Distúrbio de voz, linhas de cuidado e educação em saúde vocal para professores do ensino fundamental de Cuiabá-MT, 2023

Abstract

Introduction: The teacher is the professional who uses the voice as a teaching tool, through which knowledge is constructed in the classroom. In their daily lives, teachers often have an immense vocal demand, speak for hours at a time with high vocal intensity and face several other risk factors for the voice, causing the emergence of symptoms, vocal disorders, absences, and absenteeism, which burden the costs to society and the State. To prevent vocal problems among teachers, educational interventions in voice are important. Objective: To investigate voice disorders among teachers in the public elementary school system in Cuiabá-MT, covering the available lines of care, their frequency and associated factors, and the impacts of an educational intervention on promoting vocal health. Method: Initially, a narrative review was carried out on the Lines of Care for Work-Related Voice Disorders in the Brazilian Unified Health System (SUS). Vocal screening was then applied to 77 elementary school teachers from five public schools in Cuiabá-MT, with analysis of vocal symptoms and factors associated with self-reported voice disorders. Vocal health training was developed and implemented synchronously for teachers who participated in the initial screening. A different topic was addressed at each meeting (vocal guidelines, projection and resonance, articulation and diction, breathing and voice, vocal emphasis and modulation, vocal resistance, vocal warm-up and cool down, and body and voice integration), totaling eight meetings in the period a month. At the end, a new vocal screening was reapplied to compare the pre and post intervention moments. The data were tabulated and subjected to statistical tests. Results: With the narrative review, it was observed that the Lines of Care for Work-Related Voice Disorder were strengthened in the Brazilian Unified Health System in 2018, after the emergence of the DVRT Protocol, with basic care being the gateway to the SUS. As for the results of the initial vocal screening, 49.35% of teachers self-reported having a voice disorder, the most frequent symptoms were dry throat, throat secretion, hoarseness and tiredness when speaking. The risk factors associated with voice disorders were repetitive work, frequent heavy lifting and dissatisfaction with one's voice. Working in two or more schools was considered a protective factor. Regarding the intervention, there was a statistically significant reduction in vocal symptoms, such as hoarseness and loss of voice, and in the Voice Disorder Screening Index. Teachers reported carrying out more vocal care after the intervention, such as taking vocal rest, warming up and cooling down the voice. Furthermore, there was an increase in satisfaction with one's own voice after the intervention. However, the intervention was not enough to promote changes in vocal habits, such as talking a lot and shouting. Conclusion: It is concluded that elementary school teachers in the public school system of Cuiabá-MT presented a high frequency of vocal symptoms and factors associated with voice disorders, with the effects of the educational intervention mediated by information and communication technologies in promoting vocal health being positive.