Voice symptoms among South American prospective teachers. Associated Factors and Direct Costs

Aims: This study has two aims: [1] to determine the prevalence of voice symptoms among pre-service teachers and [2] to characterize the associated factors and direct costs of voice symptoms in pre-service teachers from Chile, Colombia, and Uruguay. Method: A cross-sectional survey of 343 pre-service teachers from three South American countries was conducted. The survey included standardized vocal health questionnaires and questions related to the training conditions of pre-service teachers. This multi-country design enabled investigation of voice symptom patterns across diverse educational environments while maintaining linguistic and cultural homogeneity. Participants completed standardized vocal health questionnaires and training condition assessments of pre-service teachers across five universities (one from Chile, one from Colombia, and three from Uruguay). Participants completed the Spanish versions of the Voice Symptom Scale (VoiSS), the Vocal Fatigue Index (VFI), and the Screening Index for Voice Disorder (SIVD). Results: Approximately 82% of participants reported experiencing voice symptoms on at least one of the three instruments administered. Students in a practicum placement were 2.54 times more likely than those not in placements to report tiredness of voice and voice avoidance, and 2.09 times more likely to report physical discomfort associated with voicing. Pre-service teachers who reported hot temperatures in the practicum placement (OR=2.77) were more likely to be identified at risk of voice disorders (SIVD) compared to those who did not report this physical condition in the schools. Despite the presence of voice symptoms, only 11% of pre-service teachers reported seeking help from healthcare professionals, indicating consistent patterns of low healthcare utilization across all three countries. Discussion and conclusion: Results indicate that voice symptoms among teachers emerge during training years, when teaching practice begins. Interestingly, like in-service teachers, pre-service teachers reported a low proportion of use of healthcare services due to voice symptoms, highlighting the lack of awareness about the importance of voice as a teaching tool. Therefore, primary prevention actions are advised to include education and training on the relationship between teachers’ working conditions and voice disorders, as well as awareness of the voice as a primary working tool for teachers, with implementation strategies adapted to diverse South American educational contexts.