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Anxiety in female teachers with dysphonia: correlation between the voice handicap index and anxiety state

The Egyptian Journal of Otolaryngology volume 28, pages 142–148 (2012)Cite this article

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Abstract

Background

Female teachers are at particular risk of developing voice disorders. They are more likely to have psychiatric disorders such as anxiety or depression.

Aim

To assess the presence of anxiety in female teachers with dysphonia, paying particular attention to the association between the patient’s self-evaluation of her voice handicap and anxiety state.

Participants and methods

Thirty-nine female teachers with dysphonia were subjected to a voice assessment protocol, Arabic voice handicap index (VHI), to quantify the degree of handicap related to voice disorders and assessment of anxiety using the Manifest Anxiety Scale of Taylor. The results obtained were compared with the results of 34 normal female teachers who were subjected to the same assessment protocols.

Results

There were highly significant differences between both the groups in the scores of VHI and the anxiety scale. Anxiety showed a significant correlation with the duration of dysphonia, the grade of dysphonia, the total score of VHI, and its three domains.

Conclusion

Anxiety is frequent among dysphonic female teachers, with a significant association between the patient’s self-evaluation of her voice handicap and anxiety state. Such a high association advocates for both vocal education programs and psychiatric consultations.

References

  1. Mattiske JA, Oates JM, Greenwood KM. Vocal problems among teachers: a review of prevalence, causes, prevention and treatment. J Voice. 1998; 12: 489–499

    Article  CAS  Google Scholar 

  2. Roy N, Merrill RM, Thibeault S, Gray SD, Smith EM. Voice disorders in teachers and the general population: effects on work performance, attendance and future career choices. J Speech Lang Hear Res. 2004; 47: 542–551

    Article  Google Scholar 

  3. Smith E, Lemke J, Taylor M, Kirchner HL, Hoffman H. Frequency of voice problems among teachers and other occupations. J Voice. 1998; 12: 480–488

    Article  CAS  Google Scholar 

  4. Sala E, Laine A, Simberg S, Pentti J, Suonpää J. The prevalence of voice disorders among day care center teachers compared with nurses: a questionnaire and clinical study. J Voice. 2001; 15: 413–423

    Article  CAS  Google Scholar 

  5. Nerrière E, Vercambre MN, Gilbert F, Kovess Masféty V. Voice disorders and mental health in teachers: a cross-sectional nationwide study. BMC Public Health. 2009; 9: 370–377

    Article  Google Scholar 

  6. De Souza CL, Carvalho FM, de Araújo TM, dos Reis EJFB, Lima VMC, Porto LA. Factors associated with vocal fold pathologies in teachers. Rev Saude Publ. 2011; 45: 914–921

    Article  Google Scholar 

  7. Ferreira LP, de Oliveira Latorre MRD, Pinto Giannini SP, de Assis Moura Ghirardi AC, de Fraga e Karmann D, Silva EE, et al. Influence of abusive vocal habits, hydration, mastication and sleep in the occurrence of vocal symptoms in teachers. J Voice. 2010; 24: 86–92

    Article  Google Scholar 

  8. Smith E, Kirchner HL, Taylor M, Hoffman H, Lemke JH. Voice problems among teachers: Differences by gender and teaching characteristics. J Voice. 1998; 12: 328–334

    Article  CAS  Google Scholar 

  9. Sliwinska Kowalska M, Niebudek Bogusz E, Fiszer M, Los Spychalska T, Kotylo P, Sznurowska Przygocka B, et al. The prevalence and risk factors for occupational voice disorders in teachers. Folia Phoniatr Logop. 2006;58:85–101

    Article  CAS  Google Scholar 

  10. Tutya AS, Zambon F, Oliveira G, Behlau M. Comparison of V-RQOL, VHI and VAPP scores in teachers. Rev Soc Bras Fonoaudiol. 2011; 16: 3

    Article  Google Scholar 

  11. Alves LA, Robazzi MLCC, Marziale MHP, de Felippe ACN, Romano CC. Health disorders and teachers′ voices: a workers’ health issue. Rev Latino-Am Enfermagem. 2009; 17: 566–572

    Article  Google Scholar 

  12. Verdolini K, Ramig LO. Review: occupational risks for voice problems. Logoped Phoniatr Vocol. 2001; 26: 37–46

    Article  CAS  Google Scholar 

  13. Malki KH, Mesallam TA, Farahat M, Bukhari M, Murry T. Validation and cultural modification of Arabic voice handicap index. Eur Arch Otorhinolaryngol. 2010; 267: 1743–1751

    Article  Google Scholar 

  14. De Medeiros AM, Barreto SM, Assunção AA. Voice disorders (dysphonia) in public school female teachers working in Belo Horizonte: prevalence and associated factors. J Voice. 2008; 22: 676–687

    Article  Google Scholar 

  15. Kotby MN. The accent method of voice therapy. 1st ed San Diego, California: Singular; 1995.

    Google Scholar 

  16. Kotby MN. Voice disorders: recent diagnostic advances, new dimensions. Otolaryngol Head Neck Surg. 1986; 11: 337–340

    Google Scholar 

  17. Taylor KF. Psychopathology: its causes and symptoms. London: Butterworth; 1953.

    Google Scholar 

  18. Dejonckere PH. Gender differences in the prevalence of occupational voice disorders. In: Dejonckere PH, editor. Occupational voice: care and cure. The Hague- Netherland: Kugler Publications; 2001. pp. 11–20.

    Google Scholar 

  19. Roy N, McGrory JJ, Tasko SM, Bless DM, Heisey D, Ford CN. Psychological correlates of functional dysphonia: an investigation using the Minnesota multiphasic personality inventory. J Voice. 1997; 11: 443–451

    Article  CAS  Google Scholar 

  20. Yiu EML. Impact and prevention of voice problems in the teaching profession: embracing the consumers’ view. J Voice. 2002; 16: 215–228

    Article  Google Scholar 

  21. Lee SY, Lao XQ, Yu IT. A cross-sectional survey of voice disorders among primary school teachers in Hong Kong. J Occupat Health. 2010; 52: 344–352

    Article  Google Scholar 

  22. Green G. The interrelationship between vocal and psychological characteristics: a literature review. Aust J Hum Commun Dis. 1988; 16: 31–43

    Article  Google Scholar 

  23. Wan CC. Correlation of voice problems and emotional status in teachers. The University of Hong Kong; 14 May 1999 [Dissertation]

  24. Cohn JR, Spiegel JR, Sataloff RT. Vocal disorders and the professional voice user: the allergist’s role. Ann Allergy Asthma Immunol. 1995; 74: 363–376

    CAS  PubMed  Google Scholar 

  25. Gotaas C, Starr CD. Vocal fatigue among teachers. Folia Phoniatr. 1993; 45: 120–129

    Article  CAS  Google Scholar 

  26. Simberg S, Sala E, Vehmas K, Laine A. Changes in the prevalence of vocal symptoms among teachers during a twelve-year period. J Voice. 2005; 19: 95–102

    Article  Google Scholar 

  27. Preciado J, Pérez C, Calzada M, Preciado P. Frequency and risk factors of voice disorders among teaching staff of la Rioja, Spain. Clinical study: Questionnaire, function vocal examination, acoustic analysis and videolaryngostroboscopy. Acta Otorhinolaringol Esp. 2005; 56: 161–170

    Article  CAS  Google Scholar 

  28. Morrison M, Rammage L. The management of voice disorders. San Diego: Singular Publishing Group; 1994.

    Book  Google Scholar 

  29. Krischke S, Weigelt S, Hoppe U, Köllner V, Klotz M, Eysholdt U, et al. Quality of life in dysphonic patients. J Voice. 2005; 19: 132–137

    Article  Google Scholar 

  30. Dietrich M, Verdolini Abbott K, Gartner Schmidt J, Rosen CA. The frequency of perceived stress, anxiety and depression in patients with common pathologies affecting voice. J Voice. 2008; 22: 472–488

    Article  Google Scholar 

  31. Schneider B, Bigenzahn W. Vocal risk factors for occupational voice disorders in female teaching students. Eur Arch Otorhinolaryngol. 2005; 262: 272–276

    Article  Google Scholar 

  32. Goldman SL, Hargrave J, Hillman RE, Holmberg E, Gress C. Stress. anxiety, somatic complaints and voice use in women with vocal nodules: preliminary findings. Am J Speech Lang Pathol. 1996; 5: 44–52

    Article  Google Scholar 

  33. Yano J, Ichimura K, Hoshino T, Nozue M. Personality factors in pathogenesis of polyps and nodules of vocal cords. Auris Nasus Larynx. 1982; 9: 105–110

    Article  CAS  Google Scholar 

  34. Bhuta T, Patrick L, Garnett JD. Perceptual evaluation of voice quality and its correlation with acoustic measurements. J Voice. 2004; 18: 299–304

    Article  Google Scholar 

  35. De Alvear RB, Martínez Arquero G. Teachers’ voice disorders collateral effects. Otorynolaryngologia. 2009; 8: 129–135

    Google Scholar 

  36. Benninger MS, Sataloff RT. The evaluation of outcomes and quality of life in individuals with voice disorders. J Singing. 1999; 56: 39–43

    Google Scholar 

  37. Behlau M, Hogikyan ND, Gasparini G. Quality of life and voice: Study of a Brazilian population using the voice-related quality of life measure. Folia Phoniatr Logop. 2007; 59: 286–296

    Article  Google Scholar 

  38. Ghandour H, Nassar J, Shoeib R. Correlation between voice handicap index scores and both acoustic measures and grade of dysphonia in non-organic voice disorders. Sci J Az Med Fac (girls). 2007; 28: 559–568

    Google Scholar 

  39. Jones SM, Carding PN, Drinnan MJ. Exploring the relationship between severity of dysphonia and voice-related quality of life. Clin Otolaryngol. 2006; 31: 411–417

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Unit of Phoniatrics, Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt, 11411

    Rasha Mohammed Shoeib MD, Jilan F. Nassar & Hassan H. Ghandour

Authors
  1. Rasha Mohammed Shoeib MD
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  2. Jilan F. Nassar
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  3. Hassan H. Ghandour
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Correspondence to Rasha Mohammed Shoeib MD.

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Shoeib, R.M., Nassar, J.F. & Ghandour, H.H. Anxiety in female teachers with dysphonia: correlation between the voice handicap index and anxiety state. Egypt J Otolaryngol 28, 142–148 (2012). https://doi.org/10.7123/01.EJO.0000413577.72909.80

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  • DOI: https://doi.org/10.7123/01.EJO.0000413577.72909.80

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