Effectiveness of a Voice Training Program for Religious Officials in Turkey.

This study examines the effectiveness of a voice training program designed for Islamic religious officials, who are occupational voice users with a significant vocal load. The participants included 34 healthy religious officials whose acoustic measures were within normal voice ranges for healthy adults (jitter < 1%; shimmer < 3%) and reported no voice complaints. Participants were randomly divided into two groups (experimental, n = 17; control, n = 17). The two-stage voice training program consisted of 32 sessions over 8 weeks with informative and voice exercise stages. Objective and subjective voice measurements were performed at the beginning and end of the research. Objective measurements included fundamental frequency, percentage of vocal pitch perturbation (jitter), percentage of vocal intensity perturbation (shimmer), and harmonics-to-noise ratio. Subjective voice measurements included the Singing Voice Handicap Index, Vocal Fatigue Index (VFI), and Voice-Related Quality of Life (V-RQoL) scores. All initial measurements other than VFI scores were within acceptable limits for both groups. There were no significant differences between the groups initially (p > 0.05) and no significant changes in the control group in the second evaluation (p > 0.05). However, there was significant improvement in the experimental group after the training program in all measures, including VFI scores (p < 0.05). This study shows the positive results of a voice training program. Voice training should be integrated into the formal education of occupational voice users or in-service training programs of relevant institutions.

Paediatric vocal fold nodules: management strategies to restore normal phonation-Speech-Language Pathologists perspective: A cross-sectional survey.

Vocal fold nodules are benign vocal cord lesions which develop in voice abusers, including children, though chronic cough, sinusitis, and reflux may also be the causative agents. Since low or no-evidence treatment strategies, like the boone technique, are in use in paediatrics, this study was conducted to determine the treatment strategies used by speech-language pathologists in paediatric vocal fold nodules using a cross-sectional survey at Riphah International University, Lahore, from October 2016 to May 2017. Sixty-five speech-language pathologists working with children in private clinics and multidisciplinary settings were recruited using purposive sampling. A self-structured questionnaire was used for data collection. Analysis using SPSS -18 revealed that a combination of voice therapy and vocal hygiene was the most favoured treatment used by 65 (100%) speech-language pathologists, followed by 58 (89.2%) who also favoured respiratory and relaxation exercises, and 56 (86.2%) who also included parental counselling. Hence, a combination of voice therapy and vocal hygiene is a good therapeutic technique being practiced by speech pathologists for the treatment of vocal nodules among paediatric population.

One-Year Follow-Up of a Vocal Hygiene Program for School-Age Children.

OBJECTIVE: This study investigated the effects of a school-based vocal hygiene education program "Green Voice for School" on promoting knowledge of healthy voice use for primary school students. METHODS: Thirty-nine grade 4 and 5 students from local primary schools participated in the "Green Voice for School" program. Students received 6 weekly vocal hygiene training sessions with the aim of enhancing their voice care knowledge. Their voice care knowledge was assessed by a 15-item questionnaire. Students' voice care knowledge was examined before training, immediately after, and 1 year after completion of the program. RESULTS: Students showed significant improvements in their voice care knowledge immediately after they received the vocal hygiene training sessions. Such improvements were maintained 1 year after the students completed training. CONCLUSIONS: The results suggest that "Green Voice for School", a school-based vocal hygiene education program, can be effective in promoting long-term improvements of voice care knowledge in school-age children.

Knowledge and Practice Regarding Vocal Hygiene Among Teachers of Selected Schools, Kathmandu.

BACKGROUND: Vocal hygiene (VH) is the practice of taking care of the voice and minimizing strain on it. This comprises avoiding smoking, alcohol, and other harmful substances, remaining hydrated, and practicing proper breathing techniques. This study intended to evaluate the level of knowledge and practices concerning VH. METHODOLOGY: A cross-sectional study design was utilized to conduct the study among teachers in Greenland Higher Secondary School, Basundhara National Academy, and Nirmal Batika Academy using a self-administered structured questionnaire. A sample of 122 teachers was taken using a complete enumerative sampling technique. The data were collected from October 1 to October 16 and were edited, coded, and entered into the Statistical Package for Social Science for further analysis. Data were examined using descriptive (frequency, percentage mean, and standard deviation), inferential statistics (chi-square test), and Karl Pearson's test. FINDINGS: The study results presented that nearly half, 49.2% of the respondents, had a moderate level of knowledge, 31.1% had an inadequate level of knowledge, and 19.7% had an adequate level of knowledge regarding VH. The results discovered that 73% of the respondents had good practice, and 27% had poor practice regarding VH. There was a statistically significant association only between the level of knowledge regarding VH and the number of classes taken per week (P = 0.0053). VALUE: The study showed that the majority of teachers have moderate knowledge about VH, whereas there is good practice among teachers. The results strongly recommend the need for VH training sessions for teachers.

Vocal Hygiene Habits in College Students With and Without Self-Reported Symptoms of a Voice Problem.

PURPOSE: The purpose of this study was to determine the prevalence of symptoms of a voice problem in college students and to assess if general health factors and vocal hygiene habits serve as risk factors for symptoms of a voice problem in this population. METHODS: Participants (n = 289) from a university in the United States completed an online survey that included demographic and general health questions, the Screen6 questionnaire, and a list of 23 vocal hygiene habits. Four participants were excluded due to receiving voice therapy and the remaining 285 participants were divided into two groups based on the results of the Screen6 questionnaire: those with two or more symptoms of a voice problem daily or weekly (n = 84) and those with fewer symptoms (n = 201). RESULTS: 29.5% of the college students in this study experienced two or more symptoms weekly or daily. Throat clearing was the most commonly reported symptom. Risk factors included having a postnasal drip, experiencing severe seasonal allergies, and taking medication for depression or anxiety. The following vocal hygiene habits were reported to occur more frequently in those with symptoms of a voice problem: use your voice until it hurts, use extra muscular effort while talking, use extra respiratory effort while talking, use a pitch that you think is too high, and use a pitch that you think is too low. Nonuse behaviors, such as water and caffeine consumption, did not vary significantly between groups. CONCLUSIONS: People with two or more symptoms of a voice problem daily or weekly report using their voice in a way that may contribute to experiencing these symptoms. Vocal hygiene education for this demographic may be more impactful if it is catered to how the voice is used rather than nonuse voice care.

Knowledge, Attitude and Practice on Vocal Abuse and Vocal Hygiene among Diverse Occupational Voice Users in Jodhpur, Rajasthan.

Background: Voice disorders in occupations connected with excessive voice use can be attributed to the inappropriate use of voice and poor vocal hygiene. Therefore, it is essential for persons in such occupations to be aware of vocal abuse, vocal hygiene, practices and their influence on maintaining healthy voice. Objectives: To assess knowledge, attitude and practice on vocal abuse and vocal hygiene among diverse occupational voice users in Jodhpur. Methodology: A cross-sectional study was conducted in Jodhpur district, Rajasthan. Data was collected from 424 participants (106 Doctors, 106 Teachers, 106 Advocates, 106 Vendors) from May 2023 to July 2023 by administrating a pretested semi structured questionnaire. Microsoft Excel and IBM SPSS (V. 23) statistical software were used for descriptive and inferential statistical analysis. Results: Majority (92%) of the participants felt that their quality of voice was good. About 55% participants were not aware about the term vocal abuse (Doctors 17.9%, Teachers 39.6%, Advocates 79.2%, Vendors 44.3%). Around 56% participants (Doctors 63.3%, Teachers 66.0%, Advocates 32.1%, Vendors 61%) had negative attitude towards vocal hygiene practices. About 47% of the participants preferred home remedies and 44.3% (Doctors 72.6%, Teachers 48.1%, Advocates 41.5%, Vendors 15.1%) preferred to consult ENT specialist for their voice related problem. Perception of vocal abuse on vocal health and hygiene practices was found to statistically significant (p = 0.001) among the different category of occupations. Conclusion: In this perception-based, cross-sectional study it was found that majority of the participants were neither aware about term vocal abuse nor followed vocal hygiene practices. In view of the above findings it is strongly recommended that excessive voice users should be made aware of vocal hygiene practices & repeated reinforcement of the same is required to prevent voice related problem.

Vocal Fatigue and Its Relationship with Vocal Hygiene and Work-Related Factors in Professional and Nonprofessional Voice Users: A Multiple Linear Regression Model Study.

OBJECTIVES: To investigate vocal fatigue severity between professional voice users (PVUs) and nonprofessional voice users (NPVUs), and across different levels of voice users. Also to examine the relationship between vocal hygiene and work-related factors with vocal fatigue. METHODS: This is a cross-sectional descriptive study. Four hundred one individuals from different professions were included in total. Participants were divided into four levels of voice users by classification of Koufman and Isaacson. The top three levels of voice users further identified as PVU, and level 4 voice users identified as NPVU. An online questionnaire which included vocal hygiene checklist, work-related factors, and Turkish version of vocal fatigue index (VFI) was submitted by the participants. RESULTS: Vocal fatigue severity of PVUs were found higher than NPVUs in all VFI scores (P < 0.05). Level 2 voice users were found to have more vocal fatigue severity than all other levels of voice users. Call center workers (CCWs) had the highest means of vocal fatigue severity. Based on the multiple linear regression model vocal hygiene and the number of vocal rest breaks were found to have related with vocal fatigue the most (P < 0.05). There was also a relation with some VFI scores (P < 0.05) with voice usage duration at work and vocal rest duration. We found no relationship between working experience and vocal fatigue. The data suggests the relation between vocal fatigue and vocal hygiene, and work-related factors explain a small proportion of the association. However, in CCWs r2 was found 0.44. CONCLUSIONS: The change in vocal fatigue severity did not match with Koufman and Isaacson's classification of voice users. We suggest that there may be other contributing factors to vocal fatigue than vocal hygiene, vocal rest, and voice usage duration even those factors may differ from profession to profession.

Modes of Educating Teachers About Vocal Hygiene: A Comparative Study.

OBJECTIVES: Educating teachers about vocal hygiene can be a means of alleviation or prevention of voice problems in this population. The present study aimed to compare four modes of educating teachers in India (n = 80) about vocal hygiene. METHOD: Four groups of 20 teachers were exposed to educative material on the vocal hygiene program created for the present study. Each group received it either in audio mode delivered by the researcher posing as a voice therapist (VA); in audio mode delivered by a researcher posing as a teacher (TA); in written mode delivered by the researcher posing as a voice therapist (VW); or in written mode delivered by a researcher posing as a teacher (TW). The improvement in the knowledge of teachers before and after vocal hygiene education was gauged by administering a written questionnaire before and after the content that the teachers received. RESULTS: Results revealed that all four modes were effective in vocal hygiene education. However, no significant difference (P > 0.05) in the improvement of knowledge in teachers across the four modes was seen although the relative mean difference was observed higher for TW mode than other modes. Individual item analyses revealed that some concepts were conveyed more effectively than others. This gave insights into improving the quality and efficacy of vocal hygiene programs in the future. CONCLUSION: Findings have implications in reaching out to remote areas and employing peer-to-peer teaching as an effective way of vocal hygiene education among teachers.

Home Remedies ("Paati Vaidyam") for Voice Disorders: Some Common Practices Among School Teachers.

AIM: The study aimed to document the practices followed as home remedies to treat voice-related symptoms among school teachers. STUDY DESIGN: Cross-sectional study. METHOD: A total of 385 school teachers from Chennai, India, participated in the study. Data were collected through six open-ended questions to elicit information about conventional remedial practices for voice-related issues. Responses from the participants were recorded and analyzed. RESULTS: Around 88% of the teachers in the study preferred to adhere to home remedies as their first treatment of choice when encountering a voice problem. A few of the reported home remedies were simple preparations using turmeric (Curcuma longa), ginger (Zingiber officinale), honey, sugar palm (Arenga pinnata), rock candy, mint (Mentha piperita), and cumin seeds (Cuminum cyminum), taken in singly or in combinations. The study also noted specific remedies for a range of vocal symptoms such as throat pain, irritation, or voice tiredness as per the belief systems of people speaking Tamil. DISCUSSION/CONCLUSION: Home remedies, also known, as "Paati Vaidyam," are commonly used by Indian households to address health problems, including voice-related issues. The study indicated the prevalence and popularity of using home remedies for voice-related issues among teachers. The scientific logic or utility of these practices was explored in this study based on available information in voice literature. The information obtained is valuable for counseling (explaining local practice methods and available evidence) and education, keeping in mind the belief system, and practice methods of Tamils while imparting vocal hygiene education to the teachers.

Social Representation of 'Vocal Hygiene' in India and Bhutan: A Cross-Sectional Survey.

BACKGROUND: The study aimed to explore the professional and recreational and/or personal voice use patterns and social representation of 'vocal hygiene' in two culturally and geographically diverse societies: India and Bhutan. METHODS: A total of 339 volunteers of Indian and Bhutanese nationality participated through snowball sampling. The responses were elicited using multiple-choice questions and a free association task. The data from the multiple-choice questions were analyzed using descriptive statistical methods. The free association task's responses underwent content and co-occurrence analysis to identify the most frequently occurring response categories. RESULTS: The professional voice use pattern differed between the two populations but not the recreational and/or personal voice use pattern. The results also revealed diverse social representations of 'vocal hygiene' in India and Bhutan. CONCLUSIONS: The present study sheds light on the voice use patterns and how the concept of vocal hygiene is represented in the two countries. These findings may have implications for developing and executing society specific awareness programs about vocal hygiene and its importance.

The Vocal Hygiene Treatment Programs for Singers: A Systematic Review.

OBJECTIVES: This systematic review aims to explore the effectiveness of voice health education interventions among singers, particularly focusing on vocal hygiene treatment programs tailored for professional voice users. STUDY DESIGN: Systematic review. METHODS: Preferred Reporting Items on Systematic Reviews and Meta-Analysis guidelines were followed to conduct this systematic review. Comprehensive searches were conducted in PubMed, Web of Science, Scopus, Science Direct, and Cochrane Library databases. Four articles were selected for detailed review. The studies were evaluated using the Effective Public Health Practice Project tool for quality assessment. RESULTS: The four reviewed studies primarily utilized the pretest-posttest design to examine the effectiveness of vocal hygiene interventions on singers' vocal health. Two studies investigated the effect of hydration as a treatment method, while the remaining two focused on vocal hygiene instruction. Significant improvements were observed in various vocal health parameters, including maximum phonation time, intensity, Dysphonia Severity Index, and number of daily vocal breaks taken. CONCLUSION: This systematic review provides valuable insights into the efficacy of vocal hygiene treatment programs for singers. The positive outcomes observed in the reviewed studies underscore the importance of voice health education tailored to singers' specific needs. However, the limited number of eligible studies and the common limitation of small sample sizes highlight the need for further research in this area. Vocal health practitioners, educators, and researchers can utilize the findings of this review to develop evidence-based vocal hygiene interventions that promote the well-being and longevity of singers' vocal performance careers.

Outcomes of Vocal Hygiene Program in Facilitating Vocal Health in Female School Teachers With Voice Problems.

BACKGROUND: Teachers suffer greater impacts of voice problems due inappropriate voice use and other contributing factors such as physiological, environmental, and individual & work related issues. Structured vocal hygiene programs (VHP) prevent/reduce the risk of vocal trauma and promote vocal health in teachers. This study aimed to estimate the outcome of instituting a sociocultural relevant vocal hygiene program in facilitating vocal health among female school teachers using a comprehensive voice assessment protocol. METHOD: VHP was developed emphasizing adequate hydration, healthy vocal diet, posture and alignment, vocal practices while teaching, and ideal speaking environment. This was administered via a face to face session to seventeen female teachers with voice concerns. All underwent a comprehensive voice assessment (subjective, objective, and self-perceptual vocal measures) before and four weeks after the VHP. Inter-rater reliability for perceptual and visual examination was estimated using Intra-Class Coefficient. Wilcoxon signed ranks test was used to compare the pre- and post-treatment measures of continuous variables (acoustic, Maximum phonation time, s/z ratio, Vocal Fatigue Index [VFI] & Voice Disorder Outcome Profile [V-DOP]), and McNemar test was used for categorical variables (vocal health questionnaire, visual examination of larynx and perceptual evaluation of voice). RESULTS: Teachers reported reduction of unhealthy vocal & nonvocal practices after VHP. Improvements in vocal and related symptoms such as sensation of heart burn (P = 0.031), discomfort around the throat (P = 0.008), inadequate breath control while speaking (P = 0.016) were noticed. Perceptually, minimal improvement was seen in voice quality (overall grade). However, MPT & s/z ratio showed no significant difference. Improvement was observed in frequency range (P = 0.004), low I0 (P = 0.044), shimmer (P = 0.017), and DSI (P = 0.013). Changes were evident in all parameters of stroboscopic evaluation (except nonvibratory portion & ventricular fold hyper-adduction). V-DOP scores indicated positive change in the overall severity (P = 0.002), physical (P = 0.003) and functional domain (P = 0.034). VFI indicated improvement in teachers voice after a period of voice rest (P = 0.048). CONCLUSION: Though VHP facilitated in improving the teachers' awareness of at risk phono-traumatic behaviors and vocal health, its efficiency was limited in producing physiological improvement in teachers' voice. The comparison of vocal metrics before & after the treatment provides information on changes that can be expected in teachers after guiding them through a systematic VHP.

Investigation of the Relationship Between Vocal Fatigue, Quality of Life, and Compliance With Vocal Hygiene in Professional Voice Users.

PURPOSE: Intensive voice use may lead to the development of voice disorders or voice complaints, such as vocal fatigue, for professional voice users (teachers, academics, call center workers, actors, singers, speech and language therapists, voice trainers, and religious officials). Vocal fatigue has a detrimental effect on occupational, emotional, and social performance, besides the quality of life of the individual. The effect of voice hygiene interventions on voice fatigue is not fully known. The results of studies conducted with different occupational groups are inconsistent. The present study aims to analyze the relationship between vocal fatigue and voice-related quality of life (V-RQOL) in professional voice users, and the impact of vocal hygiene on vocal fatigue. METHODS: Participants (24 male, 90 female), who were professional voice users without any diagnosis of voice disorders or voice complaints were divided into two groups low vocal hygiene compliance (LVH; n = 66) and high vocal hygiene compliance (HVH; n = 48). In this study, vocal fatigue was measured by the vocal fatigue index (VFI), and V-RQOL was measured by the voice handicap index (VHI-10) and V-RQOL. RESULTS: VFI subscales (tiredness, avoidance, physical discomfort) have a moderate positive correlation with VHI-10 and V-RQOL, which indicates that there is a significant relationship between vocal fatigue and quality of life amongst professional voice users. While there was no significant difference between the LVH and HVH groups in terms of quality of life, it was found that the vocal fatigue level of the LVH group was higher. CONCLUSION: This study of professional voice users with healthy voices reveals a relationship between vocal fatigue and V-RQOL. Vocal hygiene compliance may affect professional voice users' vocal fatigue symptoms; the low-compliant group has higher levels of tiredness, avoidance, and physical discomfort. The findings highlight the importance of raising awareness of the problems of professional voice users, even though they have healthy voices and the need for vocal hygiene education programs that target them.

Effectiveness of Vocal Training Techniques in School-Aged Drama Students.

OBJECTIVES: The purpose of this study was to determine whether vocal hygiene education and direct vocal training would impact student self-reported preparedness for using voice for performance. STUDY DESIGN: A single-group, pretest-posttest research design was used. METHODS: Twenty-three drama students in middle and high school participated in a 1-hour vocal training workshop, which included vocal hygiene education and vocal training for performance. Changes in student self-reported preparedness for using voice for performance were examined following participation in the workshop. Data analysis involved comparison of pretest and posttest responses to a novel questionnaire. RESULTS: Participants demonstrated a statistically significant increase in self-reported preparedness for using voice for performance following participation (P < .001, d = 2.40), as measured by mean increase in survey scores. Additionally, significant group differences were found by grade level and report of prior vocal training. CONCLUSIONS: School-aged drama students appear receptive to direct vocal training and vocal hygiene education, with significant gains in self-reported preparedness for using voice for performance observed following intervention.

Determining Knowledge Level, Attitude, Behaviors Regarding Vocal Hygiene and Use of Medical Drugs and Herbal Medicinal Products for Vocal Health in Second Level Professional Voice Users.

OBJECTIVES: This study aims to determine the knowledge level, attitude, and behaviors regarding vocal hygiene and use of medical drugs and herbal medicinal products for vocal health in second level professional voice users. METHODS: The study examined second level professional voice users comprised of amateur singers, religious officials,voice instructors and vocal coaches consisting of academicians working in conservatories and education faculties, music teachers, conservatory students majoring in opera or choir, students majoring in music education, and amateur actors who were reached via online platforms and were administered a 32-item questionnaire RESULTS: A total of 406 participants consisting of conservatory students (26.8%), religious officials (23.2%), academicians (9.1%), amateur or self-taught musicians (14.8%), conservatory graduates (8.6%), and music teachers affiliated with the Ministry of National Education were recruited for the study. It was determined that 78.8% of the participants knew the definition of vocal hygiene, and 60.6% made an effort to maintain vocal hygiene. 57.9% of the participants declared that they had at least one disease affecting their vocal health. According to our research data, 8.9% of the participants were using one or more prescription drugs or over-the-counter products daily to protect their vocal health. Lozenges, vitamins, and allergy medications constituted a large portion of these medicinal products. In total, 62.3% of participants used herbal products for vocal health in their daily life. Participants mostly consumed products containing linden, sage, ginger, chamomile, and turmeric. It was determined that more than 20 different herbal products containing plants in different mixtures and contents were used. Furthermore, 40% of the participants using herbal medicinal products consulted a health care professional.It was found that these products were mostly obtained from herbalists (79.5%), and the source of information regarding these products was quite diverse. The rate of experiencing side effects due to the use of herbal products was 2%. CONCLUSIONS: There is a lack of knowledge regarding vocal hygiene and its application on real-life behavior among second-level sound professionals. In particular, the awareness of vocal hygiene should be increased among religious officials. It was observed that the rate of use of herbal products to protect vocal health or to treat hoarseness was quite high. Further studies are needed to prove the benefits of these herbal and medicinal products on vocal health.

The Effect of Vocal Hygiene Training Via Videoconference in Teachers' Voices.

PURPOSE: Voice disorders are frequently seen among teachers. Intense and inappropriate use of the voice is the most frequent reason. In the literature, studies supporting the positive effect of voice hygiene behaviors to the voice in teachers exist. In the v pandemic era that we pass through, it's being observed that teaching via videoconference is becoming widespread all around the world. The primary aim of this study is to evaluate the risk factors for self-assessed "not normal" voice in teachers, in the light of their demographic and vocational information and voice hygiene behaviors. Our second aim in this study is to evaluate the effect of voice hygiene training via videoconference on teachers' voice. We believe this will contribute in shaping today's therapy modalities in vocal training. MATERIALS AND METHODS: One hundred nine teachers, working as primary, secondary or high school teacher actively in different cities in Turkey, between 25 and 55 years of age participated and self-assessed their voice by filling the survey including demographic, occupational, medical history and voice symptoms and vocal behaviors data as well as Voice Handicap Index (VHI)-10 ve voice self rating scale (VSRS). The teachers with VHI-10 score below 5 and VSRS score "normal" were assumed to have "Normal Voice." The teachers with VHI-10 score 5 or above and VSRS "Not Normal" (mild, moderate or severe) (N = 52) were assigned to "Voice Hygiene Group" and were invited to videoconference for a voice hygiene session. Four weeks after this session, the survey, VHI-10 and VSRS were repeated and the results were compared. RESULTS: In the first phase of the study, risk factors for not being in "Normal Voice" group for the teachers have been assessed. "Having chronic disease" and "having experienced voice problem before" have been found to be risk factors. In the second phase of the study, 52 teachers have been invited to online "Voice Hygiene" videoconference session; only 18 teachers have attended in total of three attempts of sessions. When vocal behaviors before and after the videoconference were compared, positive changes have been observed in five vocal behaviors including "avoiding smoking," "drinking enough water daily," "eating healthy food," "avoiding excessive meals," "avoiding frequent throat clearing," however VHI-10 and VSRS scores have not showed a meaningful change. Only one teacher has progressed to "normal voice" from "Voice Hygiene Group." CONCLUSION: We believe further controlled studies with more participants adherent to videoconference sessions will be needed in order to shape today's therapy modalities.

Dysphonia and Vocal Tract Discomfort While Working From Home During COVID-19.

OBJECTIVE: During COVID-19, government measures to prevent disease spread included advice to work from home. In addition to occupational risk factors, the increased use of telecommunication and changed work environment may contribute to voice and vocal tract discomfort (VTD). This study established the prevalence, incidence, characteristics and impact of self-perceived dysphonia and VTD in those working from home during COVID-19. METHODS: A cross-sectional, observational study using an online survey recruited 1575 participants. It captured information about dysphonia and VTD presence, onset, and severity. Those with dysphonia completed the voice-related quality of life to measure impact. Regression analyses identified risk factors for voice and vocal tract problems. RESULTS: Dysphonia and VTD prevalence rates were 33% and 68%, respectively, incidences were 28% and 50%. Perceived dysphonia severity was mild in 72% of cases. Dry throat was the most common VTD symptom at 66%. Mean voice-related quality of life score was 82.4 (standard deviation ± 13.2). Raising or straining the voice while working predicted new onset dysphonia and VTD. Increasing telecommunication use was associated with worse dysphonia and VTD onset. CONCLUSION: Those working from home have seen a rise in dysphonia and VTD, which were associated with communication modality and change in environment. If home offices become the 'new normal' post-COVID, workplaces should consider voice training for employees to limit potential difficulties.

Comparison Between Combination of Resonant Voice Therapy and Vocal Hygiene Education and Vocal Hygiene Education Only for Female Elementary School Teachers.

OBJECTIVE: The study compares the rehabilitation outcome of two voice intervention methods for female elementary school teachers with self-reported voice disorders. METHODS: A total of 34 female teachers from two primary schools volunteered in the study. Participants from one school were assigned to the experimental group (16 teachers), who received the combination of vocal hygiene education and resonant voice therapy. Participants from the other school were assigned to the control group (18 teachers), who received vocal hygiene education only. Pre- and post-treatment data were compared. RESULT: The total score of the Voice Handicap Index (VHI) decreased significantly from 12.19 ± 8.58 to 8.63 ± 7.27 (P < 0.05); the functional score of VHI significantly decreased from 5.38 ± 3.9 to 3.81 ± 3.62 (P < 0.05). No statistical significance was found in physiological and emotional scores of VHI. No statistical significance was found in the control group. In the experimental group, the maximum phonation time was increased from 14.34 ± 6.80s to 17.21 ± 6.06s (P < 0.05), Jitter decreased from 0.45% ± 0.13% to 0.26% ± 0.05% (P < 0.05), and Shimmer decreased from 0.21 ± 0.10. to 0.12 ± 0.03 (P < 0.05). Furthermore, the harmonic to noise ratio increased from 23.06 ± 2.99 to 25.23 ± 1.92 (P < 0.05), Spectrum Convergence Ratio increased from 0.53 ± 0.12 to 0.60 ± 0.11 (P < 0.05), yet no statistical significance was found in Nonlinear Energy Difference Ratio data for the experimental group. No statistical significance was found in the control group. In the auditory perception assessment (GRBAS), the G score decreased from 1.19 ± 0.54 to 0.81 ± 0.40 (P < 0.05), and the R score decreased from 1.19 ± 0.54 to 0.75 ± 0.45 (P < 0.05) in the experimental group. No statistical significance was found in the B, A, and S scores in the experimental group; moreover, none of the GRBAS scores in the control group demonstrated statistical significance. In the voice type component profile (VTC), the proportion of VTC1 of the experimental group increased significantly, while the proportions of VTC3 and VTC4 decreased significantly, indicating the improvement of voice quality was obvious after the intervention. The proportions of VTC of the control group did not demonstrate significant change. CONCLUSION: The results of this study show that a combination of vocal hygiene education and resonant voice therapy can significantly improve the voice function of professional voice users and effectively improve their voice quality. In this study, the professional voice users receiving vocal hygiene education only did not show significant improvement of their voice quality.

Perception of Primary School Teachers Towards Voice Problems and Vocal Health-Seeking Behaviors: A qualitative study.

OBJECTIVE: Teachers are the most common occupational group reporting to the voice clinics with dysphonia across the globe. However, less is known about teachers' perceptions about their voice and voice problems. Hence the present study aimed to explore teachers' perception about their teaching voice, voice problems and vocal health-seeking behaviors. METHOD: A qualitative phenomenological research design using semi-structured interviews were conducted with fifteen female primary school teachers. Participants were asked to express their perception of teaching voice, vocal health care knowledge, and vocal hygiene practices. Using inductive analysis, the researchers converted the raw data into concepts or themes and discussed. RESULT: The present study results showed that teachers perceive voice as the primary tool for their profession. However, teachers consider voice problems as part of their professional commitments. Despite knowing the harmful effects of voice problems, teachers' pay less attention to their voice problems and perceive them as usual, unavoidable and part of their profession. Due to their demanding work schedule and not getting enough support from the management, they hesitate to consult medical professionals unless it severely affects them. CONCLUSIONS: The data obtained from this study can be used to improve the teachers' knowledge regarding vocal health and convince the school management to extend their support for the successful implementation of the vocal health training programs for teachers.

Impact of Vocal Hygiene Training on Teachers' Willingness to Change Vocal Behaviors.

There is a high incidence of dysphonia reported in teachers, which has been shown to indicate the teacher's ability to instruct as well as students' ability to comprehend. Factors such as extra vocal load, poor classroom acoustics, and health issues may increase a teacher's risk of acquiring a voice disorder that impacts his or her career. A common approach to treating or preventing voice disorders is the use of vocal hygiene training. Many studies have addressed different types of voice training with mixed results due to lengthy training programs, poor implementation, and other factors related to teacher motivation. The purpose of this study was to determine whether education on vocal hygiene practices would impact teachers' willingness to modify vocal behaviors. A group of 26 teachers from preschool to high school was sent pre- and post-training surveys to determine demographics, daily vocal use, and history of voice issues. The survey also assessed participants' likelihood to modify their behaviors to incorporate vocal hygiene practices into their daily lives. Between the pre- and post-training surveys, teachers received a one-hour training on vocal hygiene practices. This training consisted of basic information regarding the anatomy and physiology of the voice, healthy, and unhealthy vocal behaviors and the impact of phonotrauma behaviors, and positive effects of vocal hygiene techniques. Results showed that the impact of vocal hygiene training on teachers' willingness to incorporate vocally hygienic behaviors was statistically significant (d ≥ 0.80). Increases in study participant perceived desire to engage in vocal hygiene behaviors by virtue of vocal hygiene training was manifested in nearly 90% of the targeted vocal hygiene behaviors. In conclusion, teachers appear to benefit from receiving education on voice use and vocal hygiene techniques and show willingness to incorporate these techniques into their repertoires.