Assessment of the Impact of Dysphonia on Egyptian Teachers' Quality of Life by Voice Activity and Participation Profile

Background: Voice disorders have been traditionally defined in terms of deviant quality, pitch, and loudness and by deviant structure and/or function of the laryngeal mechanism. The definition of voice disorders in an occupational context depends on the demands set upon the voice, and voice endurance is an essential criterion. Professional voice users are those who depend on their voice for practicing their profession. Various studies have reported that voice problems are common among professional voice users, especially teachers, than in other voice demanding professions. Although most of voice problems are not life threatening conditions, they have significant negative impacts on the occupational, social, psychological, physical and communicative areas of a dysphonic individual. Traditional clinical voice evaluation methods do not capture the impact of the voice problem on an individual’s daily functions in the context of personal, social, and environmental perspectives. Therefore, other tools have been developed recently to assess the impact of voice disorders. Aim: The aim of this work is to assess the impact of dysphonia on teachers’ quality of life and daily voice activities either participation or limitation using the Voice Activity and Participation Profile. Material and Methods: The study included 60 adult subjects divided in two groups, (group A): 30 dysphonic subjects and (group B): 30 dysphonic teachers, their age ranged between 25 and 59 years old, both males and females with variable social class, gender distribution of the studied groups was 22 male (37%) and 38 female (63%), Male: Female ratio=1.7 : 1, their age ranged from 26 years – 56 years , Mean 40.9, Median 40. All patients were subjected to Auditory perceptual assessment of their voice following modified GRBAS scale and the domains were graded according to 03 scale where 0 (normal) and (3) (severe). All the patients were examined by videolaryngoscopy using fiberoptic nasofibrolaryngoscopy. All participants were asked to complete the Arabic version of The Voice Activity and Participation Profile (VAPP) that contains five sections: • Self-perceived severity of voice disorder (1 question). • Work section (4 questions). • Daily communication section (12 questions). Correspondence to: Dr. Hassan H. Ghandour, E-mail: [email protected] • Social communication section (4 questions). • Emotion section (7 questions). Besides the five mentioned parameters, it is still possible to measure activity limitation and participation restriction the first is calculated by the sum of the first questions of each parameter, and the second is calculated by the sum of the second questions of each parameter. For each question, the participant’s answer according to their perception is represented on an analog scale of 10cm: Not affected (left) and affected (right). Results: Female teachers reported a higher frequency of vocal symptoms than males (38% vs. 26%), and more absence from work due to voice complaints. A significant difference was found for the frequency of voice problems among age groups, 6 at group 1 (20%) their age ranged from 25 years35 years, 13 at group 2 (37%) their age ranged from 35-45 years, 11 at group 3 (43%) their age ranged from 45-56 years The mean scores for daily communication, social communication, and emotions domains of dysphonic female teachers were found to be significantly higher in the three domains than those of dysphonic male teachers Primary and secondary school teachers both have experienced voice problems however the prevalence was significantly higher in primary school teachers. Conclusion and Recommendations: Voice problems occur more frequently and to a larger extent in teachers. This is related to their exposure to vocal abuse and misuse, biological, environmental, and psycho-emotional risk factors, in addition to other predisposing factors. Measuring Self-perception of voice problem and how much it affects quality of life by applying (VAPP) questionnaire is recommended, provides important information and is essential for the adherence to therapeutic processes.