A Biopsychosocial Perspective among Teachers With a History of Voice Related Absenteeism

Isabelle Vanhoudt, George Thomas, Wivine Decoster, Willy A.R. Wellens, Hans Vertommen, Felix I.C.R.S de Jong

This research is a cross-sectional survey, performed using questionnaires: a general voice questionnaire, the Voice Handicap Index (VHI) and the Symptom CheckList-90 (SCL-90). The aim of the study was to explore the subjective experience of teachers with a history of voice related absenteeism (VRA) in a biopsychosocial model and to explore which characteristics were more profound. The focus of the study is on those teachers who scored the highest and the lowest on the SCL-90 questionnaire as they represented the extremes of the symptom scores.
The upper quartiles scores are referred to as “high scores” and the lower quartile scores are mentioned as “low scores”. There were 55 teachers with scores in the lowest quartile and 51 teachers with scores in the highest quartile of the total score of the SCL-90 (n = 106). Teachers who had a history of VRA have a high relative risk for a high score for the subscales “somatic complaints” (OR = 1.8), “agoraphobia” (OR = 1.7) and “depression” (OR = 1.7) compared to teachers with no history of VRA. The relative risk for the other subscales were low (OR = 0.9 – 1.4) Teachers with a history of VRA had a higher relative risk for a high total score (OR = 1.9). The total score represents the total physical and psychosocial dysfunction. The results suggest that the somatic, social and psychological dimensions of vocal health in VRA are interlinked and the final outcome is a combination of somatic, psychological and social domains. The results show a complex biopsychosocial perspective of VRA. Understanding the biopsychosocial dynamics of those with a history of VRA could help clinicians to effectively respond and provide holistic voice care to teachers.

Isabelle Vanhoudt*, George Thomas***, Wivine Decoster*, Willy A.R. Wellens**, Hans Vertommen****, Felix I.C.R.S de Jong*
* LAW, Exp. ORL, Dept. Neurosciences, K.U.Leuven, Belgium
** Dep. ENT, Head and Neck Surgery -Lab. Exp. ORL, K.U.Leuven, Belgium
*** Department of ORL, Radboud University Medical Centre Nijmegen, The Netherlands
**** Research Group Psychodiagnostics and Psychopathology, K.U.Leuven, Belgium isabelle@postduif.be