Qualidade de vida em voz: pós duas modalidades terapêuticas

Abstract

The voice is an important factor in the process of human socialization, therefore, a change in its production can bring diverse damages to the individual. Voice therapy is an effective treatment for dysphonia and appears to show positive effects in several spheres of the individual's life. It is a treatment that has different therapeutic approaches, such as direct, indirect or eclectic, and can be performed individually or in a group. Group therapy provides a space for exchanging expectations, experiences, desires and allows the mutual growth of the participants, and has proved to be an efficient method in speech and language therapy. This study aimed to verify if there is difference between the two therapeutic approaches and what factors influence the voice related quality of life of patients with behavioral dysphonia. The population was composed by 97 patients of both sexes, with behavioral dysphonia, who voluntarily searched the Laboratório Integrado de Estudos da Voz (LIEV) of the Federal University of Paraíba. The volunteers were allocated randomly into two groups: individual therapy and group therapy. Both interventions had an eclectic approach, guided in a total of eight weekly meetings. The first and last meeting were destined to the application of the protocol of Voice-Related Quality of Life (V-RQOL), and the other sessions were for the voice therapy. Data were analyzed through descriptive statistical analysis and hypothesis testing using the Wilcoxon dependent sample comparison test and the Mann-Whitney test for comparison of independent samples. Subsequently, the beta regression was used to verify which variables influenced the responses of the post-therapy V-RQOL protocol. It was observed that there was improvement of the physical and total domains of the V-RQOL protocol in the group submitted to individual therapy, and improvement of the socioemotional and total scores in the population submitted to group therapy. There was no difference between the two therapeutic modalities in relation to any of the domains of the V-RQOL. When performing beta regression, three models were obtained to explain the improvement in quality of life at the post-therapy: one for the general sample, one for the individual therapy sample and one for the group sample. It was observed that the laryngeal diagnosis was a significant variable for all three models, while sex was significant for the general and group sample, and the use of voice in their profession explained the increase in the score in the group therapy sample. It was concluded that the two therapeutic modalities with eclectic approaches were effective for the improvement of the voice related quality of life of the individual with behavioral dysphonia. Individual therapy was more effective for physical issues, and group therapy for social-emotional issues related to voice quality of life. In general, the laryngeal diagnosis influences the improvement of the voice related quality of life, being individuals with laryngeal alterations more benefited by the two types of modalities. Males and voice professionals are more benefited in relation to quality of life when submitted to group therapy.