Voice Disorders in Primary School Teachers and Barriers to Care

Introduction. Teachers have an increased prevalence of voice disorders that result in reduced activities, missed workdays, and occupation changes. However, only a small fraction of these teachers have sought professional help for their disorders. The purpose of this study was to elucidate some of the barriers to care that teachers may face. Study Design. Cross-sectional survey. Methods. One thousand subjects were randomly selected from a list of 95, 364 Kindergarten-12 teachers in North Carolina. Teachers were mailed a 43-item survey, with domains including demographics, personal voice health, and barriers to care using a five-point Likert scale. Results were tabulated, and statistical analysis was performed using the chi-square test. Results. Two hundred forty-three responses were received; 237 were complete. Twenty-two percent were currently hoarse. Fifty-eight percent had been hoarse at one point. Twenty-three percent had missed work for hoarseness. Only one-third (32.6%) had sought professional help. Women and those older than 45 years were more likely to seek help (P < 0.001 and P = 0.008, respectively). Fewer than half were aware of voice therapy or believed that a doctor could help. Thirty percent believed that hoarseness was normal in teaching. Conclusions. There are multiple barriers to care for the dysphonic teacher, including the lack of awareness of the availability of professional help. Further studies should evaluate teacher education and reducing barriers to care.