[[alternative]]The Voice Quality in University Speech-Language Pathology Students and Nursing Students

[[abstract]]未來職業用聲者為即將成為職業用聲者的一群人，與職業用聲者一樣需仰賴嗓音作為謀身工具，其嗓音狀況會影響生活品質、工作及溝通效能。未來職業用聲者若具備嗓音相關專業知識，有助於預防嗓音濫用及誤用，因此早期發現未來職業用聲者的嗓音問題，並提供適當介入是相當重要的。語言治療系學生在求學過程中，具備嗓音相關專業知識及訓練，而護理系學生本身不具備嗓音相關的專業知識，故本研究想比較語言治療系學生和護理系學生之嗓音狀況，其嗓音受到具備嗓音專業知識、用聲時長、用聲對象、用聲環境影響。本研究目的為探討及比較各年級語言治療系和護理系學生在失聲障礙指數、嗓音障礙指數、嗓音聽知覺及嗓音不適症狀問卷上之差異。本研究經招募篩選出兩組各25位女大學生。依據研究參與者就讀科系及年級進行分組，分成一到四年級，每個年級各6名。研究者蒐集接受嗓音訓練課程後及實習後之語言治療系學生和護理系學生，並比較兩組未來職業用聲者在嗓音聽知覺、失聲障礙指數、嗓音障礙指數及嗓音不適症狀之差異，使用雙因子變異數分析比較兩組學生之嗓音狀況。本研究結果發現：1）嗓音聽知覺分析結果顯示，語言治療系四年級學生在整體沙啞程度及粗糙聲顯著低於護理系四年級學生。語言治療系各年級學生在GRBAS各面項無顯著差異，護理系各年級學生在GRBAS各面項無顯著差異。2）失聲障礙指數測量結果顯示，語言治療系三、四年級學生之失聲障礙指數顯著低於護理系三、四年級學生，語言治療系和護理系各年級學生失聲障礙指數無顯著差異。3）自評嗓音生活品質分析結果顯示，語言治療系三年級學生在整體嗓音總分、功能分量表分數均顯著低於護理系三年級學生。語言治療系四年級學生功能量表分數顯著低於護理系四年級學生。兩科系各年級學生在整體嗓音總分及功能分量表均無顯著差異。4）自評身體不適症狀問卷分析結果顯示，語言治療系一、二年級學生在身體不適症狀比例均高於護理系一、二年級，而語言治療系三、四年級學生在身體不適症狀比例低於護理系三、四年級學生。本研究發現，語言治療系三、四年級學生因具備嗓音相關專業課程，於長時間用聲時，會使用嗓音相關技巧，故在嗓音聽知覺、失聲障礙指數、嗓音障礙指數及嗓音不適症狀均優於護理系三、四年級學生。反觀，護理系三、四年級學生均未接受嗓音相關課程訓練課程，於實習期間需長時間用嗓，又不具嗓音相關專業知識，易有嗓音濫用或誤用情形。由本研究結果可得知，未來職業用聲者若具備嗓音相關專業知識，有助於改善整體的嗓音生理功能及提升嗓音生活品質，故日後可以將嗓音衛教或嗓音訓練課程用於未來職業用聲者，作為預防嗓音障礙或嗓音問題之發生，亦可降低醫療成本的支出及臨床語言治療師的人力負擔。[[abstract]]Future voice professionals are a group of people who rely on their voice as a tool to make a living just as much as the active voice professionals do. The condition of their voice influences their quality of life, work, and communication’s effectiveness. It would be helpful for the future voice professionals to prevent vocal abuse and misuse if they have professional knowledge in voice. Therefore, early detection of future voice professionals’ voice problems and providing appropriate intervention are extremely important. Speech-language pathology students have gained relevant professional knowledge and received training related to voice during their studies, which are what the nursing students are lacking. Therefore, this study aims to compare the voice conditions of speech-language pathology and nursing students, and how their voice was affected by the possession of professional knowledge of voice, long duration in using their voice, objects to which their voice is directed, and circumstances in which their voice is used. The purpose of this study is to explore and compare the differences between speech-language pathology and nursing students of each year-level in their dysphonia severity index, voice handicap index, voice perception, and the questionnaire on their voice symptoms.Through recruitment, two groups, each with 25 female university students, were selected for this study. Study participants were divided into groups according to their majors and school years. There were six students in each school year group, ranging from the first to the fourth year. The researchers chose speech-language pathology and nursing students who had participated in voice training courses and completed their internships, and compared the differences between the two groups of future voice professionals in terms of voice perception,the dysphonia severity index, the voice handicap index, and voice symptoms. A two-way analysis of variance was then used to compare the voice conditions of the two groups of students.The results are as follows. First, according to the analysis of the voice perception, the level of hoarseness and harshness of the senior speech-language pathology students was significantly lower than that of the senior nursing students. There was no significant difference in all dimensions of GRBAS for both the entire speech-language pathology and the nursing students. Second, the test results of the dysphonia severity index showed that the scores of the junior and senior speech-language pathology students were significantly lower than those of the junior and senior nursing students. There was no significant difference in the dysphonia severity index for both the entire speech-language pathology and the nursing students. Third, the analysis of the self-evaluated voice quality of life pointed out that the scores of the overall voice and the functional scale for the junior speech-language pathology students were significantly lower than those of the junior nursing students. As for the senior students, the functional scale scores of the speech-language pathology students were significantly lower than those of the nursing students. Last but not least, according to the results of the self-evaluation health condition questionnaire, the scores of the freshmen and sophomore speech-language pathology students were higher than those of the nursing students in the same school year. As for the junior and senior students, the scores of the speech-language pathology students were lower than those of the nursing students.The research found that the test scores, including voice perception, dysphonia severity index, voice handicap index, and voice symptoms, of the junior and senior speech-language pathology students were lower than those of the junior and senior nursing students because the former received professional voice related courses and learnt how to project voice properly in high-demand situation; however, the latter tended to abuse or misuse their voice because they were not trained by professional programs about voice knowledge, and were required to talk for a long period. As a result, it would be beneficial for the future voice professionals on improving the overall voice quality and elevate voice life quality if they receive professional voice knowledge. In the future, the programs on vocal hygiene and voice training could prevent voice disorder and problems, and further lower the cost on medical treatment and ease the burden on clinical speech therapists