Determinants and Effects of Voice Disorders among Secondary School Teachers in Peninsular Malaysia Using a Validated Malay Version of VHI-10

PLoS One. 2015 Nov 5;10(11):e0141963. doi: 10.1371/journal.pone.0141963. eCollection 2015.

Abstract

Objectives: To establish the prevalence of voice disorder using the Malay-Voice Handicap Index 10 (Malay-VHI-10) and to study the determinants, quality of life, depression, anxiety and stress associated with voice disorder among secondary school teachers in Peninsular Malaysia.

Methods: This study was divided into two phases. Phase I tested the reliability of the Malay-VHI-10 while Phase II was a cross-sectional study with two-stage sampling. In Phase II, a self-administered questionnaire was used to collect socio-demographic and teaching characteristics, depression, anxiety and stress scale (Malay version of DASS-21); and health-related quality of life (Malay version of SF12-v2). Complex sample analysis was conducted using multivariate Poisson regression with robust variance.

Results: In Phase I, the Spearman correlation coefficient and Cronbach alpha for total VHI-10 score was 0.72 (p < 0.001) and 0.77 respectively; showing good correlation and internal consistency. The ICCs ranged from 0.65 to 0.78 showing fair to good reliability and demonstrating the subscales to be reliable and stable. A total of 6039 teachers participated in Phase II. They were primarily Malays, females, married, had completed tertiary education and aged between 30 to 50 years. A total of 10.4% (95% CI 7.1, 14.9) of the teachers had voice disorder (VHI-10 score > 11). Compared to Malays, a greater proportion of ethnic Chinese teachers reported voice disorder while ethnic Indian teachers were less likely to report this problem. There was a higher prevalence ratio (PR) of voice disorder among single or divorced/widowed teachers. Teachers with voice disorder were more likely to report higher rates of absenteeism (PR: 1.70, 95% CI 1.33, 2.19), lower quality of life with lower SF12-v2 physical (0.98, 95% CI 0.96, 0.99) and mental (0.97, 95% CI 0.96, 0.98) component summary scales; and higher anxiety levels (1.04, 95% CI 1.02, 1.06).

Conclusions: The Malay-VHI-10 is valid and reliable. Voice disorder was associated with increased absenteeism, marginally associated with reduced health-related quality of life as well as increased anxiety among teachers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / complications
  • Cross-Sectional Studies
  • Depression / complications
  • Faculty
  • Female
  • Humans
  • Malaysia / epidemiology
  • Male
  • Prevalence
  • Quality of Life
  • Reproducibility of Results
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Voice / physiology
  • Voice Disorders / epidemiology*
  • Voice Disorders / etiology*
  • Voice Quality / physiology

Grants and funding

This study is funded by the Ministry of Education High Impact Research Grant (H-20001-00-E2000069). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.