Association between readiness for behavior change and complaints of vocal problems in teachers

Rossi-Barbosa, Luiza Augusta; Gama, Ana Cristina Côrtes; Caldeira, Antônio Prates

doi:10.1590/2317-1782/20152013088

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Original Articles • CoDAS 27 (2) • Mar-Apr 2015 • https://doi.org/10.1590/2317-1782/20152013088 copy

Association between readiness for behavior change and complaints of vocal problems in teachers

Authorship SCIMAGO INSTITUTIONS RANKINGS

Purpose:

To verify the association between readiness to behavioral change and self-reported vocal problems of teachers in schools from the municipal education network of Montes Claros, Minas Gerais, Brazil.

Methods:

The URICA-VOICE scale was used to measure the motivational stages of 138 teachers. Readiness to change was the variable outcome, whereas the independent variables referred to sociodemographic, economic, occupational, lifestyle, general health, and teacher's own voice factors.

Results:

The majority (59.4%) of teachers were in the pre-contemplation stage of the URICA-VOICE scale. The variables use of medication, perception of voice failure, and demand for speech and language therapy were retained for the final model.

Conclusion

: The low readiness to change showed the need for increased awareness of the risks and benefits related to the voice and general health. The results can provide public health intervention strategies that deal with individuals at various stages in the decision-making process.

Voice; Voice disorders; Health promotion; Faculty Speech; Language Pathology and Audiology

Variáveis	n	%
Age group
26–29	4	2.9
30–39	44	31.9
40–49	81	58.7
50–54	9	6.5
Marital status
Single	20	14.5
Married	98	71.0
Divorced	17	12.3
Widow	3	2.2
School
Higher education and postgraduation	62	44.9
Higher education without postgraduation	73	52.9
Secondary school	3	2.2
Number of children
None	20	14.5
One or more	118	85.5
Family income
≥R$ 2,500.00	44	31.9
<R$ 2,500.00	94	68.1
Teaching experience (years)
≤16	48	34.8
>16	90	65.2
Number of students in class
≤25	75	54.3
>25	63	45.7
Noise in class
Not important	3	2.2
Tolerable	88	63.8
Uncomfortable	44	31.8
Unbearable	3	2.2
Noise in school
Not important	7	5.1
Tolerable	83	60.1
Uncomfortable	43	31.2
Unbearable	5	3.6
Noise out of school
Not important	46	33.3
Tolerable	75	54.3
Uncomfortable	16	11.6
Unbearable	1	0.8
Ventilation in class
Satisfactory	14	10.1
Reasonable	58	42.0
Poor	46	33.3
Very poor	20	14.6
Water intake during classes
Yes	100	72.5
No	38	27.5
Amount of water/day
≥4 glasses	75	54.3
1–3 glasses	63	45.7
Alcohol intake
Never	67	48.6
Monthly or less	37	26.8
2–4 times per month	29	21.0
2–3 times per week	5	3.6
Smoking
Nonsmoker	123	89.1
Former smoker	10	7.2
Smoker	5	3.6
Physical activity
Yes	49	35.5
No	89	64.5

Variables	n	%
Gastroesophageal reflux
No	127	92.0
Yes	11	8.0
Diagnosis of respiratory allergy
No	89	64.5
Yes	49	35.5
Perception of respiratory disorder
No	75	54.3
Yes	63	45.7
Use of medication
No	98	71.0
Yes	40	29.0
Hypertension
No	123	89.1
Yes	15	10.9
Diabetes
No	137	99.3
Yes	1	0.7
Sleep disorders
No	129	93.5
Yes	9	6.5
Hoarseness
No	47	34.1
Yes	91	65.9
Sore throat
No	61	44.2
Yes	77	55.8
Fatigue when speaking
No	66	47.8
Yes	72	52.2
Presence of catarrh
No	67	48.6
Yes	71	51.4
Voice failure
No	86	62.3
Yes	52	37.7
Vocal effort
No	98	71.0
Yes	40	29.0
Pain when speaking
No	129	93.5
Yes	9	6.5
Vocal signs and symptoms
<4 symptoms	75	54.3
≥4 symptoms	63	45.7
Use of voice in daily routine
Speaks little	1	0.7
Speaks moderately	13	9.4
Speaks a lot	83	60.2
Speaks too much	41	29.7
Leave by vocal disorder
No	109	79.0
Yes	29	21.0
Default due to vocal disorder
No	94	68.1
Yes	44	31.9
Medical assistance due to vocal disorder
No	69	50.0
Yes	69	50.0
Speech therapy
No	108	78.3
Yes	30	21.7

Variables	Stages		p-value*
	Pre-contemplation n (%)	Contemplation n (%)
Sociodemographic, economic, occupational data
Age (years)
<40	28 (60.9)	18 (39.1)	0.892
≥40	54 (62.1)	33 (37.9)
Marital status
With partner	59 (62.8)	35 (37.2)	0.682
Without partner	23 (59.0)	16 (41.0)
Children
None	12 (60.0)	8 (40.0)	0.864
One or more	70 (61.9)	43 (38.1)
Income
≥R$ 2,500.00	24 (54.5)	20 (45.5)	0.236
<R$ 2,500.00	58 (65.2)	31 (34.8)
Schooling
Postgraduation	37 (62.7)	22 (37.3)	0.823
No postgraduation	45 (60.8)	29 (39.2)
Teaching experience (years)
≤16	29 (63.0)	17 (37.0)	0.811
>16	53 (60.9)	34 (39.1)
Number of students
≤25	48 (65.8)	25 (34.2)	0.284
>25	34 (56.7)	26 (43.3)
Noise in class
Not important to tolerable	58 (65.9)	30 (34.1)	0.158*
Uncomfortable to unbearable	24 (53.3)	21 (46.7)
Noise out of school
Not important to tolerable	73 (61.3)	46 (38.7)	0.830
Uncomfortable to unbearable	9 (64.3)	5 (35.7)
Ventilation in class
Satisfactory to reasonable	48 (67.3)	23 (32.4)	0.131*
Poor to very poor	34 (54.8)	28 (45.2)
Lifestyle
Water intake/day
≥4 glasses	40 (55.6)	32 (44.4)	0.116*
<4 glasses	42 (68.9)	19 (31.1)
Smoking
Nonsmoker	69 (58.5)	49 (41.5)	0.034*
Smoker/former smoker	13 (86.7)	2 (13.3)
Physical activities
Yes	28 (58.7)	20 (41.7)	0.554
No	54 (63.5)	31 (36.5)
Health
Gastroesophageal reflux
No	79 (64.8)	43 (35.2)	0.014*
Yes	3 (27.3)	8 (72.7)
Diagnosis of respiratory allergy
No	57 (66.3)	29 (33.7)	0.138*
Yes	25 (53.2)	22 (46.8)
Use of medication
No	65 (68.4)	30 (31.6)	0.011*
Yes	17 (44.7)	21 (55.3)
Hypertension
No	77 (64.7)	42 (35.3)	0.035*
Yes	5 (35.7)	9 (64.3)
Diabetes
No	82 (62.1)	50 (37.9)	0.203
Yes	0 (0.0)	1 (100.0)
Sleep disorders
No	79 (63.2)	46 (36.8)	0.147*
Yes	3 (37.5)	5 (62.5)
Voice
Hoarseness
No	29 (63.0)	17 (37.0)	0.811
Yes	53 (60.9)	34 (39.1)
Failure
No	59 (69.4)	26 (30.6)	0.014*
Yes	31 (62.0)	19 (38.0)
Presence of catarrh
No	43 (68.3)	20 (31.7)	0.138*
Yes	39 (55.7)	31 (44.3)
Fatigue when speaking
No	43 (68.3)	20 (31.7)	0.138*
Yes	39 (55.7)	31 (44.3)
Effort to speak
No	63 (85.6)	33 (34.4)	0.129*
Yes	19 (51.4)	18 (48.6)
Pain when speaking
No	71 (65.7)	37 (34.3)	0.044*
Yes	11 (44.0)	14 (56.0)
Ardor in throat
No	58 (64.4)	32 (35.6)	0.338
Yes	24 (55.8)	19 (44.2)
Self-reported voice disorder
<4	52 (70.3)	22 (29.7)	0.022*
≥4	30 (50.8)	29 (49.2)
Use of voice in daily routine
Speaks little/moderately	9 (64.3)	5 (35.7)	0.830
Speaks a lot/too much	73 (61.3)	46 (38.7)
Health assistance due to voice problems
Medical appointment due to voice problems
Yes	33 (50.0)	33 (50.0)	0.006*
No	49 (73.1)	18 (26.9)
Speech therapy
Yes	11 (40.7)	16 (59.3)	0.012*
No	71 (67.0)	35 (33.0)

Variables	p-value	Adjusted OR (95%CI)*
Use of medication	0.006	3.30 (1.40–7.74)
Voice failure	0.048	2.23 (1.01–4.96)
Speech therapy	0.015	3.25 (1.25–8.43)

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[1] Correspondence address: Luiza Augusta Rosa Rossi-Barbosa Rua São Marcos, 115, Todos os Santos, Montes Claros (MG), Brazil, CEP: 39400-128. E-mail: luiza.rossi@unimontes.br