Emilse Aparecida Merlin Servilha

Relação entre voz e qualidade de vida em professores universitários

OBJETIVO: investigar o impacto da voz na qualidade de vida de professores e comparar seus resultados com a avaliacao fonoaudiologica. METODOS: participaram 21 professores universitarios, 77% mulheres e 23% homens, com idade media de 48 anos, que preencheram o protocolo Qualidade de Vida e Voz (QVV), e foram filmados para a avaliacao fonoaudiologica nos aspectos corporais e vocais. RESULTADOS: os docentes classificaram suas vozes como boas (42,85%), razoaveis (38,09%) e muito boa e ruim, igualmente (9,52%). O Dominio Fisico apresentou escore medio de 78,18, e destaque para a dificuldade em falar alto ou ser ouvido em ambientes ruidosos e ter problemas no trabalho ou desenvolver a profissao por causa da voz. No Dominio Socio-Emocional o escore medio foi 88,98 e mostrou ansiedade ou frustracao por causa da voz. O Dominio Global teve media de 82,61. Na avaliacao fonoaudiologica constataram-se mais vozes adaptadas (61,90%) que alteradas (38,09%), estas apresentando restricao na projecao e modulacao ou rouquidao. A comparacao entre a auto avaliacao vocal, avaliacao fonoaudiologica e qualidade de vida mostrou mais consenso que divergencias. CONCLUSAO: conclui-se que o impacto da voz sobre a qualidade de vida foi baixo e que houve coerencia entre os resultados do QVV e a avaliacao fonoaudiologica, indicando percepcao apropriada dos docentes em relacao a propria voz. O QVV mostrou ter valor preditivo na relacao voz e qualidade de vida e pode ser indicado como um instrumento valioso quando utilizado juntamente com outras estrategias de pesquisa.

Riscos ocupacionais à saúde e voz de professores: especificidades das unidades de rede municipal de ensino

OBJETIVO: comparar as condicoes de trabalho, saude e voz em professores de diferentes escolas municipais. METODOS: participaram 165 professores, media de 37 anos, casados, predominio de mulheres e escolaridade superior da rede municipal de ensino de uma cidade do estado de Sao Paulo, que responderam ao questionario proposto por Ferreira et al (2003), abrangendo questoes socio-demograficas, situacao funcional, aspectos vocais e de saude. As respostas dos docentes foram separadas por unidade escolar e submetidas a analise estatistica. RESULTADOS: constatou-se diferenca significante entre as escolas quanto a presenca de local para descanso, fiscalizacao constante e facilidade para se ausentar da sala de aula, numero de alunos por classe (<0,001), ruido (0,002), iluminacao (<0,001), limpeza (0,001), higiene nos sanitarios (0,002), poeira (0,001), tamanho da sala (0,020), suficiencia de espaco em classe (0,005), comprometimento dos funcionarios com a manutencao da escola (0,033) e temperatura (<0,001). As mencoes de alteracao vocal variaram de 76,47% a 40%, sem significância nos professores das diferentes escolas. Os problemas de saude foram diversificados com diferenca significante apenas para incomodo a sons (0,036). CONCLUSAO: ha riscos ocupacionais especificos relacionados a organizacao e ambiente de trabalho, nas distintas unidades escolares, que interferem na voz e saude dos docentes, cujo desvelamento subsidia o gestor na implantacao de acoes contextualizadas, visando promover ambiente saudavel para toda comunidade escolar.

Riscos ocupacionais na legislação trabalhista brasileira: destaque para aqueles relativos à saúde e à voz do professor

Purpose: To analyze the legislation regarding occupational risks, highlighting those related to teacher’s health and voice. Methods: A bibliographic search of qualitative nature regarding the public policies about Health and Security at Work was carried out. The Regulatory Standards were read and their contents analyzed and organized into categories, detaching those from the scholar environment. Results: The 33 regulatory standards focus the risk factors, tolerance levels, and control for health and security at work. The harmful environmental agents are multiple and their specificities, such as concentration and frequency, determine the level of tolerance to exposition. At school, the environmental risks like noise, dust, temperature and inadequate lighting, among others, are present, however in a mild degree. The acoustic, lighting and exhaust ventilation treatments are indicated for the control of such risks. The documents show situations of worsening of the workers’ health in much higher degrees of risk than those from teaching activities. There is no explicitation of factors inherent to the work organization, and the care with the voice is limited to the profession of telesales workers, which can serve as a reference to the teacher’s work. Conclusion: Labor legislation is ample to cover the diversity of work conditions and to ensure the workers’ health. Teaching presents milder occupational risks to health than other professions; nevertheless, the organizational factors of work, as well as voice disorders, very frequent in this activity, demand greater attention from Brazilian legislation.OBJETIVO: Analisar a legislacao a respeito de riscos ocupacionais, com destaque para aqueles relacionados a saude e a voz do professor. METODOS: Trata-se de pesquisa bibliografica, de carater qualitativo, que considerou as politicas publicas sobre Saude e Seguranca no Trabalho. As Normas Regulamentadoras foram lidas e seus conteudos analisados e organizados por categorias, com recorte para aqueles referentes ao ambiente escolar. RESULTADOS: As 33 normas focalizam os fatores de risco, niveis de tolerância e controle para saude e seguranca no trabalho. Os agentes ambientais nocivos sao multiplos e suas especificidades, como concentracao e frequencia, determinam o nivel de tolerância a exposicao. Na escola, os riscos ambientais como ruido, poeira, temperatura e iluminacao inadequadas, dentre outros, estao presentes, porem em grau leve. O tratamento acustico, de iluminacao e de ventilacao e indicado para controle desses riscos. Os documentos mostram situacoes de agravos a saude dos trabalhadores em graus de risco muito maiores do que aqueles da docencia. Nao ha explicitacao de fatores inerentes a organizacao do trabalho e os cuidados com a voz limitam-se a profissao de teleoperador, o que pode servir de referencia para o professor. CONCLUSAO: A legislacao trabalhista e ampla ao abarcar a diversidade de condicoes de trabalho e garantir a saude dos trabalhadores. A docencia apresenta riscos ocupacionais a saude mais leves do que outras profissoes; contudo, os fatores organizacionais do trabalho, assim como os disturbios de voz, muito frequentes na docencia, carecem de maior atencao da legislacao no Brasil.

Tipificação de sintomas relacionados à voz e sua produção em professores identificados com ausência de alteração vocal na avaliação fonoaudiológica

PURPOSE: to typify the symptoms related to voice and its production self-referred by teachers, whose voices were identified as healthful in the Speech-Language Pathology evaluation. METHODS: 36 teachers took part, with mean age of 37 years, singles (75%) and college degree (83.33%), from the county school system of a city from the countryside of Sao Paulo. The teachers answered a questionnaire and referred the alteration; their voices were recorded and submitted to the perceptual Speech-Language Pathology evaluation and afterwards, both types of evaluation were compared. The socio-demographic characterization proceeded, environmental and organizational conditions of the teachers work and their symptoms typified and submitted to a statistical analysis. RESULTS: the presence of dust (91.67%), noise (75%), excess of work (88.88%), lack of time to develop the activities at school (88.88%) and constant performance monitoring (33.33%) were noted. As for the voice, the alteration has been noted for more than four years (30.56%), secondary to its intensive use (94.44%) and to stress (61.11%), classified as moderate (66.67%), being prominent like auditory symptoms, hoarseness and tiredness of speaking, both with 69.44% and classified as proprioceptive symptoms, throat clearing (63.88%) and dry throat (61.11%). The comparison among the symptoms shows that the proprioceptive ones (63.26%) were more mentioned than the auditory ones (36.73%). CONCLUSION: the teachers work in health and voice adverse environment; the prevalence of proprioceptive symptoms was greater than the auditory ones, a fact that may have interfered in the perceptual evaluation of their voices by the Speech-Language Pathologists who just counted on the auditory clue.

Conhecimento vocal e a importância da voz como recurso pedagógico na perspectiva de professores universitários

OBJETIVO: investigar o conhecimento vocal e sua importância como recurso pedagogico em professores universitarios. METODOS: participaram 112 docentes, media de 46,60 anos, 35,7% do sexo masculino e 64,3% do feminino, 66,1% doutores. Utilizou-se o questionario Condicoes de Producao Vocal-Professor, adaptado pela pesquisadora, alem da insercao de novas questoes abertas e fechadas de interesse para o estudo, as quais foram assinaladas em uma escala analogica de zero a dez. Foram coletadas amostras de voz dos professores e analisadas por avaliacao fonoaudiologica. As questoes fechadas receberam tratamento estatistico, considerando-se a media das notas autorreferidas, em cada variavel pesquisada. Os resultados foram correlacionados a partir das variaveis: sexo e presenca/ausencia de alteracao vocal. Organizaram-se as respostas das questoes abertas por similaridade de conteudo e frequencia de ocorrencia. RESULTADOS: constatou-se associacao significante entre sexo feminino e voz fina, fadiga e perda da voz; presenca de disturbio de voz e autorreferencia a voz fraca, rouquidao, voz insuficiente para o trabalho e fadiga vocal. Os professores participaram da pesquisa para colaborar e melhorar a voz na docencia; mudariam suas vozes nos aspectos de intensidade, tom e modulacao; os recursos vocais mais utilizados em sala de aula foram variacao de tom e intensidade, modulacao e pausas; e quando a voz esta alterada, recorrem ao repouso vocal e a hidratacao. Atribuiu-se a media de 9,42 para a voz como recurso pedagogico. CONCLUSAO: o conhecimento vocal dos participantes foi apropriado e eles avaliaram a voz como recurso pedagogico essencial.

Voz do professor: análise das leis brasileiras na perspectiva da promoção da saúde

OBJETIVO: analisar as leis brasileiras sobre saude vocal do professor, na perspectiva da promocao da saude. METODOS: foram captados, no periodo de 1998 a 2010, 61 documentos publicados, sendo organizados nas categorias: terminologia, objetivo, estrategias previstas e garantias ao professor. Os dados receberam tratamento quali-quantitativo. RESULTADOS: as terminologias utilizadas nos documentos foram: programa (88,52%), campanha (6,55%) e politica de saude vocal (4,91%); quanto aos objetivos, a prevencao de disfonias em professores (83,60%) foi o mais citado; a estrategia privilegiada para abordar a voz do professor se resumiu a curso teorico-pratico anual (80,32%) e a garantia prevista ao professor foi o acesso ao tratamento fonoaudiologico e medico em caso de disfonia (65,57%). A maioria dos documentos nao indicou qualquer garantia de direitos aos professores, limitando-se ao tratamento da disfonia, demonstrando que a voz do professor e seu cuidado, ainda nao constituem objeto de preocupacao do Estado. CONCLUSAO: os documentos analisados, apesar de sua importância, apresentam conteudo muito incipiente e superficial, especialmente quanto a linha de cuidado e a promocao da saude vocal dos professores. Salvo raras excecoes, restringem-se a indicacao de acoes pontuais voltadas a reabilitacao de seus disturbios da voz, desvinculadas de uma politica de saude vocal de base consistente. Ha necessidade do fonoaudiologo e seus orgaos de classe participar efetivamente na assessoria as figuras publicas visando a elaboracao de documentos para que, de forma objetiva e abrangente, promovam a saude do professor.

Percepção de ruído em sala de aula por estudantes universitários e suas consequências sobre a qualidade do aprendizado

ABSTRACT Purpose: To identify the perceptions of university students about the noise in the classroom and its consequences on learning quality. Methods: The participants were 100 healthcare undergraduate students from ten noisy classrooms indicated by their teachers. They completed a questionnaire with open and closed questions about the presence, source, type, and valuation of noise, its impact on lessons and strategies to minimize it. The closed responses were descriptively analyzed, and compared among courses. Results: Mean age was 21.3 years, female predominance (85%) and unmarried (91%). The university and the classrooms were considered noisy by the students; they indicated themselves as the largest source of noise; they react to noise with an effort to listen, difficulty in concentration and irritation which interfere in learning, grades and health. In noisy conditions, the students ask for silence, to sit in front of the class or to study at home. Conclusion: Students identified noise as a harmful factor for the teaching-learning process, realized their role in this context and were proactive in creating an environment compatible to learning.

Relation between voice disorders and work in a group of Community Health Workers

PURPOSES To compare the speechreading between individuals with hearing impairment and with normal hearing levels to verify the factors that influence the speechreading among hearing impaired patients. METHODS Forty individuals with severe-to-profound hearing loss aged between 13 and 70 years old (study group) and 21 hearing individuals aged between 17 and 63 years old (control group) were evaluated. As a research instrument, anamnesis was used to characterize the groups; three speechreading instruments, presenting stimuli via a mute video, with a female speaker; and a vocabulary test, to verify their influence on speechreading. A descriptive and analytical statistics (ANOVA test and Pearsons correlation), adopting a significance level of 0.05 (5%). RESULTS A better performance was observed in the group with hearing impairment in speechreading tests than in the group with hearing individuals. By analyzing the group with hearing loss, there was a mean difference between tests (p<0.001), which also showed correlation between them. Individuals with pre-lingual hearing loss and those who underwent therapy for speechreading had a better performance for most speechreading instruments. The variables gender and schooling showed no influence on speechreading. CONCLUSION Individuals with hearing impairment had better performance on speechreading tasks in comparison to people with normal hearing. Furthermore, it was found that the ability to perform speechread might be influenced by the vocabulary, period of installation of the hearing loss, and speechreading therapy.PURPOSE To analyze the relationship between voice disorders and work in a group of Community Health Agents (CHA). METHODS The subjects of this study were 65 CHA working in the city of São Paulo. Thefiinstrument used for data collection was an adaptation of the questionnaire named Conditions of Vocal Production - Teachers (CPV-P). The results were keyed in twice and submitted to statistical analysis, in order to verify: the self-reported frequency of voice disorder frequency of present vocal symptoms, the association among the three most frequently reported present symptoms, and environmental and organizational aspects of work. RESULTS Of the 65 (100%) CHA in the study, 37 (56.9%) self-reported having present or past vocal disorders. The most frequently reported present symptoms were: dry throat, tiredness when speaking, and burning sensation in the throat. There was significant association between: taking work to home, having personal items stolen, police intervention, violence against employees and vocal symptom dry throat, not having enough time to complete all tasks, difficulty in leaving work, inadequate furniture, intense physical strain, objects stolen from the health unit, racism and vocal symptom tiredness when speaking, dust, job dissatisfaction, work stress, building destruction, drug issues, and vocal symptom burning in throat. CONCLUSION Based on the obtained results, the initial hypothesis of association between the development of vocal disorders among the subjects and the adversities present in their work environment and organization was confirmed.

Relação entre distúrbio de voz e trabalho em um grupo de Agentes Comunitários de Saúde

PURPOSES To compare the speechreading between individuals with hearing impairment and with normal hearing levels to verify the factors that influence the speechreading among hearing impaired patients. METHODS Forty individuals with severe-to-profound hearing loss aged between 13 and 70 years old (study group) and 21 hearing individuals aged between 17 and 63 years old (control group) were evaluated. As a research instrument, anamnesis was used to characterize the groups; three speechreading instruments, presenting stimuli via a mute video, with a female speaker; and a vocabulary test, to verify their influence on speechreading. A descriptive and analytical statistics (ANOVA test and Pearsons correlation), adopting a significance level of 0.05 (5%). RESULTS A better performance was observed in the group with hearing impairment in speechreading tests than in the group with hearing individuals. By analyzing the group with hearing loss, there was a mean difference between tests (p<0.001), which also showed correlation between them. Individuals with pre-lingual hearing loss and those who underwent therapy for speechreading had a better performance for most speechreading instruments. The variables gender and schooling showed no influence on speechreading. CONCLUSION Individuals with hearing impairment had better performance on speechreading tasks in comparison to people with normal hearing. Furthermore, it was found that the ability to perform speechread might be influenced by the vocabulary, period of installation of the hearing loss, and speechreading therapy.PURPOSE To analyze the relationship between voice disorders and work in a group of Community Health Agents (CHA). METHODS The subjects of this study were 65 CHA working in the city of São Paulo. Thefiinstrument used for data collection was an adaptation of the questionnaire named Conditions of Vocal Production - Teachers (CPV-P). The results were keyed in twice and submitted to statistical analysis, in order to verify: the self-reported frequency of voice disorder frequency of present vocal symptoms, the association among the three most frequently reported present symptoms, and environmental and organizational aspects of work. RESULTS Of the 65 (100%) CHA in the study, 37 (56.9%) self-reported having present or past vocal disorders. The most frequently reported present symptoms were: dry throat, tiredness when speaking, and burning sensation in the throat. There was significant association between: taking work to home, having personal items stolen, police intervention, violence against employees and vocal symptom dry throat, not having enough time to complete all tasks, difficulty in leaving work, inadequate furniture, intense physical strain, objects stolen from the health unit, racism and vocal symptom tiredness when speaking, dust, job dissatisfaction, work stress, building destruction, drug issues, and vocal symptom burning in throat. CONCLUSION Based on the obtained results, the initial hypothesis of association between the development of vocal disorders among the subjects and the adversities present in their work environment and organization was confirmed.