 = 38.5, and G3 = 9.5, P < 0.001). The aspects that were correlated with VDCQ in the three groups were degree of vocal deviation, VAPP total score, VAPP partial scores of self-perceived severity of voice problem, effect on daily communication, effect on emotion, and participation restriction for G1; VAPP total score and partial score of effect on daily communication for G2; and all VAPP scores for G3. No correlation was found between voice signs and symptoms and coping. CONCLUSION: Teachers with vocal complaints who looked for voice therapy use more coping strategies. Moreover, they present a tendency to use more problem-focused coping strategies. Voice symptoms prompt the teachers into seeking treatment; however, they are not correlated with the coping itself. In general, the higher the perception of limitation and restriction of participating in vocal activities, the greater the use of coping strategies.
OBJECTIVES: To understand the coping strategies used by teachers with vocal complaints, compare the differences between those who seek and those who do not seek voice therapy, and investigate the relationships among coping and voice perceptual analysis, coping and signs and symptoms of voice, and coping and participation restrictions and limitations in vocal activities. STUDY DESIGN: Cross-sectional nonrandomized prospective study with control group. METHODS: Ninety female teachers participated in the study, of similar ages, divided into three groups: group 1 (G1) comprised 30 teachers with vocal complaints who sought voice therapy, group 2 (G2) comprised 30 teachers with vocal complaints who never sought voice therapy, and group 3 (G3) comprised 30 teachers without vocal complaints. The following analysis were conducted: identification and characterization questionnaire, addressing personal and occupational description, recording speech material for voice perceptual analysis, Voice Signs and Symptoms Questionnaire, Voice Activity and Participation Profile (VAPP), and Voice Disability Coping Questionnaire (VDCQ)-Brazilian Version. RESULTS: In relation to the voice perceptual analysis, there was statistically significant difference between the groups with vocal complaint (G1+G2), which had showed voices with mild-to-moderate deviation, and the group without vocal complaint (G1), which showed voices within the normal variability of voice quality (mean for G1 = 49.9, G2 = 43.7, and G3 = 32.3, P < 0.001). G1 had higher mean of voice signs and symptoms (G1 = 8.6, G2 = 6.6, and G3 = 2.0, P < 0.001) and higher scores in almost all dimensions of VAPP (P < 0.001), except for the aspects effect on job and effect on social communication. Individuals with vocal complaints who looked for voice therapy (G1) tended to use more problem-focused strategies and had higher scores in VDCQ (G1 = 45.4, G2 = 38.5, and G3 = 9.5, P < 0.001). The aspects that were correlated with VDCQ in the three groups were degree of vocal deviation, VAPP total score, VAPP partial scores of self-perceived severity of voice problem, effect on daily communication, effect on emotion, and participation restriction for G1; VAPP total score and partial score of effect on daily communication for G2; and all VAPP scores for G3. No correlation was found between voice signs and symptoms and coping. CONCLUSION: Teachers with vocal complaints who looked for voice therapy use more coping strategies. Moreover, they present a tendency to use more problem-focused coping strategies. Voice symptoms prompt the teachers into seeking treatment; however, they are not correlated with the coping itself. In general, the higher the perception of limitation and restriction of participating in vocal activities, the greater the use of coping strategies.