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Introdução: a relação entre voz e trabalho é objeto de estudo constante. Ainda não há investigação sobre a relação de monotonia e autonomia com queixas vocais. Objetivo: investigar a relação entre a monotonia e a autonomia no ambiente de trabalho com o surgimento de queixas vocais entre professores. Método: estudo exploratório, qualitativo e descritivo, realizado a partir de grupo focal considerando o ineditismo da temática do estudo. Dez professores triados em estudo anterior com suspeita de distúrbio de voz pelo Índice de Triagem de Distúrbio de Voz, que indicaram percepção de monotonia e falta de autonomia no ambiente de trabalho por meio do instrumento Condições de Produção Vocal de Professores foram convidados a participar. Sete professores aceitaram e foram conduzidos dois grupos focais. Perguntas disparadoras sobre monotonia e autonomia no ambiente de trabalho foram feitas. Após análise de conteúdo, foram criadas quatro categorias principais e subcategorias de análise. Resultados: os participantes debateram questões relacionadas à quebra de expectativas sobre o trabalho, frustrações, rotina e desafios diários. Considerações sobre a voz estavam relacionadas ao uso repetitivo e por longos períodos e ambiente com acústica desfavorável. Queixas como rouquidão e baixa projeção vocal foram citadas. Conclusão: monotonia no ambiente de trabalho foi percebida como algo repetitivo e as relações com o surgimento de queixas vocais podem estar relacionadas a situações de uso da voz de forma intensa e constante. A falta de autonomia parece ocasionar a monotonia e, consequentemente, desmotivação, frustração com a carreira e adoecimento, dentre eles, o distúrbio de voz. (AU)
Introduction: the relationship between voice and work is the subject of constant study. There is still no investigation into the relationship between monotony and autonomy and vocal complaints. Objective:to investigate the relationship between monotony and autonomy in the workplace with the emergence of vocal complaints among teachers. Method: exploratory, qualitative and descriptive study, carried out through a focus group considering the novelty of the study theme. Ten teachers screened in a previous study with suspected voice disorders using the Voice Disorder Screening Index, who indicated a perception of monotony and lack of autonomy in the work environment using the Teacher Vocal Production Conditions instrument were invited to participate. Seven teachers accepted and two focus groups were conducted. Triggering questions about monotony and autonomy in the workplace were asked. After content analysis, four main categories and subcategories of analysis were created. Results: participants discussed issues related to broken expectations about work, frustrations, routine and daily challenges. Considerations about the voice were related to repetitive use for long periods and an environment with unfavorable acoustics. Complaints such as hoarseness and low vocal projection were cited. Conclusion: monotony in the work environment was perceived as something repetitive and the relationship with the emergence of vocal complaints may be related to situations of intense and constant use of the voice. The lack of autonomy seems to cause monotony and, consequently, demotivation, frustration with one's career and illness, including voice disorders. (AU)
Introducción: la relación entre voz y trabajo es objeto de constante estudio. Todavía no se ha investigado la relación entre monotonía, autonomía y quejas vocales. Objetivo: investigar la relación entre monotonía y autonomía en el lugar de trabajo con la aparición de quejas vocales entre docentes. Método: estudio exploratorio, cualitativo y descriptivo, realizado a través de un grupo focal considerando la novedad del tema de estudio. Se invitó a participar a diez docentes evaluados en un estudio previo con sospecha de trastornos de la voz mediante el Voice Disorder Screening Index, que indicaron una percepción de monotonía y falta de autonomía en el ambiente de trabajo utilizando el instrumento Teacher Vocal Production Conditions. Siete profesores aceptaron y se realizaron dos grupos focales. Se formularon preguntas desencadenantes sobre la monotonía y la autonomía en el lugar de trabajo. Luego del análisis de contenido, se crearon cuatro categorías y subcategorías principales de análisis. Resultados:los participantes discutieron cuestiones relacionadas con expectativas rotas sobre el trabajo, frustraciones, rutina y desafíos diarios. Las consideraciones sobre la voz estuvieron relacionadas con el uso repetitivo por períodos prolongados y un ambiente con acústica desfavorable. Se citaron quejas como ronquera y baja proyección vocal. Conclusión: la monotonía en el ambiente laboral fue percibida como algo repetitivo y la relación con la aparición de quejas vocales puede estar relacionada con situaciones de uso intenso y constante de la voz. La falta de autonomía parece provocar monotonía y, en consecuencia, desmotivación, frustración con la propia carrera y enfermedades, incluidos trastornos de la voz. (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Distúrbios da Voz/etiologia , Professores Escolares , Condições de Trabalho , Voz , Saúde Mental , Saúde Ocupacional , Grupos Focais , Pesquisa QualitativaRESUMO
Introdução: considera-se importante que fonoaudiólogos apresentem suas vozes como modelo ao realizar uma intervenção fonoaudiológica. Objetivo: conhecer a autoavaliação da voz e sintomas vocais de um grupo de acadêmicos de fonoaudiologia relacionando os achados ao diagrama de desvio fonatório. Método: estudo do tipo analítico, observacional, com 88 estudantes de Fonoaudiologia de uma mesma faculdade, 82 mulheres e seis homens, média de idade de 21,9 anos, sem diagnóstico de disfonia, autorreferidos saudáveis. Foram registrados e comparados dados relativos à autoavaliação da voz e de sintomas vocais, utilizando-se a Escala de Sintomas Vocais. Numa segunda etapa os estudantes foram convidados a realizar uma análise acústica de suas vozes e os que aceitaram (63,6%) procederam com a coleta das amostras de voz, programa VoxMetria® CTS. Para tratamento dos dados foram utilizados Teste T student e Matriz de Correlações construída com os resultados do Teste T- student (nível de confiança de 95%, alpha 5%). Resultados: a Escala de Sintomas Vocais revelou 44,31% dos participantes com escores brutos igual ou superior a 16 pontos, indicando risco vocal, com maior comprometimento do domínio físico. Alunos do último ano obtiveram escores mais elevados, com predomínio de secreção e pigarro na garganta. Houve correlação positiva entre fumar (7,95%) e aumento da nota final. A análise acústica revelou 40% das vozes com diagrama de desvio fonatório fora do quadrante de vozes normais, irregularidade da voz, jitter e shimmer alterados. Conclusão: a combinação dos dois instrumentos utilizados para conhecimento de risco de disfonia em estudantes de Fonoaudiologia mostra-se relevante e reforça a importância de programas de prevenção de saúde vocal também em futuros fonoaudiólogos. (AU)
Introduction: speech therapists must present their voices as a model for a speech therapy intervention. Objective: to understand the voice self-assessment and vocal symptoms of a group of speech therapy students, relating the findings to the phonatory deviation diagram. Method: an analytical observational study was conducted with 88 speech therapy students from the same college, consisting of 82 women and 6 men, averaging 21.9 years old, who reported no diagnosis of dysphonia, and self-reported as healthy. Data relating to voice self-assessment and vocal symptoms were recorded and compared, using the Vocal Symptoms Scale (VoiSS). In the second stage, students were invited to perform an acoustic analysis of their voices and those who accepted (63.6%) proceeded with the collection of voice samples, using the VoxMetria® CTS program. To process the data, the T-student Test and Correlation Matrix constructed with the results of the T-student Test (confidence level of 95%, alpha 5%) were used. Results: The Vocal Symptoms Scale (student T-test) revealed 44.31% of participants with raw scores equal to or greater than 16 points, indicating vocal risk and greater impairment of the physical domain. Final year students obtained higher scores, with a predominance of secretion and throat clearing. There was a positive correlation between smoking (7.95%) and an increase in the final grade. The acoustic analysis revealed 40% of the voices with a phonatory deviation diagram outside the quadrant of normal voices, voice irregularity, altered jitter, and shimmer. Conclusion: The combination of the two instruments used to understand the risk of dysphonia in speech therapy students is relevant and reinforces the importance of vocal health prevention programs for future speech therapists. (AU)
Introducción: los fonoaudiologos deben presentar su voz como modelo para realizar una intervención logopédica. Objetivo: comprender la autoevaluación vocal y los síntomas vocales de un grupo de estudiantes de fonoaudiología, relacionando los hallazgos con el diagrama de desviación fonatoria. Método: se realizó un estudio observacional analítico, observacional, con 88 estudiantes de fonoaudiología de la misma facultad, conformados por 82 mujeres y 6 hombres, com edad promedio de 21,9 años, quienes no refirieron diagnóstico de disfonia y se autorefiriron como sanos. Los datos relacionados con la autoevaluación de la voz y los síntomas vocales se registraron y compararon mediante la Escala de Síntomas Vocales. En la segunda etapa, los estudiantes fueron invitados a realizar un análisis acústico de sus voces y los que aceptaron (63,6%) procedieron a la recolección de muestras de voz, utilizando el programa VoxMetria® CTS. Para procesar los datos se utilizó la Prueba T de Student y la Matriz de Correlación, construida con los resultados de la Prueba T de Student (nivel de confianza del 95%, alfa 5%). Resultados: La Escala de Síntomas Vocales (prueba T de Student) reveló puntuaciones brutas iguales o superiores a 16 puntos (44,31%), lo que indica riesgo vocal y mayor afectación del dominio físico. Los estudiantes de último año obtuvieron puntuaciones más altas, con predominio de secreción y carraspeo. Hubo correlación positiva entre fumar (7,95%) y aumento en la nota final. El análisis acústico reveló voces presentando diagrama de desviación fonatoria fuera del cuadrante de normaliadad (40%), irregularidad de la voz, jitter y shimmer alterados. Conclusión: La combinación de los dos instrumentos utilizados para comprender el riesgo de disfonía en estudiantes de fonoaudiologia es relevante y refuerza la importancia de los programas de prevención de la salud vocal para futuros fonoaudiologos. (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Estudantes de Ciências da Saúde , Voz , Fonoaudiologia , Autoteste , Qualidade da Voz , Distúrbios da Voz , Estudos Prospectivos , DisfoniaRESUMO
Introdução: o presente estudo visa mapear e avaliar a produção registrada sobre Fonoaudiologia Empresarial, a fim de identificar as temáticas mais pesquisadas, bem como as temáticas pouco exploradas em dissertações e teses na área. Objetivo: analisar a produção científica brasileira defendida entre 2002-2022, considerando nível de produção, ano, rede de ensino, instituição de ensino superior (localização geográfica), tipo de pesquisa, descritor registrado (primeiro), local, temática, total da amostra pesquisada e áreas de conhecimento. Método: revisão realizada na Biblioteca Digital Brasileira de Teses e Dissertações, em 05 de maio de 2023, considerando os termos "Fonoaudiologia" e "Empresa", pesquisados no período 2002-2022, segundo as variáveis anteriormente descritas, analisados de forma descritiva. Resultados:dentre 30 fontes registradas, 24-80,0% são dissertações, sendo 2007 o ano mais produtivo (6-20,0%). A Região Sudeste liderou a pesquisa (20-66,7%), representada pela PUC-SP (10-33,3%) e o destaque foi de pesquisas do tipo observacional (22-73,3%), sendo Empresas os locais mais pesquisados (20-66,7%) e o descritor "saúde do trabalhador" o mais utilizado (03-10,0%). A área de conhecimento (CNPq) que mais pesquisou foi Ciências da Saúde (25-83,3%) por meio da subárea Fonoaudiologia (20-66,7%%), sendo a Audiologia a temática mais pesquisada (16-53,3%). Conclusão: foram encontrados 16,53,3% registros na área de Audiologia e as pesquisas realizadas na área de Voz (7-23,3%) abordam os temas relacionados a qualidade vocal, comunicação e expressividade, no entanto, não abordam liderança. Tal dado sugere esforços em pesquisas científicas e atuação profissional, já que a Fonoaudiologia tem como objeto de estudo e atuação, a comunicação humana.(AU)
Introduction: this study aims to explore the Speech-Therapy's literature and its contribution to identify the most researched and few explored themes in dissertations and theses in the area. Objective:to analyze the Brazilian scientific production submitted between 2002 and 2022, considering production level, publication year, institution of defense, geographical location, research methodology, the first descriptor, research location, the thematic focus, total sample size and knowledge areas. Method: the review analysis was conducted using data obtained from the Brazilian Digital Library of Theses and Dissertations on May 5, 2023, using the terms: "Speech-Therapy" and "Company" to retrieve theses and dissertations from 2002 to 2022 according to the variables described above. Data were analyzed descriptively. Results: among the 30 entries retrieved, 24-80,0% were dissertations, most of which defended in 2007 (6-20,0%). The majority of the studies were from the Southeast region (20- 66.7%), represented by Pontifícia Universidade Católica de São Paulo: PUC-SP (10-33.3%) and the highlight was observational researches (22-73.3%) and the majority of the research was conducted at business companies (20-66,7%). In addition, "worker's health" was the most used descriptor (3-10,0%). The knowledge area (CNPQ) that produced the most studies was Health Sciences (25-83,3%) through the subarea of Speech-Language-Pathology (20-66,7%%), with Audiology being the most researched theme (16-53,3%). Conclusion: Audiology was the area with the highest number of studies found 16,53,3%. Research conducted in the Voice field (7-23,3%) addresses topics related to vocal quality, communication and expressiveness, however, they do not address leadership. The findings suggest a need for future research. Further studies can build upon insights to advance knowledge and promote evidence-based practice in the field of business companies, considering that Speech-Therapy has as its object of study and activity human communication. (AU)
Introducción: este estudio tiene como objetivo mapear y evaluar la producción grabada sobre Fonoaudiología Empresarial, con el fin de identificar los temas más investigados, así como los temas poco explorados en disertaciones y tesis en el área. Objetivo: analizar la producción científica brasileña defendida entre 2002-2022, considerando nivel de producción, año, red educativa, institución de educación superior (ubicación geográfica), tipo de investigación, descriptor registrado (primero), ubicación, tema, muestra total investigada y áreas. del conocimiento. Método: revisión realizada en la Biblioteca Digital Brasileña de Tesis y Disertaciones, el 5 de mayo de 2023, considerando los términos "Fonoaudiología" y "Empresa", investigados en el período 2002-2022, según las variables previamente descritas, analizadas en una manera descriptiva. Resultados: entre 30 fuentes registradas, 24-80,0% son disertaciones, siendo 2007 el año más productivo (6-20,0%). La Región Sudeste lideró la investigación (20-66,7%), representada por la PUC-SP (10-33,3%) y destaque para la investigación observacional (22-73,3%), siendo las Empresas las localidades más investigadas (20-66,7%) y el descriptor "salud del trabajador" el más utilizado (03-10,0%). El área del conocimiento (CNPq) más investigada fue Ciencias de la Salud (25-83,3%) a través de la subárea Fonoaudiología (20-66,7%), siendo la Audiología el tema más investigado (16-53,3%). Conclusión: Se encontraron 16,53,3% registros en el área de Audiología y las investigaciones realizadas en el área de Voz (7-23,3%) abordan temas relacionados con la calidad vocal, la comunicación y la expresividad, sin embargo, no abordan el liderazgo. Estos datos sugieren esfuerzos en la investigación científica y en el desempeño profesional, ya que la Fonoaudiología tiene como objeto de estudio y actividad la comunicación humana. (AU)
Assuntos
Organizações , Dissertações Acadêmicas como Assunto , Fonoaudiologia , Fala , Voz , Brasil , Bibliometria , Comunicação , LiderançaRESUMO
OBJECTIVE: Zombification, a magical and religious process in Haiti, has been scientifically studied and remains relevant. Originating from the convergence of African, Caribbean, and Christian rites, it involves a comatose trance, transforming individuals into living dead through Voodoo practices. Haitian zombies consistently exhibit a preserved expression marked by a nasal voice, a result of nasalization-using nasal cavities as resonators during phonation. The aim of this study was to ascertain the mechanisms through which zombification could impact the voices of the subjects. METHODS: A comprehensive investigation was conducted using both primary and secondary sources. Primary sources involved direct or reported testimonies of individuals undergoing zombification, with audio or video recordings available from the collections of the Laboratory of Anthropology, Archaeology, and Biology (UVSQ/Paris-Saclay University), as well as on the internet. Secondary sources encompassed the entirety of existing literature regarding zombification in Haiti on one hand, alterations in the voices of subjects when mentioned on the other hand, and toxicological hypotheses or evidence available on PubMed/Medline and Google Scholar. RESULTS: Few post-zombification observations exist, but 20th-century studies clarified the physio pathological process, confirming its reality. Wade Davis demonstrated in 1983 that zombification results from poisoning, with effects ranging from reversible to fatal, implicating substances like tetrodotoxin and datura. Nasalization can be natural or pathological, affecting various phonemes. No mutilating acts or surgery have been reported related to Haitian zombification. CONCLUSION: The pharmacological characteristics of tetrodotoxin, coupled with testimonials, present a medical hypothesis elucidating the biological mechanism underlying nasalization in this context. Given that tetrodotoxin induces flaccid paralysis as a neurotropic poison, its neurological impact could account for soft palate paralysis or spasms. Additionally, the severe hypotension induced by tetrodotoxin may elucidate oral and pharyngeal necrosis.
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Introduction Teachers are a high-risk group for the development of vocal dysfunction, as they use voice extensively in their profession. Objective To know the prevalence and risk factors associated with voice strain in teachers. Methods A cross-sectional study was conducted among schoolteachers in Chitwan, Nepal. The Voice Handicap Index questionnaire was used as a survey tool. Result A total of 315 teachers were enrolled in the study. The mean age of the participants was of 36.7 years. Teachers from public schools, primary grade classes, > 50 pupils in the classroom, > 24 hours of classes per week, dust in class, and recurrent tonsil problems were associated with various degrees of vocal handicap. Conclusion There is a high prevalence of voice disorder among teachers. A holistic approach, which includes teacher education regarding voice care during their work and management of their voice handicap by taking into consideration different risk factors, must be adopted.
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OBJECTIVE: To analyze the reliability, measurement error, and responsiveness of the Voice Handicap Index (VHI) for measuring voice handicap in individuals with voice disorders. METHODS: This systematic review followed the recommendations of the COnsensus-based Standards for the Selection of Health Measurement INstruments. Studies that validated the VHI, analyzed the measurement properties of reliability, measurement error, or responsiveness, and had dysphonic individuals as the study population were included. The following electronic databases were searched: Cochrane Library, EMBASE, LILACS, PubMed, Scopus, and Web of Science. The manual search was carried out on gray literature in the Biblioteca Digital Brasileira de Teses e Dissertações and ProQuest Dissertation & Theses, in addition to mapping citations and consulting an expert in the field. Evidence selection, data extraction, risk of bias analysis, certainty of evidence, and good psychometric measurements were performed by two blinded and independent reviewers. A meta-analysis was performed using Fisher's transformed r-to-z correlation coefficient and standardized mean difference. Heterogeneity was calculated using Tau² and I² statistical tests in JAMOVI 2.3.2 software. RESULTS: Eighty studies were included in the meta-analysis. When assessing the risk of bias, most studies were classified as inadequate during the reliability and measurement error stages. In the responsiveness stage, they were classified as doubtful in the sensitivity and specificity sub-boxes and good in the comparison sub-box with a gold standard instrument. For psychometric properties, most studies were classified as indeterminate in terms of both reliability and responsiveness. In test-retest reliability and responsiveness, the average outcome differed significantly from zero, indicating agreement between the test and retest moments and a significant reduction in the VHI score after intervention. Considering certainty of the evidence, the level of evidence was very low in both the reliability and responsiveness stages. The analyzed studies did not evaluate observational errors, and hence, they were not considered in this review. CONCLUSION: The VHI proved to be reliable and responsive in measuring voice handicap. However, it should be used with caution, as there is heterogeneity, a risk of bias, and no adherence to the analysis of observational error.
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Abstract Objective: Emergence delirium is a common complication in children. Recorded mother's voice, as a non-pharmacological measure, is increasingly used to prevent the emergence of delirium in pediatric patients, but sufficient evidence is still needed to prove its efficacy. Methods: Embase, PubMed, Cochrane Library, Web of Science, CINAHL, and Sinomed databases were searched for randomized controlled trials exploring the efficacy of recorded mother's voice in preventing the emergence of delirium in pediatric patients undergoing general anesthesia. The original data were pooled for the meta-analysis with Review Manager 5.4.1. This study was conducted based on the Cochrane Review Methods. Results: Eight studies with 724 children were included in the analysis. Recorded mother's voice reduced the incidence of emergence delirium when compared with either no voice (RR: 0.45; [95 % CI, 0.34 - 0.61]; p < 0.01; I2 = 7 %) or stranger's voice (RR: 0.51; [95 % CI, 0.28 - 0.91]; p = 0.02; I2 = 38 %) without increasing other untoward reactions. In addition, it shortened the post-anesthesia care unit stay time when compared with no voice (MD = -5.64; [95 % CI, -8.43 to -2.58]; p < 0.01, I2 = 0 %), but not stranger's voice (MD = -1.23; [95 % CI, -3.08 to 0.63]; p = 0.19, I2 = 0 %). It also shortened the extubation time and reduced the incidence of postoperative rescue analgesia. Conclusion: The current analysis indicated that recorded mother's voices could reduce the incidence of emergency delirium, shorten post-anesthesia care unit stay time and extubation time, and decrease the incidence of postoperative rescue analgesia in children.
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Introdução: A voz é um indicador de estados emocionais, influenciada por fatores como o tônus vagal, a respiração e a variabilidade da frequência cardíaca. O estudo explora esses fatores e a relação com a regulação emocional e a prática meditativa como técnica de autorregulação. Objetivo: Investigar a diferença nas características vocais e na variação da frequência cardíaca em meditadores experientes (EM) e novatos (NM) antes e depois de uma prática meditativa e em não praticantes de meditação grupo controle (CG), antes e depois de um teste controle. Métodos: Estudo quase-fatorial 3 x 2. Três grupos foram avaliados (meditadores experientes EM; meditadores novatos NM; e grupo controle CG, não praticantes de meditação) em dois momentos da manipulação experimental antes e depois de uma sessão meditativa para praticantes de meditação, e antes e depois de uma tarefa de busca de palavras para o grupo controle. A frequência fundamental, jitter, shimmer, relação harmônico-ruído e o primeiro (F1), o segundo (F2) e terceiro (F3) formantes da vogal [a]; a variação da frequência cardíaca (SDNN, RMSSD, LF/HF, SD1 and SD2); estado de ansiedade e autopercepção vocal, foram investigados, antes e após a intervenção. Resultados: O grupo EM alcançou ótimo relaxamento do trato vocal. Os grupos NM e CG apresentaram mudanças em F1. Prática meditativa, de longa duração, está associado com grande diferença em F3, SDNN e SD2 na variação da frequência cardíaca. Conclusão: Os resultados sugerem que prática meditativa influencia a expressão vocal e reação emocional, e que a experiência em prática meditativa favorece esta relação. (AU)
Introduction: The voice is an indicator of emotional states, influenced by factors such as vagal tone, breathing and heart rate variability. This study explores these factors and their relationship with emotional regulation and meditative practice as a self-regulation technique. Purpose: To investigate the difference in vocal characteristics and heart rate variability in experienced (EM) and novice (NM) meditators before and after a meditation practice and in non-meditators - control group (CG), before and after a control test. Methods: 3 x 2 quasi-factorial study. Three groups were evaluated (experienced meditators EM; novice meditators NM; and control group CG, non-meditators) at two points in the experimental manipulation - before and after a meditation session for meditators, and before and after a word search task for the control group. The fundamental frequency, jitter, shimmer, harmonic-to-noise ratio and the first (F1), second (F2) and third (F3) formants of the vowel [a]; heart rate variation (SDNN, RMSSD, LF/HF, SD1 and SD2); anxiety state and vocal self-perception, were investigated, before and after the intervention. Results: The EM group achieved optimal vocal tract relaxation. The NM and CG groups showed changes in F1. Long-term meditative practice was associated with a large difference in F3, SDNN and SD2 in heart rate variation. Conclusion: The results suggest that meditation practice influences vocal expression and emotional reaction, and that experience in meditation practice favors this relationship. (AU)
Introducción: La voz es un indicador de los estados emocionales, influida por factores como el tono vagal, la respiración y la variabilidad de la frecuencia cardiaca. Este estudio explora estos factores y su relación con la regulación emocional y la práctica de la meditación. Objetivo: Investigar la diferencia en las características vocales y variabilidad de la frecuencia cardiaca en meditadores experimentados (EM) y novatos (NM) antes y después de una práctica de meditación y en no meditadores - grupo control (GC), antes y después de una prueba control. Métodos: Estudio cuasi-factorial 3 x 2. Se evaluaron tres grupos (meditadores experimentados EM; meditadores novatos NM; y grupo control CG, no meditadores) en dos momentos - antes y después de una sesión de meditación para los meditadores, y antes y después de una tarea de búsqueda de palabras para el grupo control. Se investigaron la frecuencia fundamental, jitter, shimmer, relación armónico-ruido y los formantes primero (F1), segundo (F2) y tercero (F3) de la vocal [a]; la variación de la frecuencia cardiaca (SDNN, RMSSD, LF/HF, SD1 y SD2); el estado de ansiedad y autopercepción vocal, antes y después de la intervención. Resultados: El grupo EM consiguió una relajación óptima del tracto vocal. Los grupos NM y CG mostraron cambios en F1. La práctica de meditación a largo plazo se asocia con una gran diferencia en F3, SDNN y SD2 en la variación de la frecuencia cardiaca. Conclusión: Los resultados sugieren que la práctica de meditación influye en la expresión vocal y reacción emocional. (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Voz , Meditação , Regulação Emocional , Estudos Controlados Antes e Depois , Reconhecimento de Voz/fisiologiaRESUMO
El presente documento resume los principales aportes del conversatorio titulado "Trabajo interdisciplinario en las profesiones de la voz humana: retos, límites y proyecciones", organizado por Vocology Center el 18 de julio de 2023, que reunió a líderes y representantes de diversas agremiaciones relacionadas con la voz humana, incluyendo profesionales del ámbito clínico, artístico, rehabilitación vocal, voz ocupacional, pedagogía vocal y otras disciplinas afines. El propósito de este conversatorio fue promover un debate crítico sobre la naturaleza del trabajo interdisciplinario en el estudio de la voz humana. Se exploraron los desafíos que surgen al configurar equipos de trabajo que incluyan profesionales con diferentes enfoques y experticias en el abordaje de la voz, así como los límites inherentes a los diversos roles y funciones desempeñados por los profesionales especializados en este campo, junto con las cuestiones éticas emergentes en este proceso. Con un enfoque encaminado a fortalecer alianzas interdisciplinarias, el evento se centró en la búsqueda de una comunicación y colaboración más efectiva. Este documento marca un avance significativo en la comprensión y colaboración interdisciplinar en el cuidado de la voz humana.
This document summarizes the main contributions of the panel discussion titled "Interdisciplinary work in the human voice professions: challenges, limits and projections" organized by the Vocology Center on July 18, 2023. The event brought together leaders and representatives from various associations related to the human voice, including professionals from the clinical, artistic, vocal rehabilitation, occupational voice, vocal pedagogy, and other related disciplines. The purpose of this panel discussion was to promote a critical debate on the nature of interdisciplinary work in the study of the human voice. The discussion explored the challenges that emerge when teams that include professionals with different approaches and expertise address voice production, as well as the inherent boundaries of the various roles and functions performed by specialized professionals in this field, along with the emerging ethical issues in this process. With a focus on strengthening interdisciplinary collaborations, the event centered on seeking more effective communication and collaboration. This document represents a significant step forward in understanding and fostering interdisciplinary cooperation in the care of the human voice.
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Introduction: The conditions of teachers' work during the COVID-19 pandemic affected teachers' lives regarding voice disorder and stress, even in emergency remote classroom situation. Objective: To analyze the relationship between the presence of voice disorder, job stress, and COVID-19 in teachers when in emergency remote classroom teaching situation at the time of the pandemic. Method: This is a primary, exploratory, observational cross-sectional study with the use of survey forwarded online during the period of emergency classes after the arrival of COVID-19 pandemic in Brazil. The teachers answered the sociodemographic questions about the presence of COVID-19 and the following instruments: Condition of Vocal Production-Teacher [Condição de Produção Vocal - Professor (CPV-P)], Screening Index for Voice Disorder (SIVD), and Job Stress Scale (JSS). Results: Of the 118 teachers analyzed, 94.1% were female; the average age was 44 years. The SIVD recorded the presence of voice disorder in 66.9% of the participants. Regarding the JSS, which are the findings related to stress at work in the demand domain, the teachers showed high levels, a fact which presupposes the existence of pressure of psychological nature to perform their work. Conclusion: The teachers self-reported the presence of voice disorder even in remote class situation, on the occasion of COVID-19, which were more common in older teachers. When comparing the presence of voice disorders, coronavirus symptoms, and stress domains in relation to demand, control, and social support, there was no significance. It is hoped that this study will help to reflect on the need to improve teachers' working conditions, strengthening work-related voice disorder actions and guiding actions for vocal care and well-being.
Introducción: Las condiciones de trabajo de los profesores durante la pandemia de COVID-19 afectaron sus vidas en lo que respecta al trastorno de la voz y el estrés, incluso en situaciones de emergencia en aulas remotas. Objetivo: Analizar la relación entre la presencia de trastorno de la voz, estrés laboral y COVID-19 en profesores cuando se encontraban en situación de emergencia de enseñanza en aulas remotas en la época de la pandemia. Método: Se trata de un estudio primario, exploratorio, observacional de tipo transversal, con el uso de encuesta remitida online durante el periodo de clases de emergencia tras la llegada de la pandemia de COVID-19 en Brasil. Los profesores respondieron a las preguntas sociodemográficas sobre la presencia de COVID-19 y a los siguientes instrumentos: Condición de Producción Vocal-Profesor (CPV-P), Índice de Detección de los Trastornos de la Voz (SIVD) y Escala de Estrés Laboral (JSS). Resultados: De los 118 profesores analizados, el 94,1% eran mujeres; la mediana de edad era de 44 años. El (SIVD) registró la presencia de trastorno de la voz en el 66,9% de los participantes. En cuanto a la JSS, que son los hallazgos relacionados con el estrés laboral en el dominio de la demanda, los profesores mostraron niveles elevados, hecho que presupone la existencia de presiones de naturaleza psicológica para realizar su trabajo. Conclusión: Los profesores autoinformaron de la presencia de trastornos de la voz incluso en situación de clase a distancia, con ocasión del COVID-19, que fueron más frecuentes en los profesores de más edad. Al comparar la presencia de trastornos de la voz, los síntomas del coronavirus y los dominios de estrés en relación con la demanda, el control y el apoyo social, no hubo resultados significativos. Se espera que este estudio ayude a reflexionar sobre la necesidad de mejorar las condiciones de trabajo de los docentes, fortaleciendo las acciones de Trastorno de la voz relacionado con el trabajo (WRVD) y orientando acciones para el cuidado y bienestar vocal.
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In recent years, there have been international references to the vocal approach for the specific group of transgender individuals, although the Latin American literature is still very timid on this matter. The purpose of this article is to identify the current norms, statistics, and vocal approach towards transgender individuals in Chile and Argentina, considering the experience of two speech and language pathologists with more than twenty years of experience on voice therapy. Reflections were made on the transgender reality in these countries, the limitations in the implementation of the depathologization of the transgender group were outlined, some current and unreliable statistics were presented, some innovative actions in the public system were highlighted, and the lack of knowledge about the benefits of vocal work for transgender men and women was discussed. The identified aspects could benefit from multicenter research that strengthens speech therapy actions with this group, contributing to depathologization and positive approach.
Desde los últimos años es posible encontrar referencias internacionales sobre el abordaje vocal al grupo específico de las personas transgénero, aunque la literatura latinoamericana sigue muy tímida en este asunto. La propuesta de este artículo es identificar las normas vigentes, estadísticas y abordaje vocal hacia las personas transgénero en Chile y Argentina, considerando la experiencia de dos fonoaudiólogas con más de veinte años de experiencia en terapia vocal. Se hicieron reflexiones sobre la realidad transgénero en los países citados, se delinearon las limitaciones en la puesta en práctica de la despatologización del grupo transgénero, se expusieron algunas estadísticas -vigentes y poco confiables-, se plasmaron algunas acciones novedosas en el sistema público y el desconocimiento sobre los beneficios del trabajo vocal en hombres y mujeres transgénero. Los aspectos detectados podrían beneficiarse de investigaciones multicéntricas que fortalezcan acciones fonoaudiológicas con este grupo, contribuyendo a la despatologización y el abordaje positivo.
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Objetivo: Este estudio tuvo como objetivo principal validar el Voice Handicap Index (VHI) y su versión abreviada (VHI-10) adaptados al español rioplatense de Argentina, con objetivos específicos centrados en evaluar su fiabilidad y validez. Metodología: La adaptación cultural incluyó técnicas de traducción directa, síntesis y retrotraducción, evaluación de la equivalencia semántica y aplicación a un grupo piloto. Para la validación se evaluó la fiabilidad de ambos índices adaptados mediante la consistencia interna (coeficiente alfa de Cronbach) y la estabilidad test-retest (prueba de Bland-Altman, CCI y r de Spearman). Además, se examinó la validez de criterio y de constructo. 213 sujetos participaron en la validación del índice adaptado de 30 ítems (123 disfónicos; 90 de control); 113, en la del índice abreviado (63 disfónicos; 50 de control). Resultados: Se constituyó el Índice de Desventaja Vocal (IDV) como la versión adaptada del VHI al español rioplatense de Argentina. Ambos índices demostraron excelente consistencia interna (IDV-30 α = 0,96; IDV-10 α = 0,92) y estabilidad y concordancia (IDV-30 CCI = 0,95; IDV-10 CCI = 0,96). Se halló alta correlación entre los puntajes de ambos índices y la autoevaluación de la severidad de la disfonía de los participantes (r = 0,85). Ambos índices demostraron capacidad de diferenciar entre individuos con disfonía y sujetos sanos (p< 0,001). El análisis factorial reveló tres factores para el IDV-30 y un factor para el IDV-10. Conclusiones: El IDV-30 e IDV-10 presentan grados adecuados de fiabilidad y validez. Ambos pueden ser incluidos en protocolos de valoración de la función vocal por profesionales de Argentina.
Aim: This study aimed to validate the Voice Handicap Index (VHI) and its abbreviated version (VHI-10) adapted into Rioplatense Spanish from Argentina, with specific goals centered on assessing their reliability and validity. Methods: Cultural adaptation involved direct translation, synthesis and back-translation techniques, followed by an assessment of semantic equivalence and application to a pilot group. For the validation process, the reliability of both adapted indices was assessed through measures of internal consistency (Cronbach's alpha coefficient) and test-retest stability (Bland-Altman test, ICC and Spearman's correlation coefficient). Additionally, we conducted analyses to asses criterion and construct validity. 213 subjects participated in the validation of the adapted 30-items index, (123 with dysphonia; 90 from control group); 113, in the abbreviated version (63 with dysphonia; 50 from control group). Results: The "Índice de Desventaja Vocal" (IDV) was established as the adapted version of the VHI into Rioplatense Spanish from Argentina. Both indeces exhibited excellent internal consistency (IDV-30 α = 0,96; IDV-10 α = 0,92) and satisfactory stability and agreement (IDV-30 CCI = 0,95; IDV-10 CCI = 0,96). Regarding validity, a strong correlation was observed between the scores of both indeces and the participant's self-assessment of dysphonia degree (r = 0,85). Both indices effectively differentiated between individuals with dysphonia and healthy subjects (p< 0,001). Factor analysis revealed three factors for the IDV-30 and one factor for the IDV-10. Conclusion: The IDV-30 and IDV-10 demonstrate satisfactory levels of reliability and validity. Both indices can be incorporated into the assessment protocols for evaluating the vocal function by professionals in Argentina.
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Objective: This study examines factors predicting self-reported voice symptoms in call center workers. Methods: Multivariate analysis and predictive modeling assess personal, work-related, acoustic, and behavioral factors. Generalized Linear Models (GLMs) and Receiver Operating Characteristic (ROC) curves are employed. Results: Age and sleep patterns impacted voice quality and effort, while workplace factors influenced symptom perception. Unhealthy vocal behaviors related to tense voice and increased effort, while hydration was protective. Voice acoustics showed diagnostic potential, supported by ROC data. These findings emphasize voice symptom complexity in call center professionals, necessitating comprehensive assessment. Limitations: This study recognizes its limitations, including a moderate-sized convenience sample and reliance on PROM metrics. Future research should incorporate more objective measures in addition to self-reports and acoustic analysis. Value: This research provides novel insights into the interplay of personal, occupational, and voice-related factors in developing voice symptoms among call center workers. Predictive modeling enhances risk assessment and understanding of individual susceptibility to voice disorders. Conclusion: Results show associations between various factors and self-reported voice symptoms. Protective factors include sleeping more than six hours and consistent hydration, whereas risk factors include working conditions, such as location and behaviors like smoking. Diagnostic models indicate good accuracy for some voice symptom PROMs, emphasizing the need for comprehensive models considering work factors, vocal behaviors, and acoustic parameters to understand voice issues complexity.
Objetivo: Este estudio examina los factores que predicen los síntomas de voz en los trabajadores de call centers. Métodos: Se utilizan análisis multivariados y modelos predictivos para evaluar factores personales, laborales, acústicos y de comportamiento. Se emplean Modelos Lineales Generalizados (GLM) y curvas ROC. Resultados: La edad y los patrones de sueño afectaron la calidad vocal y el esfuerzo, mientras que los factores laborales influyeron en la percepción de síntomas. Los comportamientos vocales no saludables se relacionaron con voz tensa y mayor esfuerzo, mientras que la hidratación fue protectora. Los parámetros acústicos de voz mostraron potencial diagnóstico respaldado por datos de ROC. Los hallazgos subrayan complejidad de síntomas vocales en profesionales de centros de llamadas, requiriendo una evaluación integral. Limitaciones: Este estudio reconoce sus limitaciones, que incluyen una muestra de conveniencia de tamaño moderado y la dependencia de medidas PROMs. Futuras investigaciones deberían incorporar medidas objetivas, además de los autorreportes y análisis acústico. Importancia: Esta investigación aporta nuevos conocimientos sobre factores personales, laborales y síntomas de voz en trabajadores de call centers. El modelado predictivo mejora la evaluación de riesgos y la comprensión de la susceptibilidad individual a trastornos de la voz. Conclusión: Los resultados muestran asociaciones entre diversos factores y los síntomas vocales reportados. Los factores de protección incluyen dormir más de seis horas y una hidratación constante; los factores de riesgo incluyen las condiciones de trabajo, como la ubicación y comportamientos como fumar. Los modelos de diagnóstico indican una buena precisión para algunas PROMs de síntomas de la voz, lo que subraya la necesidad de modelos integrales que tengan en cuenta los factores laborales, los comportamientos vocales y los parámetros acústicos para comprender la complejidad de los problemas de la voz.
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Objective: To explore the training and use of auditory perceptual evaluation of the voice reported by Colombian speech-language pathologists. Study Design: Cross-sectional observational research with a quantitative approach. Methods: A digital questionnaire was designed and distributed to gather information regarding professionals' training process and implementation of auditory-perceptual evaluation procedures. Descriptive statistics were applied, and several generalized linear models were adjusted to determine the influence of certain variables on others. Results: The survey received responses from 40 speech-language pathologists, revealing that the most used scales for training and evaluating vocal quality within this group are direct magnitude estimations (82.5% and 77.5%). Similarly, in this group, the tasks most frequently used to train and use as an evaluation strategy are vowel assessments (38%) followed by spontaneous speech (30%). Practitioners of this group were mostly trained using a conceptual framework involving multiple exposures to rating (42.5%). The use of direct magnitude estimation in training with a normal voice showed significance (p = 0.015), as did the use of the vowel /i/ in training with an equal-appearing interval (p = 0.013). The statistical models relating the scale used to the scale on which participants were trained were also significant (p < 0.05). Conclusions: The GRBAS scale is the training tool most used by the group of speech-language pathologists of the study group in Colombia. Future efforts should focus on improving training practices for auditory-perceptual evaluation, exploring alternative conceptual frameworks, and incorporating external references to enhance validity and reliability.
Objetivo: Explorar los reportes de fonoaudiólogos colombianos acerca del entrenamiento y uso de la evaluación perceptual auditiva de la voz. Diseño de estudio: Se eligió un diseño de investigación observacional transversal con un enfoque cuantitativo. Metodología: Se diseñó y distribuyó un cuestionario digital para recopilar información sobre el proceso de formación de los profesionales y la implementación de procedimientos de evaluación perceptual auditiva. Se aplicaron estadísticas descriptivas y se ajustaron varios modelos lineales generalizados para determinar la influencia de ciertas variables en otras. Resultados: La encuesta recibió respuestas de 40 fonoaudiólogos, revelando que las escalas más utilizadas para la formación y la evaluación de la calidad vocal en el grupo son las estimaciones de magnitud directa (82.5% y 77.5%). Del mismo modo, en este grupo las tareas más frecuentemente utilizadas para la formación y el uso como estrategia de evaluación son las vocales (38%), seguidas por el habla espontánea (30%). La mayoría de los profesionales del grupo fueron formados utilizando un marco conceptual que involucra múltiples exposiciones a la calificación (42.5%). El uso de la estimación de magnitud directa en la formación con una voz normal mostró significancia (p = 0.015), al igual que el uso de la vocal /i/ en la formación con intervalos de igual apariencia (p = 0.013). Los modelos estadísticos que relacionan la escala utilizada con la escala en la que los participantes fueron entrenados también fueron significativos (p < 0.05). Conclusiones: La escala GRBAS es la herramienta de formación más utilizada por el grupo de fonoaudiólogos del estudio. Los esfuerzos futuros deberían centrarse en mejorar las prácticas de formación para la evaluación perceptual auditiva, explorar marcos conceptuales alternativos e incorporar referencias externas para mejorar la validez y la confiabilidad.
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Purpose: To describe the acoustic characteristics of a classroom, voice quality, fatigue, and vocal load of university professors. Methods: Exploratory, observational, longitudinal, and descriptive study with a single group of participants, including vocal monitoring data over two weeks. Acoustic characterization of the classroom, perceptual-auditory evaluation, and acoustic analysis of voice samples were conducted before and after classes. Vocal dosimetry was performed during classes, and the Vocal Fatigue Index (VFI) was assessed at the beginning of each week. Descriptive analysis of the findings was conducted, and randomization test was performed to verify the internal reliability of the judge. Results: All participants reported speaking loudly in the classroom, with the majority reporting vocal changes in the past six months, and only one participant reported a current vocal change. The classroom had acoustical measures and estimations that deviated from established standards. The professors used high vocal intensities during classes. After the classes, an increase in the absolute values of the aggregated data for CAPE-V, jitter, and fundamental frequency was found, varying within the range of normality. Furthermore, there was an observed increase in both post-lesson intensity and VFI when comparing the two-week period. Conclusions: Vocal intensities and VFI were possibly impacted by the acoustics of the classroom. The increase in average VFI between the weeks may be attributed to a cumulative fatigue sensation. Further research with a larger number of participants and in acoustically conditioned classrooms is suggested in order to evaluate collective intervention proposals aimed at reducing the vocal load on teachers.
Objetivo: Describir las características acústicas, calidad vocal, fatiga y carga vocal de profesores universitarios. Métodos: Estudio exploratorio, observacional, longitudinal, descriptivo con un solo grupo de participantes y datos de monitoreo vocal durante dos semanas. Se realizó caracterización acústica de la sala, evaluación auditiva-perceptiva y acústica de muestras de voz antes y después de las clases. Se realizó dosimetría vocal durante las clases y se verificó el Índice de Fatiga Vocal (IFV) en dos semanas. Se realizó un análisis descriptivo de los hallazgos y una prueba de aleatorización para verificar la confiabilidad interna del juez. Resultados: Todos los participantes informaron hablar en voz alta en clase, la mayoría informó cambios vocales en los últimos seis meses y solo uno informó cambios vocales actuales. La sala presentó mediciones y estimaciones acústicas fuera de las normas establecidas. Los profesores utilizaron intensidades vocales altas durante las clases. Hubo un aumento en los valores absolutos de los datos agrupados para CAPE-V, jitter y frecuencia fundamental, variando dentro de los límites normales, después de las clases. La intensidad después de las clases y el IFV, en la comparación entre las dos semanas, mostraron un aumento. Conclusiones: La dosis vocal y el IFV posiblemente se vieron afectados por la acústica del aula. El aumento del IFV medio entre semanas pudo deberse a la sensación de cansancio acumulada. Se sugieren nuevas investigaciones con un mayor número de participantes y que se realicen en la sala acondicionada acústicamente para evaluar propuestas de intervención colectiva, con el objetivo de reducir la carga vocal de los docentes.
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Objectives: To present a simple form of vocal and breathing conditioning for voice professionals based on concepts from vocal science. The vocal conditioning program called Voice Athletes Conditioning uses the principles of exercise physiology to gradually improve vocal and respiratory overload to achieve endurance, power, and flexibility. Methods: Due to our personal experience with high voice users, we synthesized a vocal conditioning program (AVCP) that combines voice science, exercise physiology, sports science and physical therapy principles. This is an 8-week program of daily vocal and breathing exercises with overload enhancement each week using different types of breathing devices and semi-occluded vocal tract exercises, designed and developed according to the specific requirements and performance of the voice professional. Reflections: Professional voice users often experience episodes of vocal fatigue that can directly affect their performance and vocal health. As with physical training for athletes, voice exercises can also contribute to improving vocal conditioning, preventing voice disorders, as well as helping to obtain better performance, greater tolerance to fatigue and shorter recovery time. Conclusions: AVCP is an approach that considers the principles of muscle training aimed objectively at the respiratory and vocal muscles, carried out with a variety of breathing devices and specific vocal exercises in search of greater performance time, less physiological stress, and shorter recovery time in the professional use of the voice.
Objetivos: Presentar una forma sencilla de acondicionamiento vocal y respiratorio para profesionales de la voz, basada en conceptos de la ciencia vocal. El programa de acondicionamiento vocal denominado Voice Athletes Conditioning utiliza los principios de la fisiología del ejercicio para mejorar gradualmente la sobrecarga vocal y respiratoria, con el fin de lograr resistencia, potencia y flexibilidad. Métodos: Debido a nuestra experiencia personal con usuarios de voz aguda, sintetizamos un programa de acondicionamiento vocal (AVCP) que combina principios de la ciencia de la voz, la fisiología del ejercicio, las ciencias del deporte y la fisioterapia. Se trata de un programa de 8 semanas de ejercicios vocales y respiratorios diarios con realce de sobrecarga cada semana utilizando diferentes tipos de dispositivos respiratorios y ejercicios semioclusivos del tracto vocal, diseñado y desarrollado de acuerdo con los requerimientos específicos y el rendimiento del profesional de la voz. Reflexiones: Los usuarios profesionales de la voz experimentan a menudo episodios de fatiga vocal que pueden afectar directamente su rendimiento y salud vocal. Al igual que ocurre con el entrenamiento físico de los deportistas, los ejercicios vocales también pueden contribuir a mejorar el acondicionamiento vocal, prevenir trastornos de la voz, además de ayudar a obtener un mejor rendimiento, una mayor tolerancia a la fatiga y un menor tiempo de recuperación. Conclusiones: El AVCP es un enfoque que considera los principios del entrenamiento muscular dirigido objetivamente a la musculatura respiratoria y vocal, realizado con diversos aparatos respiratorios y ejercicios vocales específicos en busca de un mayor tiempo de actuación, menor estrés fisiológico y menor tiempo de recuperación en el uso profesional de la voz.
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In a context where different protocols for recommended practices in clinical voice assessment exist, while there are gaps in the literature regarding the evidence base supporting assessment procedures and measures, clinicians from regions where a strong community holding expertise in clinical and scientific voice practices lack can struggle to confidently develop their voice assessment practices. In an effort to improve voice assessment practices and strengthen professional identity among speech-language pathologists in Quebec, Canada, a community of practice (CoP) was established, with the aim of promoting knowledge sharing, implementing change in clinical practice, and improving professional identity. Thirty-nine participants took part in the CoP activities conducted over a four-month period, including virtual meetings and in-person workshops. Participants had a high rate of attendance (> 74% participation rate in virtual meetings), and were highly satisfied with their participation and intended to remain involved after the project's end. Statistically significant changes in voice assessment practices were observed post-CoP, regarding probability of performing assessments (p < .001), and perceived importance of assessment for evaluative purposes (p <.001), as well as improvements in assessment specific confidence, specifically for procedure of auditory-perceptual assessment (p < .001) and purpose of aerodynamic assessment (p = .05). Moreover, there was an increase in professional identity post-CoP (p < .001) and participants felt they made significant learnings. The present study highlighted the need to involve SLPs in future research to identify assessments that are relevant to the specific evaluative objectives of SLPs working with voice, and suggests CoPs are an efficient tool for that purpose.
En un contexto en el que existen diferentes protocolos para las prácticas recomendadas en la evaluación vocal clínica, y en el que se presentan vacíos en la literatura respecto a la base de evidencia que respalda los procedimientos y medidas de evaluación, los profesionales de regiones donde no hay una comunidad sólida con experiencia en prácticas vocales clínicas y científicas pueden enfrentar dificultades para desarrollar con confianza sus prácticas de evaluación vocal. Con el propósito de mejorar las prácticas de evaluación vocal y fortalecer la identidad profesional entre los logopedas de Quebec, Canadá, se estableció una comunidad de práctica (CdP). Esta tenía como objetivo fomentar el intercambio de conocimientos, implementar cambios en la práctica clínica y mejorar la identidad profesional. Un total de treinta y nueve participantes se involucraron en las actividades de la CdP, llevadas a cabo durante un período de cuatro meses, que incluyeron reuniones virtuales y talleres presenciales. Los participantes tuvieron una alta tasa de asistencia (> 74% de participación en las reuniones virtuales) y expresaron un alto grado de satisfacción con su participación, manifestando su intención de continuar involucrados después de la finalización del proyecto. Se observaron cambios estadísticamente significativos en las prácticas de evaluación vocal posterior a la CdP, en lo que respecta a la probabilidad de llevar a cabo evaluaciones (p < .001) y la percepción de la importancia de la evaluación con fines evaluativos (p < .001), así como mejoras en la confianza específica en la evaluación, particularmente en el procedimiento de evaluación auditivo-perceptual (p < .001) y el propósito de la evaluación aerodinámica (p = .05). Además, se registró un aumento en la identidad profesional posterior a la CdP (p < .001) y los participantes sintieron que obtuvieron aprendizajes significativos. El presente estudio destacó la necesidad de involucrar a los logopedas en investigaciones futuras, para identificar evaluaciones pertinentes a los objetivos evaluativos específicos de los logopedas que trabajan con la voz, y sugiere que las CdP son una herramienta eficiente con ese propósito.
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OBJECTIVES: Identifying voice handicap and voice-related quality of life in patients presenting pulmonary impairment associated with COVID-19 infection, comparing pulmonary parameters between these patients and individuals in the control group, as well as correlating pulmonary parameters to self-assessment questionnaires (IDV-10 and QVV). METHODS: Thirty-five (35) patients presenting pulmonary impairment with COVID-19 infection were herein selected and compared to 35 individuals who were not affected by COVID-19 infection. Two self-assessment questionnaires were applied (vocal handicap index and voice quality of life protocol). Maximum phonation time Forced Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) were measured and videolaryngoscopy was performed. RESULTS: There was statistically significant difference in scores recorded in voice self-assessment questionnaires (IDV-10 and QVV), Expiratory Pressure (PEF) and Forced Inspiratory Pressure (PIF) between patients with pulmonary impairment associated with COVID-19 infection and those in the control group. Correlation between PEF/PIF and scores recorded in voice self-assessment questionnaires was also observed. CONCLUSION: Pulmonary impairment associated with COVID-19 infection has worsened voice handicap and voice-related quality of life in the assessed patients, as well as reduced their forced expiratory and inspiratory pressure in comparison to the control group.
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COVID-19 , Qualidade de Vida , Distúrbios da Voz , Qualidade da Voz , Humanos , COVID-19/complicações , COVID-19/fisiopatologia , Masculino , Feminino , Pessoa de Meia-Idade , Distúrbios da Voz/etiologia , Distúrbios da Voz/fisiopatologia , Inquéritos e Questionários , Estudos de Casos e Controles , Adulto , SARS-CoV-2 , Idoso , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/psicologia , Pneumonia Viral/fisiopatologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/psicologiaRESUMO
OBJECTIVE: To identify the accuracy and cut-off values of the cepstral peak prominence (CPP) and cepstral peak prominence-smoothed (CPPS) obtained from different speech tasks, to identify dysphonic voices in Brazilian Portuguese speakers, and to verify the correlation between these measures and the overall severity of dysphonia (OS). METHOD: In a study with 376 subjects-277 with dysphonia and 99 controls-we recorded four speech tasks and assessed OS with a visual analog scale. We extracted CPP and CPPS from these recordings and analyzed them using receiver operating characteristic curves to determine cut-off values and other performance metrics (area under curve, accuracy, sensitivity, specificity, predictive values, and likelihood ratios). RESULTS: CPP values below 28.15 dB (sustained vowel [Æ]), 28.77 dB (sustained vowel [a]), 28.58 dB (all Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) sentences), and CPPS values below 16.42 dB (sustained vowel [Æ]), 17.02 dB (sustained vowel [a]), and 11.30 dB (all CAPE-V sentences) are indicative of the presence of dysphonia. CPPVE, CPPVA, CPPCAPE-V, CPPVS, CPPSVE, CPPSVA, CPPSCount, CPPSCAPE-V e CPPSVS, and CPPSVS can explain the variability of OS from 19% to 57.9%. CONCLUSIONS: The cut-off values for CPPVE, CPPVA, CPPCAPE-V, CPPSVE, CPPSCAPE-V, and CPPSVA obtained from Praat software can be used as a reference for the clinical voice assessment of Brazilian Portuguese speakers in the respective speech tasks. Analysis of the correlation coefficients of the cepstral measures investigated provided us with a predictive model of OS perception based on each measure/speech task.
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OBJECTIVES: To analyze self-esteem, self-satisfaction with voice, and self-assessment with descriptive terms of one's own voice among Brazilian LGBTQIAPN+ people. STUDY DESIGN: Cross-sectional, observational, qualitative-quantitative study. METHODS: The study included any person who identified as Brazilian LGBTQIAPN+ and excluded those under 18 years old. Participants answered a sociodemographic questionnaire, the Rosenberg Self-Esteem Scale, and the Descriptive terms of one's own voice (which were analyzed with text processing techniques). The 10 terms most listed as positive or negative were selected for simple logistic regression associated with the Rosenberg Self-Esteem Scale. The alpha level of significance used in all analyses was 5%. RESULTS: The study considered the responses from 411 participants. It is noteworthy that 92.45% (n = 380) of the studied population identified as cisgender. Among the participants, 28 were classified as having unsatisfactory self-esteem, 208 as having average self-esteem, and 178 as having satisfactory self-esteem. Individuals with unsatisfactory scores described themselves using terms such as "high," "boring," "ugly," "unfriendly," and "masculine," while those with average scores used terms like "insecure," "nasal," "out of tune," and "high." Those with satisfactory scores associated themselves with terms such as "expressive," "sympathetic," "kind," "pleasant," and "stable." The terms "cheerful," "adequate," and "boring" significantly associated with the Rosenberg Self-Esteem Scale.score. CONCLUSION: LGBTQIAPN+ people with unsatisfactory self-esteem referred to their voices with negative descriptive terms, similar to people with average self-esteem, who often did not select any positive term. On the other hand, people with satisfactory self-esteem assessed their voices with positive descriptive terms and few negative adjectives. People with satisfactory scores are more likely to think that their voice is "cheerful" and less likely to consider it "adequate" or "boring" than people with unsatisfactory scores on the Rosenberg Self-Esteem Scale. The majority of participants were cisgender homosexual males, thus caution should be exercised in generalizing the data to the entire community.