Voice perception in teachers : life-story narratives between workspaces and the scenic choir Percepção da voz em professoras : narrativas de vida entre os espaços do trabalho e do coro cênico

Accepted: October 14, 2018 Study conducted at Coro Cênico “Céu da Boca”, Secretaria Municipal de Educação de Santos Santos (SP), Brasil. 1 Seção de Vigilância e Referência em Saúde do Trabalhador – SEVREST, Secretaria Municipal de Saúde Santos (SP), Brasil. 2 Universidade Federal de São Paulo – UNIFESP Santos (SP), Brasil. Financial support: nothing to declare. Conflict of interests: nothing to declare. ABSTRACT


INTRODUCTION
In the midst of the political, cultural, and musical effervescence of the 1960 and 1970's, the city of Santos (state of São Paulo) saw the rise of several music groups and Festival Música Nova [New Music Festival].Among them, a reference choir for most Brazilian singers and musicians stands out to this day.This singing group, "Madrigal Ars Viva", created in 1961, became an important laboratory for composers, conductors, and teachers (1) .Inspired by the group, one of its former singers, Iva Passos-musician, teacher, conductor, and artistic directorcreated, in 2005, the "Coro Cênico Céu da Boca" [Céu da Boca Scenic Choir], composed of early childhood education teachers of Department of Education, in the city of Santos.The choristers in Céu da Boca use their voice both to exercise their profession and as an artistic expression, such as singing.It is important to note that these teachers' lifestyle goes beyond their professional presence in the classroom, where their voice is a tool-they also experience art inside and out of their working environment, being in touch with the art of music by means of their voice.
Upon a literature review in search of other scenic choirs composed by active early childhood education teachers, other choirs or scenic choirs with these characteristics were not found.Therefore, as an unparalleled form of artistic and cultural expression in Santos and in Brazil, its singularity and importance are noteworthy.
A more comprehensive review of the literature resulted in four scientific productions referring to the aspects investigated in this research-i.e. the effects of choir singing on choristers' vocal health, personal care, and lifestyle.The first study discusses the actions of the choir (of teachers) of Instituto Federal de Educação Ciência e Tecnologia do Acre [Federal Institute of Education, Science, and Technology of the State of Acre], reiterating and validating group singing as an activity promoting health (including vocal health) and citizenship (2) .
The second scientific production refers to the influence of choir singing on the quality of life of the public health system's users (3) ; the third, the effects of choir singing on a group of elderly choristers (4) ; and the fourth study consists of an account of the experience of Coro Cênico Cidadãos Cantantes, composed of the staff and patients of a mental health institution in São Paulo (5) .
It can be said that, despite the progress in Speech-Language Therapy with respect to teachers' health, studies that focus on the subjective aspects of the profession-such as teachers' perceptions and experience concerning voice/vocal health in choir singing-have not been found.Nevertheless, studies such as Poéticas e marginalidade: experiência no Projeto Cidadãos Cantantes (6) and the aforementioned scenic choir Cidadãos Cantantes: um espaço entre a música e a saúde (5) are noteworthy.
These publications refer to experiments on the interface between contemporary choir singing, art, and health from a collective singing experience in a context focused on mental health (5) .The authors consider that choir singing reinstates the meaning of art as a human characteristic capable of changing attitudes and placements of knowledge and existence.Consequently, it is capable of changing ways of life.Choir singing aims to further the ability to communicate, favoring the establishment of unique and collective resources of creativity, self-confidence, autonomy, and solidarity.The choir is also a place of production and access to culture, attention and care to a diverse audience (5) .
In this context, this paper addresses knowledge production in the field of Speech-Language Therapy regarding commonly underrated aspects in voice research and seeks to understand how choristers confer meaning to their everyday experience and perceive self-care.This paper aims to investigate the perception of voice use as a work and artistic expression tool in a choir of early childhood education teachers.This research was carried out under a Master's Degree course, in which topics such as the meanings of voice to these teachers, their perception on the process of health/illness/voice care, music, singing in their lives, contact with art, and their professional activities are addressed.
In this vein, art, health, and society have been articulated with the aim to further knowledge production on the perception of teachers and choristers about voice, its use, and vocal health, as well as how they interpret and deal with vocal disorders.

METHODS
This is a qualitative research based on the ethnographic method, which resorted to field journals and participant observation.Composing life-story narratives was a methodological resource for data production and development of rapport between the researcher and the study participants.
The study was submitted to Coordenadoria de Formação Continuada em Saúde (Coform) [The Coordinating Body of Continuing Education in Healthcare] of Santos City Hall and the Research Ethics Committee of UNIFESP, having been approved under protocol 1.121.940.All of the study's participants were informed about the research and signed the Free Informed Consent Term.
With regard to participant observation, the researcher met the choristers and interacted with them for six months.This time allowed for the observation of group interactions and their dialogs, with the researcher's participation in the process.
Throughout the field observation, it was possible to observe the organization of a show, from its conception to its opening, held in a special venue, with all of the emotions, difficulties, struggles and, in this case, demonstrations of sisterhood it involved i (7) .
As mentioned, the instruments for the study's data production consisted of a field journal and life-story narratives.A field journal was produced for each meeting, in which participant observation was recorded: facts, events, impressions, and the remarks made.The journal was a tool that allowed systematization of the experiences gathered for result analysis.The records also consist of videos and photographs.These records portrayed the reality seen from the observer's perspective, with their perceptions, subjectivities and encounter with the field and the study's participants.
The teachers composing scenic choir Céu da Boca are active teachers in schools, aged between 32 and 58 years old, and have not studied music (with the exception of one participant, who teaches the discipline), although they have received basic training in music.The group performs thematic shows focused on the art of singing combined with gentle body movement.The choice of repertoire for the rehearsals and performances begins with the selection of a composer, followed by selection of the songs.Then, arrangements are prepared considering the composition and vocal fabric of the choir.
The choice of this group was driven by the fact that its composition favors the participation of active public-school teachers in Santos.
The selection criteria for participants were based on the principal characteristics of the active population of teachers in Santos' public schools: early childhood education teachers exercising their profession, within the abovementioned age range, active for over five years, and working eight hours a day-as it is assumed that this voice use frequency allows for the observation of changes caused by their professional activity.
Five teachers who took part in scenic choir Céu da Boca were followed-up during rehearsals and performances for a period of six months.That is, the research was carried out at the rehearsal and performance venues-namely schools, Orquidário Municipal, Concha Acústica, and Pinacoteca de Santos.Life-story narratives were produced for each of the study's participants: the choir conductor and founder plus four choristers and early childhood education teachers of the city of Santos, henceforth referred to by pseudonyms inspired by Greek art muses: Calliope, Thalia, Polimnia, Terpsichore, and Euterpe.
The five life-story narratives and the field journal content have been analyzed under the perspective of a few themes, henceforth referred to as analyzers.Analyzers are events revealing the different relations taking place on the experiential level of the research, so as to consider intervention and how it is constituted.In addition, they analyze the institutional implications and the role of the researcher (8) .The researcher's observation was guided by the analyzers addressed below, which arose upon a first reading of the material.From this, it was possible to outline topics in the findings that are either repeated, different, or outstanding upon reading, where interesting or innovative data also played a role.As the topics are interrelated, they have not been laid out hierarchically nor chronologically.They were randomly used with a view to facilitate the presentation of data throughout the text.The analyzers are: -voice use in art and at work; -the influence of work organization on these teachers' vocal health; -vocal health care by the teachers-singers; -different ways to manage time, different roles, and take care of themselves.
After a period of observation of the choir's activities, a meeting was organized with the group with the aim to select the members interested in taking part in the study.From this moment, individual meetings (two to three) were set up in order to collect their testimonies, which were supposed to constitute free life-story narratives.For such, the study proposed themes to be addressed, to the detriment of closed questions.This approach allowed the researcher to get better acquainted with these women's life stories while respecting their particularities, which was transposed into the text and observed on the style of each narrative.They were all readily available to refrain from singing and talk about themselves, their dreams and frustrations, what makes them who they are, which paths led them to their work and the choir.
In addition to representing a guiding axis of their professional and artistic activities, their voice has also taken the lead role in their written life stories, so as to emphasize how these multitasking women of today are charmed and charm others with the sound of their own unique voices.

RESULTS
It is worth noting that the narrative is an excerpt of a person's story that recaptures moments of their life in light of their current emotions and experiences.In short, it stresses the understanding about these women's subjective position in today's world.It must be stressed that the written narrative is also pervaded by the researcher's listening-in and perspective.Imbrizi et al. (8) state that the person's account presupposes a selection of events, their interpretation of these facts, and the establishment of subjective relations.Furthermore, this subjectivity is important to the detriment of the chronological succession of objective facts, as the narrative's inaccuracies express how irregular their life itself is felt and represented.Therefore, this material represents an outline of these teachers-singers' subjectivity and is analyzed as such.

Voice use in art and at work
It was observed that all of the narrators acknowledged the vital importance of their voice to their life-both at work and in the choir.All of them reported that their voice is still the most important work tool in early childhood education, although they recognize that it is necessary to use other media of communication.
In their narratives, Thalia, Polimnia, and Euterpe report intensive use of their voice during the week.They notice the accentuation of voice change throughout this period, although they have learned to live with hoarseness.Additionally, Thalia mentioned that she did not make resting breaks, so her hoarseness worsened and she did not take any remedial action.
A meaning of voice use in art, music, and the choir, beyond singing, was observed: noticing and discovering oneself, having the courage to change oneself.The choir has been a trigger for self-care, as they noticed and felt their voice-both its potential and its limits.Euterpe: It is like the woman stored in there came out and took over, isn't it?'Now, it's my turn.'I often feel like this.
Thalia expresses her feelings: [...] to me, this is a privilege; I feel honored to be part of this group.
The choir represents the way in which these teachers express their art, externalize their feelings and reach out to people.Singing in the choir brings about new possibilities, experiences, and social relationships.The voice can create a fascination for music.

The influence of work organization on the teachers' vocal health
All of the teachers reported working tiring hours with short breaks for lunch or commuting to another school, which hinders rest-including vocal rest-before the next series of classes.
From the narrators' accounts, it was noted that their working environment are provided with appropriate conditions, such as yards with plants, comfortable spaces, and adequate lighting.However, ventilation was reported as insufficient in the warm season, and the noise level-both outside and inside the classrooms (children speaking)-was considered high, which contributes to inadequate voice use in the classroom.Thalia was the only one not to report such conditions, as she teaches computer classes in dedicated rooms.They also mentioned the number of students in the classrooms, often lacking assistant teachers.None of the teachers mentioned dust produced by chalk as a relevant factor for vocal health.This may be explained by a minimal use of chalk in early childhood education, as they resort to other materials for teaching, besides using several vocal and body language techniques.That is, work organization has not raised any issues.On the other hand, the accounts pinpointed inadequate working conditions, which also constitute factors related to voice disorders in teachers (9) .

The teachers-singers' vocal health care
As to vocal health, it was observed that all of the narrators are aware, informed, and knowledgeable with regard to basic voice care and voice use in their professional environment and in the scenic choir.They have also reported that this knowledge and the attitudes towards voice care were triggered by their involvement in the choir, as Thalia states: I have leaned to live with hoarseness: I would scratch my voice from Monday to Thursday and, on Friday, I would be completely hoarse.The choir helped me to seek help from speech-language therapy: I began to take care of myself, to know myself better.
All of them are aware that lifestyles-which include their choices and ways of relating to themselves, to other people, and even to nature-and certain habits such as smoking, drinking alcoholic beverages, consuming certain foods, and clearing the throat, among others, may harm vocal health and affect voice use.The teachers-choristers have shown their awareness of the fact that vocal weariness results from continued high-intensity voice use or screaming, and that it is necessary to hydrate the larynx during professional voice use-all of them drink water during classes and during the rehearsals of the scenic choir.This habit is corroborated by research data showing that comfort and dysphonia reduction following water ingestion is due to increased thinning of vocal folds' secretion.Therefore, it is important to use hydration to prevent vocal disorders that may impact professional activity (10) .
The choristers admitted they take care their voice because of the choir singing: Terpsichore states: When I sing, besides drinking a lot of fluids during rehearsal and eating apples, I avoid eating chocolate.I don't have a specific care routine at work.
Polimnia states that she only exercises during the choir's rehearsal, besides considering herself a heavy smoker.She is the only smoker in the group and none of them drinks alcohol.Abstaining from smoking and drinking is established as positive behavior to maintain vocal health, especially for those who use their voice professionally.

Different ways to manage time, different roles, and care for themselves
Both the married and the single choristers teach two shifts a day (morning and afternoon), besides taking part in the choir rehearsals on Monday nights, Saturday mornings, and sporadic performances.Additionally, all of them seek improvement in their professional field, even because it is currently required by the Department of Education and due to recently added assignments and frequent evaluations.
The time available for them to look at and take care of themselves, besides their family life (husband, children, parents, or nephews), is at night and on weekends.All of them consider their life as "very fast-paced", although they acknowledge the need to take time to have a coffee with their husbands, spend time with their children, go out with friends, read, listen to music, work on crafts, or just be alone with themselves.One of the narrators, Terpsichore, expresses the issues she faces with her husband, as he considers that her activities require her to occupy public spaces, besides taking up the time she would have to take care of their home and family:

[...] because art exposes us, puts us on the spotlight. And it requires rehearsing, time, dedication. But today I am able to negotiate my time, I realize that I need individual moments to take care of myself.
The narrators are aware of the possibilities and restraints of the daily life of women with multiple roles: haste and anguish are a burden; on the other hand, they believe that they lead a fuller life, among their social environs and society in general, leaving their mark.
With regard to general health, they are all aware of their problems: some put themselves first, paying more attention to self-care, making time and seeking ways to introduce healthy habits in their daily life.Others, not as much, but all of them see themselves more like a person entitled to attention and care after joining and experiencing Céu da Boca group.
All of them stress the strong affection between them, especially Calliope: "[…] a bound that has been tied by them, and among them, and is constantly reinforced."The choir is seen as a very cohesive group, a family embracing its members and their personal anguish, dramas, and sorrows, without competition, anger or envy of each other's performance in the choir.On the contrary, they encourage each other's improvement in a particular stage-a solo, for instance.They might, at some point, feel discouraged or tired, or want to leave the choir, but they support each other and stay on the artistic path.
The narratives unanimously evinced the choir as a unified group, whose members are friends and mutually supportive at all times, in spite of their work and everyday life.This is observable in the researcher's field journal, which shows women of different ages and life stories who establish ties by means of music and movement.The interface between art-music, in this caseand health has been investigated by Maluf et al. (5) .This work is analogous to the choristers' accounts: the practice of choir singing reinstates the meaning of art as a human ability capable of changing attitudes, knowledge placements, and existence.Thus, it may lead to changes in lifestyle, favoring the growth of the cultural and intellectual resources of the group and each of its members.
Another result observed that stresses the power of art, related to health improvement, is the idea of "distribution of the sensible" (11) , which refers to the fact that artistic sensibility may be exercised in everyday life and shared among people, as well as among them and music and voice use in choir singing.This distribution of the sensible does not only take place on the speech level, but it refers to a certain way of occupying places in space, the visibility regimen produced, the affective sphere, knowledge sharing, new temporalities, and the invention of lifestyles that take shape by means of a process with no particular end (11)(12)(13) .
Rancière (12) also points out the sensibility regimens in contemporary society and postulates the importance of the public art sphere-art inserted on the city landscape and common life, one that intervenes in the public space and changes the collective life landscape in the sense of restoring a way of social existence.In this vein, it can be said that Céu da Boca's performances interfere with the collective urban space, as they take up different venues, such as Concha Acústica, a secular building located in the city's historical center, by the sea.Art is political when it establishes other visibility regimens far and beyond the hegemonic models and amplifies the voice of lives often silenced by the acceleration of historical time and working conditions.It seems that the scenic choir's members did not pass on the opportunity to take part in a distribution of the sensible centered on the art of music as an element producing other ways of life and different ways to use and manage personal time in the everyday life pruned by professional and family-life demands.

DISCUSSION
Teaching is the profession most susceptible to vocal disorders-despite uncountable technological possibilities, their voice remains their primary work tool (14) .
Studies point out that, in Brazil, 66.7% of teachers report hoarseness at some point in their career.This figure is significant as a sign of the adverse effects of vocal disorders on performance throughout these professionals' career (15) .
The members of Céu da Boca scenic choir acknowledge the vital importance of their voice to their life-both at work and in the choir.Voice in music and art is a challenge to all of the narrators: they report that, in the choir, their voice is an object of reflection and work and it is taken care of and treated.It is prepared with exercises for relaxation, vocal warming, posture, breathing, resonance, and body movement.
They tune their voices in an effort to combine them in harmony, by listening and perceiving the vocal quality of each member in a joint stimulus to produce an overlap between the collective connection of the group and the senses of the repertoires, whether it takes the shape of holding the tune or not (6) .
The teachers-choristers use this space (the scenic choir) as an important scenario of life, production of subjectivity, and access to culture, which also provides a diverse audience with attention and care.This line of choir singing is also addressed in a study conducted by Luiz et al. (2) , in which the authors describe the experience of a traditional choir composed of students and the teaching staff of a federal institute of education, concluding that results do not only concern musical and vocal development, but also social integration, group interaction, and health improvement.The authors confirm that facilitating knowledge sharing is associated with the success of this choir singing project.This becomes evident throughout Céu da Boca's rehearsals and organization of each performance.
Additionally, the fact the scenic choir incorporates body movements to singing also contributes to adequate voice production.In their study, Behlau et al. (16) mention that early childhood education teachers with inadequate body posture also presented higher levels of vocal disorder.It was notable that the choristers learn to be aware of their body posture.As to voice care, hydration is often present in information about vocal health, which focus on its capacity to reduce or prevent voice disorders affecting professional development (10) .
The narrators acknowledge the importance of speech-language therapy intervention in voice care: Thalia and Calliope have undergone speech-language therapy, whereas Polimnia and Euterpe recognize this need, although they have never seen a therapist.They have all had their voice structure assessed by an otolaryngologist upon the choir conductor's request.
A relevant aspect unanimously reported was the inadequacy of care for the teacher's voice at work, evidenced by the lack of guidance, prevention campaigns, screening, referrals for evaluation or monitoring of vocal health.
Thalia states that, in the educational network, there are several cases of teachers withdrawn from work due to hoarseness or nodules, and yet there is no investment or leave to undergo speech-language therapy.The narrators inform that bureaucracy hinders teachers' incentives to seek assistance.This complaint was common to all of the narratives, as there are no vocal health policies or actions in place to assist teachers in schools, nor in the educational network or public health clinics.This also corroborates the findings of academic research, which points out that teachers seem to be minimally aware of their vocal behavior, although they are not fully informed about its ideal usage with a view to promote better health (17) .
It was observed that teachers often prioritize their professional development, due to the extent of their responsibilities and roles, to the detriment of their personal life and self-care.The time and energy they must invest in their work reduce their opportunity to problematize their dreams, wishes, personal projects and working and health conditions, in addition to the matters related to their health/illness process.Thus, the supposed difficulty to perceive and recognize milder vocal disorder signs and symptoms may be but one component of a wider and more complex framework encompassing the relations between work and health.
The interaction of the choir members, rehearsals, performances, and personal experiences made it clear that being part of the group and in touch with music makes the choristers feel stronger.
Music-more specifically, singing in the scenic choirinfluenced the perception and problematization of the health/ illness process of the teachers taking part in this study.All of them perceive the choir as of high importance in their life, reporting one or numerous striking facts in which their participation was decisive and key to overcome the matter at hand.
The choir has been essential in solving emotional and physical problems, as well as to address a health condition of one of the narrators.Thus, the artistic use of voice (in singing) has allowed for self-knowledge and the strengthening of self-confidence beyond artistic expression.
Throughout the research development, the meaning of sisterhood, whose etymology traces back to the Latin sororitas, -from the root sóror, meaning sister-came to surface and may be applied to the relationship between the teachers-choristers of Céu da Boca.
From the data produced in the field journals, it is possible to perceive the relationship of sisterhood in the integration among all of the members of the group.During rehearsals they gather to produce everything they need to put the show together: the set, costumes, accessories, make-up, and even fund-raising events, such as Pizza Night.
Another emblematic moment of sisterhood takes place at the end of each rehearsal, when, often moved, everyone sings hand in hand the songs or prayers with melodies composed by the pianist.
The care they show for their own voice and everything that relates to the choir, such as objects, sheet musics, and costumes, besides their relationships, welcome an appropriate quote from Lagarde y de Los Ríos (7) which mentions that women come together not to think alike, but to think; not to act in unison, but in the same direction.
Art aimed at society as a health-promoting tool and agent is observed in the singing of Céu da Boca choir, in which one witnesses the expansion of their cultural and affective repertoires and the expansion of human and collective potential by means of artistic and creative expression.
Art contributes to the health-promoting process of individuals and society, rooted in everyday life, beyond the so-called health institutions.It is thus integrated as a way of care incorporated by society as a way to address health.Artistic spaces become a place of creative expression fostering moments of human bonding and contact (18) .
What kind of art do the conductor and the choristers produce in their performances of multifold themes in public spaces?It is a sprawling art that is not limited to the artist and choir conductor's ego, one that pursues a movement of expansion towards the other, everyday life, and the city (13) .It consists of musical experiences with the power to bring forward in others the will to be in a group, to part-take in the collective, where sensible experiences can be shared (19) .

CONCLUSION
Singing in a scenic choir and sharing the artistic manifestation of voice in a group can contribute to reduce or even prevent vocal damage and help psychological organization and, body and vocal perception.In addition, it reveals how these teachers look after their health and lead their life.
Interdisciplinary studies between Speech-Language Therapy and Music can bring about many contributions of great importance to both areas of knowledge bound by the common link of voice.Among these contributions, we point out the development of voice potential in singing and the use of scientific research innovations in Music to improve voice in speech and as a work tool.
In short, the art of music in a scenic choir can bring about the feeling of sisterhood among women in today's society, in addition to constituting an efficient means of voice care, fostering vocal health promotion and damage prevention actions and programs aimed at teachers.