Assessment Of Voice-Related Quality Of Life Of School Teachers In Rural Areas Using The Voice Handicap Index-10 (VHI-10)- A Cross-Sectional Study

Abstract

Introduction: Teachers are professional voice users who face a high risk of developing voice disorders due to continuous vocal demands. Such problems often lead to hoarseness, vocal fatigue, absenteeism, and impaired quality of life. Despite this burden, many teachers tend to normalise symptoms and underreport them. The Voice Handicap Index-10 (VHI-10) is a validated tool to measure the self-perceived impact of voice disorders. However, there is limited data on voice-related quality of life in teachers from  rural regions of India.

Objectives: To assess the prevalance and severity of Voice-related quality of life (QoL) impairement among school teachers, using the Voice Handicap Index-10 (VHI-10) questionnaire.

Methods: A cross-sectional study was conducted among 100 school teachers aged 25–60 years, currently employed in government or private schools in rural areas, with at least one year of teaching experience, and a minimum of three teaching hours per day. Data were collected using a structured proforma that included demographic details, occupational history, vocal hygiene practices, and the VHI-10 questionnaire. Descriptive statistical analyses were performed using SPSS version 25, and a p-value < 0.05 was considered significant.

Results: The mean age of the teachers was 41.2 ± 8.3 years, and 64% were female. Of the respondents, 50% had >10 years of teaching experience, and 49% taught for ≥4 hours daily. VHI-10 scores indicated that 40% had no significant vocal handicap (scores 0–10), while 33%, 17%, and 10% had mild, moderate, and severe voice-related impact, respectively. Significant associations were found between VHI-10 ≥11 and factors such as frequent shouting (p < 0.0001), lack of hydration during teaching (p < 0.0001), absence of voice rest (p < 0.0001), poor ventilation (p = 0.01), larger class size (p = 0.003), and teaching ≥4 hours/day (p = 0.004).

Conclusion: Most school teachers in rural areas experience some degree of voice-related impairment, influenced by modifiable occupational and behavioural factors.