Hrvatska adaptacija Upitnika za probir poremećaja glasa SIVD za rano otkrivanje glasovnih teškoća kod učiteljica

Ana Bonetti, Luka Bonetti, Ivana Šimić

Uvod i cilj: Učiteljice su u riziku od poremećaja glasa, koji negativno utječe na profesionalnu učinkovitost te kvalitetu života. Najučinkovitiji tretmanski ishodi povezani su s ranim otkrivanjem poremećaja glasa, za što se učinkovitim pokazuju upitnici samoprocjene, poput upitnika Screening Index for Voice Disorder (SIVD). Cilj ovog rada bio je kreirati i validirati njegovu hrvatsku inačicu (SIVD-HR) te ispitati njezin potencijal za predikciju bio- -psiho-socijalnih posljedica poremećaja glasa kvantificiranih već adaptiranim i validiranim upitnikom Indeks vokalnih teškoća (VHI-HR). Ispitanici i metode: SIVD-HR sadrži dvanaest simptoma čija se izraženost samoprocjenjuje na Likertovoj ljestvici. Uvijek ili gotovo uvijek prisutan simptom boduje se jednim bodom, a veći broj bodova ukazuje na veći rizik poremećaja glasa. SIVD-HR je nakon informiranog pristanka ispunilo 109 učiteljica, podijeljenih u skupine s dijagnozom poremećaja glasa (VP) i bez dijagnoze poremećaja glasa (BVP) dobivene do unatrag dvije godine od vremena prikupljanja podataka. Rezultati: Izraženost simptoma prosječno je procijenjena niskom, a njihov bio-psiho-socijalni utjecaj blagim, no u oba slučaja procjena VP skupine bila je značajno nepovoljnija. Barem jedan simptom (gotovo) uvijek osjeća gotovo 50% učiteljica VP skupine i tek svaka osma učiteljica BVP skupine. Korelacije SIVD-HR s dobi, stažem i dnevnim radnim opterećenjem nisu pronađene. Pokazalo se da je SIVD-HR pouzdan te da posjeduje diskriminacijsku, konvergentnu i prediktivnu valjanost. Područje ispod krivulje operativnih karakteristika od 0,672 pri granici od dva ili više bodova te osjetljivost od 46,2% i specifičnost od 84% upućuju na klinički nedostatnu točnost SIVD-HR u identifikaciji učiteljica s ranije postavljenom dijagnozom poremećaja glasa kao rizičnih i stoga na njegovu ograničenu iskoristivost. Međutim, SIVD-HR značajno i snažno predviđa izraženost bio-psiho-socijalnih posljedica vokalnih problema pa ga je uputno validirati na većem broju vokalnih profesionalaca. Zaključak: Rezultati sugeriraju neosviještenost učiteljica o simptomima promjena kvalitete glasa i prihvaćanje njihovih posljedica kao otegotnih okolnosti posla, što upućuje na potrebu sustavnog obrazovanja učitelja o vokalnom zdravlju.

Introduction and aim: Female teachers are at risk of voice disorders, which negatively affect professional effectiveness and quality of life. The most effective treatment outcomes are associated with early detection of voice disorders, for which self-assessment questionnaires, such as the Screening Index for Voice Disorder (SIVD), have been shown to be effective. The aim of this study was to create and validate its Croatian version (SIVD-HR) and to examine its potential for predicting the bio-psycho-social consequences of voice disorders quantified by the already adapted and validated Voice Handicap Index (VHI-HR). Subjects and methods: The SIVD-HR contains
12 symptoms whose severity is self-assessed on a Likert scale. A symptom that is always or almost always present is scored with one point, and a higher number of points indicates a higher risk of voice disorders. The SIVD-HR was completed, after informed consent, by 109 female teachers, divided into groups with (VP) and without (BVP) diagnosis of voice disorder obtained up to two years from the time of data collection. Results: The severity of symptoms was assessed as low on average, and their bio-psycho-social impact as mild, but in both cases the assessment of the VP group was significantly less favorable. At least one symptom is (almost)always felt by nearly 50% of teachers in the VP group and only one in eight teachers in the BVP group. Correlations with age, experience and daily workload were not found. The SIVD-HR was shown to be reliable and to have discriminant, convergent and predictive validity. The area under the receiver operating characteristic curve of 0.672 at a cut-off of two or more points, with sensitivity of 46.2% and specificity of 84%, indicate that the SIVD-HR is not accurate enough in identifying teachers with a previously diagnosed voice disorder as at risk, and therefore has limited clinical usefulness. However, the SIVD-HR significantly and strongly predicts the severity of the bio-psycho-social consequences
of vocal problems, so it is advisable to validate it on a larger number of vocal professionals. Conclusion: The results suggest that teachers are unaware of the symptoms of voice quality changes and accept their consequences as aggravating circumstances at work, which indicates the need for systematic education of teachers about vocal health.