以教師為例回顧嗓音疲勞下之嗓音功能相關研究

A Review of Vocal Function of Vocal Fatigue in Teachers

10.6143/JSLHAT.202012_(43).0001

謝馨誼(Hsin-Yi Hsieh)；蔡昆瀛(Kuen-Ying Tsai)

教師 ； 嗓音疲勞 ； 嗓音恢復 ； Teachers ； Vocal fatigue ； Vocal recovery

台灣聽力語言學會雜誌

43期（2020 / 12 / 01）

1 - 10

繁體中文

教師為職業用聲者中最常發生嗓音異常的族群之一。高度的用聲需求伴隨各種風險因子（例如：室內聲學條件欠佳、恢復時間不足），可能造成嗓音疲勞，衍生各種嗓音問題。過去對於嗓音疲勞之探討，依研究方式可分為：在實驗室情境以嗓音負荷作業誘發嗓音疲勞，或在真實工作情境中，探討職業用聲者於長時間用聲後的嗓音變化。本文除了回顧在實驗室情境下誘發嗓音疲勞，所造成的嗓音功能變化及恢復等相關文獻，亦以教師為例，回顧其在真實工作情境下的嗓音疲勞情形。整體而言，用聲者在長時間用聲後，常出現平均說話基頻、自覺發聲費力程度及喉部不適程度增加等症狀，嗓音恢復時間則從數分鐘至24小時不等。

Teachers are one of the most common professional voice users who probably have voice disorders. Heavy vocal demands in combination with other risk factors (e.g., poor room acoustics, insufficient recovery time) may cause vocal fatigue, and eventually lead to many kinds of voice problems. Past studies on vocal fatigue include voice changes of vocal fatigue induced by vocal loading tasks (i.e., experimentally induced), and of professional voice users after prolonged voice use in real-life situations. In addition to reviewing literatures on changes of vocal function and vocal recovery under vocal fatigue in laboratory setting, this article reviews vocal fatigue of teachers in natural settings. In general, average speaking fundamental frequency, self-perception of phonation effort, and laryngeal discomfort increased after prolonged voice use, and it may take several minutes to 24 hours for vocal recovery.

1. 董貞吟,黃乾全(2000)。教師嗓音保健知識、行為及自覺健康之分析研究─吵靜地區學校教師之比較。師大學報：教育類，45(2)，75-86。
   連結：
2. American Speech-Language-Hearing Association. (n.d.). Voice disorders. Retrieved October 15, 2019, from https://www.asha.org/practice-portal/clinical-topics/voice-disorders
3. Angelillo, M.,Di Maio, G.,Costa, G.,Angelillo, N.,Barillari, U.(2009).Prevalence of occupational voice disorders in teachers.Journal of Preventive Medicine and Hygiene,50,26-32.
4. Chang, A.,Karnell, M. P.(2004).Perceived phonatory effort and phonation threshold pressure across a prolonged voice loading tasks: A study of vocal fatigue.Journal of Voice,18,454-466.
5. Chen, S. H.,Chiang, S.-C.,Chung, Y.-M.,Hsiao, L.-C.,Hsiao, T.-Y.(2010).Risk factors and effects of voice problems for teachers.Journal of Voice,24,183-192.
6. Devadas, U.,Rajashekhar, B.,Maruthy, S.(2017).Prevalence and risk factors of voice problems among primary school teachers in India.Journal of Voice,31(1),117.e1-117.e10.
7. Fujiki, R. B.,Sivasankar, M. P.(2017).A review of vocal loading tasks in the voice literature.Journal of Voice,31(1),388.e33-388.e39.
8. Gotaas, C.,Starr, C. D.(1993).Vocal fatigue among teachers.Folia Phoniatrica et Logopaedica,45(3),120-129.
9. Hunter, E. J.,Banks, R. E.(2017).Gender differences in the reporting of vocal fatigue in teachers as quantified by the Vocal Fatigue Index.Annals of Otology, Rhinology & Laryngology,126,813-818.
10. Hunter, E. J.,Smith, M. E.,Tanner, K.(2011).Gender differences affecting vocal health of women in vocally demanding careers.Logopedics Phoniatrics Vocology,36(3),128-136.
11. Hunter, E. J.,Titze, I. R.(2009).Quantifying vocal fatigue recovery: Dynamic vocal recovery trajectories after a vocal loading exercise.Annals of Otology, Rhinology & Laryngology,118,449-460.
12. Kelchner, L. N.,Toner, M. M.,Lee, L.(2006).Effects of prolonged loud reading on normal adolescent male voices.Language Speech and Hearing Services in Schools,37(2),96-103.
13. Laukkanen, A.-M.,Ilomäki, I.,Leppänen, K.,Vilkman, E.(2008).Acoustic measures and self-reports of vocal fatigue by female teachers.Journal of Voice,22,283-289.
14. Laukkanen, A.-M.,Kankare, E.(2006).Vocal loading-related changes in male teachers’ voices investigated before and after a working day.Folia Phoniatrica et Logopaedica,58,229-239.
15. Leão, S. H. de S.,Oates, J. M.,Purdy, S. C.,Scott, D.,Morton, R. P.(2015).Voice problems in New Zealand teachers: A national survey.Journal of Voice,29,645.e1-645.e13.
16. McCabe, D. J.,Titze, I. R.(2002).Chant therapy for treating vocal fatigue among public school teachers: A preliminary study.American Journal of Speech-Language Pathology,11,356-369.
17. Medeiros, J.,Santos, S. M. de M.,Teixeira, L. C.,Gama, A. C. C.,de Medeiros, A. M.(2016).Vocal symptoms reported by teachers with dysphonia and associated factors.Audiology Communication Research,21,e1553.
18. Munier, C.,Kinsella, R.(2008).The prevalence and impact of voice problems in primary school teachers.Occupational Medicine,58,74-76.
19. Rantala, L.,Vilkman, E.,Bloigu, R.(2002).Voice changes during work: Subjective complaints and objective measurements for female primary and secondary schoolteachers.Journal of Voice,16,344-355.
20. Remacle, A.,Finck, C.,Roche, A.,Morsomme, D.(2012).Vocal impact of a prolonged reading task at two intensity levels: Objective measurements and subjective self-ratings.Journal of Voice,26,e177-e186.
21. Roy, N.,Merrill, R. M.,Thibeault, S.,Parsa, R. A.,Gray, S. D.,Smith, E. M.(2004).Prevalence of voice disorders in teachers and the general population.Journal of Speech, Language, and Hearing Research,47,281-293.
22. Seifpanahi, S.,Izadi, F.,Jamshidi, A.-A.,Torabinezhad, F.,Sarrafzadeh, J.,Sobhani-Rad, D.,Ganjuie, M.(2016).Prevalence of voice disorders and associated risk factors in teachers and nonteachers in Iran.Journal of Voice,30,506.e19-506.e23.
23. Smith, E.,Gray, S. D.,Dove, H.,Kirchner, L.,Heras, H.(1997).Frequency and effects of teachers’voice problems.Journal of Voice,11,81-87.
24. Smith, E.,Lemke, J.,Taylor, M.,Kirchner, H. L.,Hoffman, H.(1998).Frequency of voice problems among teachers and other occupations.Journal of Voice,12,480-488.
25. Smolander, S.,Huttunen, K.(2006).Voice problems experienced by Finnish comprehensive school teachers and realization of occupational health care.Logopedics Phoniatrics Vocology,31(4),166-171.
26. Solomon, N. P.(2008).Vocal fatigue and its relation to vocal hyperfunction.International Journal of Speech-Language Pathology,10,254-266.
27. Stemple, J. C.,Roy, N.,Klaben, B. K.(2014).Clinical voice pathology: Theory and management.San Diego, CA:Plural.
28. Van Houtte, E.,Claeys, S.,Wuyts, F.,Van Lierde, K.(2011).The impact of voice disorders among teachers: Vocal complaints, treatment-seeking behavior.Journal of Voice,25,570-575.
29. Verdolini, K.,Ramig, L. O.(2001).Review: Occupational risks for voice problems.Logopedics Phoniatrics Vocology,26,37-46.
30. Vilkman, E.(2000).Voice problems at work: A challenge for occupational safety and health arrangement.Folia Phoniatrica et Logopaedica,52,120-125.
31. Vilkman, E.(2004).Occupational safety and health aspects of voice and speech professions.Folia Phoniatrica et Logopaedica,56,220-253.
32. Welham, N. V.,Maclagan, M. A.(2003).Vocal fatigue: Current knowledge and future directions.Journal of Voice,17,21-30.
33. Whitling, S.,Lyberg-Åhlander, V.,Rydell, R.(2017).Recovery from heavy vocal loading in women with different degrees of functional voice problems.Journal of Voice,31(5),645.e1-645.e14.
34. Xue, C.,Kang, J.,Hedberg, C.,Zhang, Y.,Jiang, J. J.(2019).Dynamically monitoring vocal fatigue and recovery using aerodynamic, acoustic, and subjective self-rating measurements.Journal of Voice,33(5),809.e11-809.e18.
35. Yiu, E. M.-L.(2002).Impact and prevention of voice problems in the teaching profession: Embracing the consumers’ view.Journal of Voice,16,215-229.
36. 陳麗鈴(2009)。台北市，台北市立教育大學。
37. 鄧敦弘(2015)。國立台北護理健康大學。
38. 蕭自佑(1999).音聲醫學概論.台北市:藝軒.