Protective Factors for Vocal Health in Teachers: The Role of Singing, Voice Training, and Self-Efficacy.

Voice disorders occur frequently in schoolteachers. The aim of the present cross-sectional study involving 124 German teachers was to investigate whether singing, voice training, and high self-efficacy are protective factors for vocal health. Furthermore, vocal self-concept was examined as a potential mediator explaining this relationship. Participants were assigned to the cases group if they had a clinically significant finding in voice examinations consisting of video laryngoscopy (VLS), auditory assessment (RBH), and the Voice Handicap Index (VHI) were assigned to the cases group. Psychosocial assessments comprised questions about singing activities and participation in voice training as well as validated questionnaires regarding self-efficacy (LSWS) and vocal self-concept (FESS). Group comparisons and mediation analyses were conducted. Analyses revealed a decreased risk of voice problems for teachers who sing regularly (OR: 0.442, p = 0.038). Furthermore, the absence of voice problems was associated significantly with higher self-efficacy ratings (t(113) = 1.71, p = 0.045). Both associations were mediated by vocal self-concept ratings (singing: ab = -0.422, 95%-CI [-1.102, -0.037]; self-efficacy: ab = -0.075, 95%-CI [-0.155, -0.022]). Participation in voice training in the past did not reduce the risk of voice problems significantly. The presented data suggest that regular singing and self-efficacy should be promoted in health care and prevention programs. Since no impact of sporadic participation in voice training activities on the occurrence of voice problems was found, efforts regarding the transfer of regular vocal exercises into daily life need to be intensified.