Letícia Caldas Teixeira

Correlação entre dados perceptivo-auditivos e qualidade de vida em voz de idosas

BACKGROUND: vocal quality and voice-related quality of life in elderly women AIM: to assess the vocal quality and voice-related quality of life in elderly women, as well as verify if the presence of dysphonia has an influence on the life quality of these women. METHODS: one hundred and three elderly women, with ages ranging from 60 to 103 years, were recruited. The V-RQOL was answered by the participants and their voices were registered and analyzed perceptually by five experienced speech pathologists, using the GRBASI scale. After the intra-rater reliability analysis, three speech pathologists were selected with whom a single GRBASI scale was built for each of the participants voice. Later, this single assessment was compared to the physical, socio-emotional and total V-RQOL scores. RESULTS: most of the elderly women presented V-RQOL total scores between 70 and 100. They also presented a mild to moderate vocal disorder in the overall scores related to dysphonia, roughness, breathiness and instability in the GRBASI scale and did not present scores related to asthenia or strain. The G, R, B and I parameters of the GRBASI scale were statistically correlated to the physical and total V-RQOL scores. CONCLUSIONS: although most of the elderly women presented some level of dysphonia, the vocal disorders did not have an influence on their life quality. However, the physical and total V-RQOL scores were correlated to dysphonia severity, indicating that the more sever the dysphonia, the lower the voice-related quality of life.

Escala URICA-VOZ para identificação de estágios de adesão ao tratamento de voz

OBJETIVOS: Adaptar a escala URICA a avaliacao dos estagios de mudanca para a adesao de pacientes em tratamentos de voz; e verificar a relacao destes com a idade do paciente, o tipo de disfonia, a escolaridade, a profissao e o numero de sessoes de fonoterapia. METODOS: Estudo transversal, com amostra de conveniencia, composta por 66 pacientes com disfonia, sendo 58 mulheres e oito homens, com idade entre 18 e 65 anos, atendidos em dois ambulatorios de instituicoes de ensino de Fonoaudiologia. Como instrumento exploratorio, procedeu-se a adaptacao brasileira da escala URICA para a area de voz, tendo como base situacoes especificas relacionadas ao comportamento vocal, denominada URICA-VOZ. O instrumento foi aplicado individualmente e as variaveis foram relacionadas. RESULTADOS: A maioria dos pacientes, 38 (57,6%), concentrou-se no estagio de contemplacao, 20 (30,3%) no de pre-contemplacao e apenas oito (12,1%) no de acao, ideal para a terapia fonoaudiologica. Nao houve associacao entre os estagios de adesao com as variaveis idade, tipo de disfonia, escolaridade e numero de sessoes de fonoterapia. A variavel profissao apresentou associacao com o estagio de acao URICA-VOZ. CONCLUSAO: O uso da escala URICA-VOZ revelou que a maioria dos pacientes com disfonia em tratamento ainda se encontra no estagio de contemplacao, o que pode restringir os resultados da terapia. Nao houve relacao entre as demais variaveis estudadas e os estagios de adesao do protocolo URICA-VOZ.

Adesão a orientações fonoaudiológicas após a alta do tratamento vocal em docentes: estudo prospectivo

PURPOSE: to investigate the adherence to voice therapy guidelines of teachers in municipal schools that were treated at the Voice Clinic of Hospital das Clinicas, Federal University of Minas Gerais, and that were discharged from voice therapy. METHOD: 39 patients treated at the Voice Clinic of Hospital das Clinicas, Federal University of Minas Gerais were interviewed by phone from August 2007 to December 2008. The interviews aimed to analyze the adherence to the guidelines after voice therapy discharge. RESULTS: this study outcome indicates that 34 patients (87.1%) report following the guidelines, four (10.2%) do it partially and one (2.5%) referred not following the guidelines. CONCLUSION: the majority of teachers adhere to the guidelines after voice therapy discharge. The outcome suggests that the voice therapy helps to maintain the standard of voice and a healthy vocal behavior.

Relationship between adherence to speech therapy in patients with dysphonia and quality of life.

OBJECTIVE The present study analyzed if aspects of voice-related quality of life (VRQOL) were associated with adherence to voice therapy in teachers. STUDY DESIGN Retrospective survey in which the medical records of 179 dysphonic teachers (62, abandonment group and 114, discharge group) who underwent speech therapy at the Speech Therapy Clinic at the Hospital das Clínicas of the Universidade Federal de Minas Gerais (AV-HCUFMG) were analyzed. METHODS Female teachers with dysphonia referred by Gerência de Saúde e Perícia Médica (Department of Health and Medical Analysis) of Belo Horizonte City Hall were included. The variables of interest were: age, number of voice therapy sessions attended (attendance), number of sessions missed (absence), type of dysphonia, and Vocal Activity and Protocol Profile (VAPP) scores administered during the first therapy session as a component of voice assessment. The chi-square test was used to assess categorical variables. For continuous variables, the Mann-Whitney test, a nonparametric test for independent samples, was used. RESULTS The groups differed with regard to the type of dysphonia as well as the several parameters of the VAPP: vocal self-perception, effects at work, effects on daily communication, effects on emotion, and the total VAPP score. CONCLUSIONS Individuals with less favorable VRQOL scores were less adherent to voice therapy compared with subjects with more favorable VRQOL.

Adesão das professoras disfônicas ao tratamento fonoterápico

PURPOSE: To study the possible factors associated with adherence to the speech-language pathology treatment of dysphonia in female teachers of municipal schools of Belo Horizonte. METHODS: This was a retrospective study that analyzed the medical records of 251 teachers treated at the Voice Ambulatory Speech Language Pathology Service, Hospital das Clinicas da Universidade Federal de Minas Gerais (AV-UFMG) from August 2007 to December 2009. The collected data included age, number of scheduled sessions, number of absences, number of children, type of dysphonia, degree of dysphonia, monthly family income, and education. We calculated the distance, in kilometers, of the residence to the place of treatment and the workplace to place of treatment. We also analyzed the social vulnerability index of the workplace. RESULTS: The results of this research indicated that of the 135 records that were included in the study, 89 (65.93%) corresponded to the discharged group and 46 (34.07%) corresponded to the abandonment group. In comparison with all the variables studied, only the number of faults and the type of dysphonia were associated with poor adherence to voice therapy. CONCLUSION: Results showed that the number of absences in sessions, treatment-related factor, organofuncional dysphonia type, and clinical-related factor were all associated with the abandonment of voice therapy.

Percepção de agentes comunitários de saúde sobre os riscos à saúde fonoaudiológica

OBJETIVO: Investigar a percepcao dos agentes comunitarios sobre os aspectos relacionados a saude fonoaudiologica da populacao usuaria de um programa de saude da familia. METODOS: Trata-se de estudo observacional transversal com aplicacao de questionario a 85 agentes comunitarios. Foram investigadas 20 situacoes hipoteticas abordando os temas fonoaudiologicos na rotina de trabalho dos agentes. As variaveis analisadas foram: idade, tempo de atuacao, escolaridade, percepcao dos riscos a saude da populacao nas areas de voz, motricidade orofacial, linguagem e audiologia. RESULTADOS: A media de idade dos agentes foi de 38 anos (±9,1), e o tempo de medio de atuacao no programa 5,0 anos (±2,9). Observou-se que 80 profissionais (94%) possuiam pelo menos o Ensino Medio completo, e todos eram do genero feminino. Entre as situacoes hipoteticas investigadas, os agentes demonstraram ter a percepcao do risco e atitude de leva-lo para discussao da equipe em 49% das situacoes envolvendo o risco a saude auditiva, 53% saude vocal, 60% e 62% os riscos relacionados a motricidade orofacial e linguagem, respectivamente. Nao foi encontrada relacao entre o tempo de atuacao e a percepcao do risco a saude fonoaudiologica. CONCLUSAO: Os agentes comunitarios mostraram ter percepcao de muitas situacoes de risco a saude fonoaudiologica dos usuarios, especialmente no que se refere a saude vocal e das estruturas e funcoes orofaciais. E necessario ao agente comunitario ir alem das habilidades e competencias conceituais e procedimentais no que se refere a saude da comunicacao humana, pois se almeja um profissional com habilidades atitudinais.

Medidas de biossegurança em audiologia

BACKGROUND: biosafety precautions for audiologic practice. PURPOSE: to review the biosafety precautions suggested in the literature for infection control in audiology. The biosafety precautions suggested for many health professionals were adapted for the inherent activities of audiologic practice in Audiology Service at Hospital das Clinicas of UFMG. CONCLUSION: the submitted biosafety precautions can be used by any institution, hospital or clinic where the audiologic performance is becoming more widespread and, consequently, demanding specific precautions for audiologic practice.

Analysis of aspects of quality of life in teachers' voice after discharged: longitudinal study

PURPOSE To evaluate the long-term effects of voice therapy on the life quality of teachers who were discharged or abandoned the voice therapy for dysphonia. METHODS This was a longitudinal study based on analysis of assessments with teachers of municipal schools in Belo Horizonte, who were referred to voice therapy and were discharged or abandoned the speech-language therapy for more than six months. A total of 33 teachers in the discharged group and 20 teachers in the abandoned group were contacted by phone and invited to participate in the study by answering the Voice activity and participation profile, which was forwarded to the researchers and sent via letter. RESULTS At the moment of the pre speech therapy, the discharged and abandoned groups were homogeneous, except in relation to daily communication parameter. Comparing the discharged group in the pre and post speech-language therapy, it was showed improvements in social communication parameter as well as in the total score. The discharged group presented worsening in self-perception parameter when comparing the average values in the post therapy and current moments, and the group abandoned presented worsening in work, social communication and total score when comparing to the average values in the pre therapy and current moments. The discharged and abandoned groups differ in the present moment in all investigated parameters. CONCLUSION Speech-language therapy for dysphonia have long term positive effects on life quality and voice of teachers who were soon discharged from the therapy and in a period of two years on average. Teachers who have abandoned treatment and did not obtain improvement in the voice showed negative impact in life quality and voice in a time of 2 years and 2 months on average.

Bioética: esclarecimento e fonoaudiologia

PURPOSE: to determine the clarification of the persons in charge for the children in speech language pathology attendance, to check the self-judgment of the person in charge for the decision on the type of treatment and the interference of the persons in charge scholar level on knowledge as for the therapy of their children. METHODS: a questionnaire was carried out under interview form with a pattern of 33 trainee and 33 persons in charge for children between 2 and 12-year-old, under treatment in the Clinic of Speech Language Pathologist of The Federal University of Minas Gerais. For analyzing the data we used Chi-Square test and Pearson test, through the program: Minitab 13. RESULTS: in 95% of the cases, the guardians considered participating in the decision-making regarding treatment; however, when questioned as for what treatment was being performed, only 39.4% answered correctly. The majority of the persons in charge (95%) related having participated in the childs treatment decision, however just 39,4% answered correctly on the treatment. The percentage of correct answers was more elevated for the individuals with complete high-school degree (60%), than individuals with incomplete elementary degree (30%), however its was not a significant statistic value (p=0.36). CONCLUSIONS: the major portion of the persons in charge do not have participation in decisions concerning the treatment carried out in their children, once that they related passive attitudes in front of this decision process and do not show knowledge on the treatment carried out with their children. The knowledge tends to be better for individuals with higher scholar level.

Fear of Public Speaking: Perception of College Students and Correlates.

OBJECTIVES The aims of the study were to determine the prevalence of fear of public speaking among college students and to assess its association with sociodemographic variables and those related to the voice and oral communication. METHODS A cross-sectional descriptive and analytic study was conducted with 1135 undergraduates aged 17-58 years. The assessment instruments were (1) a questionnaire addressing the variables sex, age, field of undergraduate study, voice, and frequency of exposure to public speaking, and (2) the Self-statements During Public Speaking Scale (SSPS), which includes variables implicated in specific domains of public speaking. A descriptive analysis was performed of the variables as well as uni- and multivariate logistic regressions to examine their association with fear of public speaking. The level of significance was set at 5%. RESULTS In all, 63.9% of the college students reported fear of public speaking. As many as 89.3% of the students would like their undergraduate program to include classes to improve public speaking. Being female, having infrequent participation as speakers in groups, and perceiving their voice as high-pitched or too soft increase the odds of exhibiting fear of public speaking compared with students without those features. CONCLUSION A great number of undergraduates report fear of public speaking. This fear is more prevalent among women, students who participate in few activities involving speaking to groups of people, and those who have a self-perception of their voice as high-pitched or too soft.