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OBJECTIVE: To validate the Vocal Tract Discomfort Scale for the Brazilian Portuguese (VTDS-BR), based on internal consistency, reliability, and accuracy. METHODS: The participants were 431 adults of both sexes, divided in two groups: dysphonia (DG) and vocally healthy (VHG). We built a digital database with personal, professional information and the item-by-item VTDS-BR responses of the participants. We applied Cronbach's alpha, exploratory factor analysis; confirmatory factor analysis; Item Response Theory (IRT) using the Samejima model; and ROC (Receiver Operating Characteristic) curve analysis to obtain the VTDS-BR cut-off point. RESULTS: The VTDS-BR has an eight-item structure and two factors: vocal hyperfunction without phonotraumatic injury and with phonotraumatic injury. Each item is evaluated based on two facets related to frequency and intensity, with a Likert scale response key. There are four possible answers: never, sometimes, often, and always for frequency and none, mild, moderate, and intense for intensity. We applied an IRT model, which allowed the identification of which items are more related to dysphonia, based on higher values in the parameters discrimination (a) and difficulty (b), which contributed to the calculation of each participant's aptitude for the development of voice problems, by means of a score. The cut-off value was determined using the ROC curve, in which values greater than - 1.432 indicate a higher probability of voice alterations. CONCLUSION: VTDS-BR went through the stages of validation of internal consistency, reliability, and accuracy. It presents an 8-item, two-factor, and two-facet structure to assess frequency and intensity of vocal tract discomfort symptoms. VTDS-BR is suitable for clinical use or in screening activities, as it is quick to apply and its interpretation is indicative of people with and without phonotraumatic injury.

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OBJECTIVES: To investigate the psychometric properties of the Brazilian version of the Vocal Tract Discomfort Scale, known as Escala de Desconforto do Trato Vocal (EDTV), based on factor analysis, in patients with dysphonia. METHODS: This was a retrospective documentary and cross-sectional study. The study database contained sociodemographic variables, laryngeal diagnosis, auditory-perceptual evaluation and EDTV items. All of these variables were extracted from the medical records of 310 patients seen at the Integrated Laboratory of Voice Studies. A descriptive statistical analysis, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were performed. RESULTS: The sample consisted of patients of both sexes with a mean age of 39.36 (SD = 15.80) years; the majority were female and were nonvoice professionals. The EFA grouped the EDTV items into four factors according to the interitem correlations. The CFA grouped the EDTV items into three factors because the last two factors found in the EFA were correlated and constituted a single factor. Thus, the CFA revealed that the EDTV was organized as follows: Factor 1, "Hybrid," comprised the items corresponding to the frequency and severity of the symptoms of burning, sore, and irritated throat; Factor 2, "Inflammatory process/tissue lesion," comprised the items related to throat itching and throat sensitivity; and Factor 3, "Muscle discomfort," comprised the items related to symptoms of tightness, dryness, and the sensation of a lump in the throat. Item responses are dichotomous (High/Low), and the result is determined by the sum of the responses, in which high frequency/severity is assigned two points and reduced frequency/severity assigned one point. CONCLUSIONS: The CFA allows the proposal of an adjustment to the EDTV and suggests that the described changes be made to the instrument to make it a scale with three factors that behave differently but are related.

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OBJECTIVE: To evaluate the impact of group therapy in patients with dysphonia, as well as to verify the correlation between vocal symptoms and levels of anxiety. METHODS: The study was composed of 52 patients subdivided into two groups, named the Experimental Group (EG) with 28 volunteers and the Control Group (CG) with 24 volunteers. Anxiety and voice protocols were used for data collection. The State-Trait Anxiety Inventory (STAI) was used to measure trait levels of anxiety that after collection were categorized according to the variation in scores value: low anxiety (20-40 points); average anxiety (40-60 points); high anxiety (60-80 points). In addition, the Voice Symptom Scale (VoiSS) was used for voice assessment. Inferential statistical analysis from the Student's t test for paired and independent data, in order to compare the average scores of STAI trait levels and VoiSS domains of the pre- and postmoments, intra- and intergroups, EG and CG, respectively. For that purpose, the program Statistical Package for Social Sciences (SPSS) was used. RESULTS: Half of the patients in the survey presented an average trait level of anxiety. Regarding the EG, there was a significant reduction of state anxiety when comparing the moments before and after group therapy. There was also a significant reduction in the values of the VoiSS-Total and VoiSS-Physical domains when compared to the pre- and postgroup therapy moments. It was verified the existence of a positive correlation between the levels of anxiety after group therapy and VoiSS-Total, VoiSS-Limitation, and VoiSS-Physical domains. As for the CG, there was an increase in anxiety levels as well as in all domains of the VoiSS scale when compared to the pre- and postmoments. CONCLUSIONS: Group voice therapy was effective for a significant reduction of vocal symptoms and anxiety - common conditions in patients with dysphonia. It was possible to perceive the positive correlation between anxiety levels and vocal symptoms.

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RESUMO Objetivo Avaliar a efetividade da terapia de grupo na redução dos sintomas vocais em pacientes com disfonia comportamental e compará-la a uma modalidade de terapia tradicional/individual. Métodos Trata-se de uma pesquisa explicativa, quantitativa e de intervenção. Participaram 99 pacientes com disfonia comportamental, de ambos os sexos, alocados em dois grupos: Terapia Individual (TI) e Terapia de Grupo (TG). Todos foram submetidos à terapia com abordagem eclética. Foram realizadas oito sessões, sendo a primeira e a última destinadas à avaliação e as outras seis de intervenção. Realizou-se análise estatística descritiva e inferencial para comparar os grupos e os momentos pré e pós-intervenção. Resultados A maioria dos participantes era do sexo feminino, não usava a voz profissionalmente e com lesão na porção membranosa da prega vocal. Ambos os grupos apresentavam escores médios semelhantes, no início da terapia, fato que mostra a homogeneidade dos grupos. Houve redução de todos os escores da Escala de Sintomas Vocais (ESV) no momento pós-intervenção individual e em grupo. Não foi observada diferença significativa, ao comparar as médias dos escores da ESV pós-terapia entre os grupos. Em relação aos itens da ESV, foi possível observar que alguns podem não detectar as diferenças entre os momentos pré e pós-intervenção. Conclusão Tanto a TI, quanto a TG foram efetivas na redução significativa dos sintomas vocais. Não houve diferença ao comparar os grupos. Alguns itens da ESV, principalmente no domínio limitação, foram mais sensíveis nos momentos pós-intervenção, em ambas modalidades. O tipo de intervenção influencia a redução dos sintomas vocais.

ABSTRACT Purpose To evaluate the effectiveness of two therapeutic approaches in reducing vocal symptoms in patients with behavioral dysphonia. Methods This was an explanatory, quantitative and interventional study. A total of 99 patients of both sexes with behavioral dysphonia who sought speech therapy participated in this study. These patients were allocated into two groups: individual therapy (IT) and group therapy (GT). All participants were subjected to therapy with an eclectic approach. Eight sessions were conducted, comprising a first and a last session for evaluation, with six intervention sessions in between them. A descriptive and inferential statistical analysis was performed to compare the groups and the moments before and after the intervention. Results The majority of participants were female, and there was a predominance of patients who did not use their voice professionally and who had a diagnosis of a laryngeal lesion in the membranous portion of the vocal fold. It should be noted that patients presented similar mean scores at the beginning of therapy regardless of the group to which they were allocated, which indicated the homogeneity of the groups. There were reductions in all Vocal Symptoms Scale (VoiSS) scores after individual and group therapy. No significant differences were observed when comparing the mean posttherapy VoiSS scores between the groups in either domain. Some VoiSS items were unable to detect differences between the pre- and posttherapy timepoints. Conclusion Individual and group therapeutic modalities are effective in significantly reducing self-reported vocal symptoms. The type of intervention influences the reduction in vocal symptoms. Some items of the VoiSS, mainly in the area of limitations, were more sensitive at the posttherapy timepoint in both modalities.

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Introdução: Para acompanhar as mudanças teórico-metodológicas relacionadas às práticas no âmbito da saúde coletiva, é necessário repensar a formação em saúde, especificamente, em fonoaudiologia. Objetivo: Este estudo tem o objetivo de analisar as experiências vivenciadas por estudantes de graduação em Fonoaudiologia durante estágio supervisionado em saúde coletiva. Métodos: Trata-se de uma pesquisa de abordagem qualitativa, onde registrou-se, a partir do depoimento de quatro alunas de graduação do curso de Fonoaudiologia, seus relatos de experiências, suas impressões pessoais, valores, opiniões e representações do período de estágio. Resultados: Percebeu-se durante realização do estágio, muito aprendizado nas vivências dos setores e processo de trabalho da unidade, atividades educativas em sala de espera, territorialização, visitas domiciliares, visitas técnicas à rede de atenção secundária, gestão, ações de saúde em escolas, grupos de idosos, gestantes e voltadas ao cuidado com o trabalhador. Conclusão: Conclui-se que o estágio em questão contribui para formação de profissionais com habilidade de atender às demandas reais da população e desenvolver um cuidado integral em saúde (AU).

Introduction: To follow the theoretical-methodological changes related to practices in the field of collective health, it is necessary to rethink the training in health, specifically, in speech and language pathology. Objective: This study aims to analyze the experiences undergone by undergraduate students in SpeechLanguage Pathology during a supervised internship in public health. Methods: This is a qualitative research, where, based on the testimony of four undergraduate students of the Speech-Language Pathology course, their reports of experiences, their personal impressions, values, opinions and representations of the internship period were registered. Results: It was perceived during the internship, much learning in the experiences of the sectors and work process of the unit, educational activities in waiting room, territorialization, home visits, technical visits to the secondary care network, management, health actions in schools, groups of the elderly, pregnant women and caregivers. Conclusion: It is concluded that the stage in question contributes to the formation of professionals with ability to attend to the real demands of the population and to develop integral health care (AU).

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