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Audiology - Communication Research     Open Access   (Followers: 10)
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Audiology - Communication Research
Number of Followers: 10  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2317-6431
Published by SciELO Homepage  [737 journals]
  • Effectiveness of referral and counter-referral systems in a
           high-complexity Speech, Language and Hearing healthcare service in the
           city of São Paulo

    • Abstract: RESUMO Introdução Conhecer o fluxo de referência e contrarreferência de serviços de saúde de alta complexidade é imprescindível para o aperfeiçoamento da assistência fonoaudiológica. Objetivo Analisar o fluxo de pacientes de um serviço de Fonoaudiologia de alta complexidade no Sistema Único de Saúde (SUS). Métodos Estudo descritivo, realizado em serviço de Fonoaudiologia de hospital de alta complexidade. Foram analisados os dados de 373 usuários submetidos à triagem fonoaudiológica (consulta a prontuários). As variáveis analisadas foram: perfil sociodemográfico e fonoaudiológico; origem dos usuários (referência); tempo entre a referência e a realização da triagem; encaminhamentos após a triagem (contrarreferência); tempo entre a conclusão da triagem e o primeiro atendimento fonoaudiológico no serviço de contrarreferência; grau de satisfação com o atendimento fonoaudiológico de contrarreferência. Resultados Predominaram indivíduos com idades entre 0 e 11 anos e 11 meses, do gênero masculino, residentes na cidade de São Paulo, com ensino fundamental incompleto. A hipótese diagnóstica fonoaudiológica de disfonia foi a mais prevalente. A maioria dos usuários foi referenciada pela atenção terciária. A média de tempo de espera para a triagem foi de 56,6 dias (intervalo predominante de 51 a 60 dias). Pouco mais da metade dos sujeitos foi encaminhada para o nível terciário. O tempo de espera pelo atendimento foi maior no nível secundário. A maioria dos usuários referiu como excelente ou bom o grau de satisfação com o atendimento. Conclusão Observou-se alto grau de resolutividade no serviço analisado (atenção terciária) e necessidade de reorganização dos sistemas de referência e contrarreferência na atenção secundária e primária.ABSTRACT Introduction For optimum quality in Speech, Language and Hearing (SLH) healthcare, it is essential to be aware of the flow of referrals and counter-referrals for high-complexity health services. Purpose To analyze the flow of patients of a high-complexity SLH service in Brazil’s Unified Health System (Sistema Único de Saúde – SUS). Methods Descriptive study, made at a Speech, language and hearing (SLH) service of a high complexity hospital. Participants were 373 users who underwent SLH screening (consultation of health records). The variables analyzed were: social-demographic profile; SLH profile; origin of referral of users; time between referral and screening being carried out; referrals after screening (counter-referral); time between conclusion of screening and first SLH consultation in the counter-referred service; and degree of satisfaction with the SLH consultation of the counter-referral. Results The largest group was the age range zero to 11 years 11 months, male, resident in the city of São Paulo, who had not completed primary education. The most prevalent initial diagnosis in SLH terms was dysphonia. The majority of users were referred to tertiary care. The average waiting time for screening was 56.6 days. Just over half the subjects were referred for tertiary care. The waiting time for care was longest at the secondary level. The majority of users stated their degree of satisfaction with the care to be excellent or good. Conclusion A high degree of resolutiveness was observed in the tertiary care service analyzed; and a need was observed in secondary and primary care for reorganization of the systems of referral and counter-referral.
       
  • Hearing screening and perceived participation restriction in the elderly

    • Abstract: RESUMO Introdução Aparelhos portáteis realizam triagem que identifica possíveis alterações auditivas, permitindo maior número de beneficiados. Além disso, questionários de autoavaliação podem oferecer panorama da percepção que o idoso tem do seu problema. Objetivo Verificar se os resultados da triagem auditiva em idosos se relacionam com a percepção da restrição de participação social e se existe influência da idade, gênero e escolaridade, nas variáveis. Métodos Estudo transversal realizado com idosos em dois centros de convivência. Foi realizada uma anamnese, em que constavam dados de identificação, idade e escolaridade. Foi realizada a inspeção visual do meato acústico externo e, em seguida, a triagem auditiva, utilizando equipamento portátil. Em forma de entrevista, aplicou-se o questionário Hearing Handicap Inventory for the Elderly – Screening Version (HHIE-S), constituído de 10 questões e dividido em duas escalas, a social e a emocional, cada uma composta de cinco questões. Os dados foram tabulados e analisados estatisticamente. Resultados Foram avaliados 64 idosos, de ambos os gêneros, com média de idade de 70 anos e 8 meses. Destes, 48 (75%) apresentaram-se sem percepção de restrição, 12 (18,75%), com percepção leve a moderada e quatro (6,25%), com percepção significante, segundo classificação do questionário. Os resultados da triagem e do questionário não foram influenciados pelo gênero e pela escolaridade. A idade também não influenciou a pontuação do questionário, porém, houve associação da idade com a triagem e também houve associação entre a triagem auditiva e o questionário. Conclusão Idosos que “falharam” na triagem auditiva apresentaram maior pontuação no questionário e idosos mais velhos apresentaram piores resultados na triagem auditiva.ABSTRACT Introduction Portable equipment can now perform screenings that identify possible hearing loss, allowing a greater number of people to be evaluated. Self-assessment questionnaires may also provide an overview of the elderly’s perception of their problem. Purpose To examine if the hearing-screening results in the elderly are related to their perceived restriction in social participation, and whether they are influenced by age, gender and schooling. Methods A cross-sectional study was carried out with elderly people of two cohabitation centers. Medical history and participant details were collected, including name, age, and schooling data. Visual inspection of the external auditory meatus and hearing screening using portable equipment were then performed. The Hearing Handicap Inventory for the Elderly – Screening Version (HHIE-S) questionnaire was then administered in the form of an interview. The HHIE-S consists of ten questions divided into two scales—social and emotional - each composed of five questions. The data were then statistically analyzed. Results Sixty-four elderly people, comprising men and women, with a mean age of 70 years and 8 months, were evaluated. Of these, 48 (75%) were classified as without perceived restriction, 12 (18.75%) with mild to moderate perceived restriction, and four (6.25%) with significant perceived restriction, according to the questionnaire criteria. The screening and questionnaire results were not influenced by gender and schooling. Age did not influence the questionnaire score, but was associated with the hearing-screening outcome. There was a relationship between hearing screening and scores on the questionnaire. Conclusion Elderly patients who “failed” the hearing screening had higher scores in the questionnaire and older adults had worse hearing-screening results.
       
  • Restrictions in participation and mental state in new hearing aids users

    • Abstract: RESUMO Introdução: A deficiência auditiva pode exacerbar mudanças cognitivas decorrentes do envelhecimento. Objetivo: Estudar a restrição de participação em atividades diárias e processos cognitivos em idosos, novos usuários de próteses auditivas. Métodos: Foram avaliados 50 idosos com perda auditiva neurossensorial de grau leve a moderadamente severo, novos usuários de amplificação sonora, distribuídos em três grupos, segundo o grau da perda auditiva. Foram aplicados o Hearing Handicap Inventory For Elderly e o Mini Exame do Estado Mental, antes e após 12 a 16 semanas de uso das próteses auditivas. O tratamento estatístico foi realizado por meio da análise de variância e comparações múltiplas de Bonferroni, com nível de significância de 0,05. Resultados: Após a estimulação acústica por meio do uso de próteses auditivas por 12 a 16 semanas, houve redução da restrição de participação em atividades diárias, tanto na subescala emocional, quanto na social/situacional do Hearing Handicap Inventory For Elderly. Idosos com perda de grau moderadamente severo apresentaram maiores restrições de participação na subescala social e no escore total do Hearing Handicap Inventory For Elderly. O Mini Exame do Estado Mental revelou maiores escores total e dos domínios orientação, memória imediata, atenção e cálculo, evocação e linguagem, após o uso das próteses auditivas. Quanto ao gênero, idosos do gênero feminino apresentaram média dos escores menores em atenção e cálculo. Conclusão: Os idosos com deficiência auditiva apresentaram redução da autopercepção das restrições de participação e melhora dos processos cognitivos de orientação, memória imediata, atenção e cálculo, evocação e linguagem, com a estimulação acústica.ABSTRACT Introduction: Hearing impairment may accentuate cognitive decline caused by ageing. Purpose: To study restriction of participation in daily activities and cognitive processes in new elderly hearing aids users. Methods: Fifty elderly individuals, all new users of amplification, with mild to moderately severe post-lingual symmetrical sensorineural hearing loss were evaluated. They were then divided into three groups according to the degree of hearing loss. The Hearing Handicap Inventory for the Elderly questionnaire and the Mini Mental State Examination were applied pre and post-fitting of the hearing aids (after 12 to 16 weeks). The analysis of variance and Bonferroni multiple comparisons with significance level of 0.05 were used as statistical analyses. Results: After acoustical stimulation through the use of hearing aids for 12 to 16 weeks, there was a reduction in the restriction of participation in daily activities both in the emotional and social/situational scales of the Hearing Handicap Inventory for the Elderly. Elderly individuals with moderately severe loss reported higher hearing handicap at the social subscale and the global score. The Mini Mental State Examination analysis revealed higher scores for the Orientation to Time and Place, Repetition/Registration, Attention and Calculation, Recall, and Language domains at the post-fitting evaluation. Regarding gender, females presented lower mean scores in Attention and Calculation. Conclusion: Elderly individuals were benefited by the use of hearing aids, which reduced self-perception of hearing handicap and improved cognition aspects of Orientation to Time and Place, Repetition/Registration, Attention and Calculation, Recall, and Language.
       
  • Influence of auditory feedback in the vocal acoustic parameters of
           individuals without vocal complaints

    • Abstract: RESUMO Introdução: A qualidade da emissão vocal é dependente da integridade do mecanismo de retroalimentação auditiva. A presença de eventuais falhas nesse mecanismo está relacionada à indução do abuso e/ ou mau uso vocal e, por conseguinte, do surgimento de quadros de disfonia. Objetivo: Avaliar a influência da retroalimentação auditiva na intensidade e na frequência da voz, em indivíduos sem queixas vocais. Métodos: Participaram da pesquisa 40 sujeitos do gênero feminino, sem queixas vocais e com limiares auditivos dentro dos padrões de normalidade. As participantes foram submetidas a uma avaliação auditiva, composta por audiometria tonal liminar, imitanciometria e por uma avaliação acústica vocal dos parâmetros de intensidade e frequência, realizada em três momentos: antes, durante e após a exposição ao ruído branco. Resultados: Houve diferença significativa na relação das médias obtidas na intensidade e entre o limiar dos reflexos acústicos contralaterais e as frequências vocais, nos três momentos da avaliação acústica. Conclusão: Os achados sugerem que a retroalimentação auditiva interfere no controle da intensidade e frequência vocal.ABSTRACT Introduction: The quality of the vocal emission is dependent on the integrity of the auditory feedback mechanism of the presence of eventual failures is related to the induction of abuse and / or vocal misuse, and therefore of the surgeon of dysphonia. Purpose: To evaluate the influence of auditory feedback in voice intensity and frequency in individuals with no vocal complaints. Methods: Participants were 40 female subjects without vocal and auditory thresholds within normal standards complaints. Participants underwent an auditory evaluation composed of pure tone audiometry, tympanometry and a vocal acoustic assessment of intensity and frequency parameters, carried out in three stages: before, during and after exposure to white noise. Results: There was significant difference in the average of the ratio obtained in intensity and between the threshold of contralateral acoustic reflexes and vocal frequencies in the three moments of acoustic evaluation. Conclusion: Thus, the findings suggest that auditory feedback interferes with the control of the intensity and vocal frequency.
       
  • Communicative performance training in university health students

    • Abstract: RESUMO Introdução: A expressão do conhecimento é um desafio na vida dos alunos no ensino superior. Objetivo: Avaliar a eficácia da intervenção fonoaudiológica por meio do programa Treinamento da Performance Comunicativa (TAPCo) para universitários. Métodos: Participaram desta pesquisa 26 universitários de ambos os gêneros e de quatro diferentes cursos da área da saúde. A pesquisa foi realizada em seis etapas, a saber: registro audiovisual de uma apresentação oral dos discentes antes do treinamento; treinamento das habilidades comunicativas por meio do programa TAPCo; registro audiovisual após o treinamento; tabulação dos dados obtidos pelos pesquisadores; avaliação randomizada e cega dos 26 discentes, por três fonoaudiólogas não participantes da pesquisa, de forma qualitativa; autoavaliação dos participantes. O TAPCo foi composto por oito sessões de treinamento, que envolveram os seguintes aspectos: vestuário, expressão corporal e facial, fala e voz. Resultados: Houve melhora, com diferença estatisticamente significativa, em todos os aspectos treinados, de acordo com a autoavaliação. Quanto à avaliação qualitativa das juízas, observou-se que a classificação predominante foi boa, em todos os aspectos avaliados. No aspecto vestuário, houve maior presença do indicador indiferente. O aspecto fala e voz apresentou a maior predominância da qualificação excelente. Conclusão: Tanto as avaliações das juízas, quanto as autoavaliações, mostraram a eficiência do TAPCo para o treinamento de estudantes universitários. Embora a autoavaliação tenha apresentado algumas divergências em relação à avaliação das juízas, esse procedimento se mostrou uma excelente ferramenta de acompanhamento da evolução do TAPCo.ABSTRACT Introduction: Knowledge expression is a challenge in the lives of students in higher education. Purpose: Evaluation of the efficacy of Speech-Language Pathology intervention in a Communicative Performance Training (TAPCo) program for university students. Methods: Twenty six students of both genres and from four different health courses participated in this study. The research was carried out in six stages: audiovisual record of an oral presentation of the students before the training; training of communicative skills through the TAPCo program; audiovisual recording after training; tabulation of participants by the researchers of this paper; randomized and blinded qualitative evaluation by three Speech-Language Pathologists that did not participate of the research of the 26 students, and; self-assessment performed by the 26 participants. The TAPCo was composed of eight training sessions that involved the following aspects: dress code, body and facial expression, voice and speech. Results: There was significant difference, according to self-assessment, in all trained aspects. Regarding the qualitative classification of judges’ evaluations, it was observed that good was predominant in all evaluated aspects. In the dress code aspect was observed that there was a greater presence of the indifferent indicator. The speech and the voice aspects presented the highest predominance of the excellent qualification. Conclusion: Both the evaluations of the judges and the self-assessments showed the efficiency of TAPCo in training university students. Although the self-assessment presented some divergences compared to the judges’ evaluation, this procedure proved to be an excellent tool to monitor the evolution of TAPCo.
       
  • Oral motor rehabilitation for temporomandibular joint disorders: a
           systematic review

    • Abstract: RESUMO Introdução: A disfunção temporomandibular (DTM) é complexa e multifatorial. São encontrados, na literatura, estudos que comparam diferentes métodos de tratamento. Objetivo: Investigar estudos sobre o tratamento das disfunções temporomandibulares (DTMs) nas diversas áreas da saúde, avaliando a eficácia das técnicas empregadas, principalmente no que se refere ao uso da terapia miofuncional orofacial. Estratégia de pesquisa: Os artigos compilados neste estudo foram selecionados por meio da base de dados PubMed, utilizando os descritores “temporomandibular disorders and oral motor therapy”, “orofacial myofunctional therapy and temporomandibular disorders” e “temporomandibular disorders and myofunctional rehabilitation”. O levantamento realizado limitou-se aos artigos publicado nos idiomas Inglês e Português, entre janeiro de 2006 e dezembro de 2016. Critérios de seleção: Foram incluídos artigos sobre os tratamentos das DTMs associados aos exercícios musculares e/ou terapias manuais. Publicações sem acesso completo, repetidas por sobreposição das palavras-chave, revisões de literatura, cartas ao editor e não relacionadas diretamente ao tema foram excluídas. Resultados: Dos 102 estudos selecionados, 22 atenderam aos critérios estabelecidos. Em geral, a maioria dos tratamentos descritos apresentou efeitos benéficos para pacientes com DTMs. Foi observada grande variabilidade da metodologia adotada para a aplicação e verificação dos efeitos dos tratamentos e somente poucos estudos fizeram uso de grupo controle. Conclusão: Apesar do crescimento no número de pesquisas sobre DTMs, ainda não é possível estabelecer qual a melhor técnica de tratamento. Após análise dos artigos selecionados, observou-se que as técnicas combinadas de terapia (ex.: exercício associado ao uso de equipamento para redução da dor) produzem melhores resultados, com maior redução da dor e melhora da mobilidade mandibular.ABSTRACT Introduction: Disorders of TMJ are complex and multifactorial. Studies comparing different treatment methods are found in the literature. Purpose: To verify the effectiveness of muscle and orofacial myofunctional rehabilitation for temporomandibular joint disorders (TMJ). Research strategy: This qualitative review of the literature analyzed international scientific publications in PubMed database that used the following keywords: temporomandibular disorders and oral motor therapy; orofacial myofunctional therapy and temporomandibular disorders; temporomandibular disorders and myofunctional rehabilitation. Our investigation was limited to articles published in English or Portuguese languages, between January 2006 and December 2016. Selection criteria: Scientific publications about rehabilitation strategies for TMJ associated to muscle exercises and/ or manual therapy were included. The publications that did not present access to the full text, that were repeated by overlapping keywords, case studies, letters to the editor and those that were not directly related to the topic of investigation were excluded. Results: One hundred and two studies were identified out of which 22 matched our inclusion criteria. Overall, most of the treatments described in the investigated studies presented positive outcomes for the patients with TMJ. The studies presented a wide variability in terms of treatment proposals and methodology used to verify treatment effectiveness. A very small number of studies included control groups. Combined techniques (e.g. exercises associated to the use of equipment to reduce pain) produced better therapy effects, with greater pain reduction and improved mandibular mobility. Conclusion: Although we observed a growing number of publications about TMJ rehabilitation, the best therapeutic technique and its real benefits remains unclear.
       
  • Expressive vocabulary performance of students aged from 4 to 5 years
           attending public and private schools

    • Abstract: RESUMO Introdução O desempenho no vocabulário pode variar em razão de estímulos ambientais e contexto socioeconômico e cultural. Objetivo: Comparar o desempenho em prova de vocabulário expressivo entre pré-escolares da rede pública e privada de ensino, na faixa etária de 4 a 5 anos, e analisar os processos de substituição mais frequentes. Métodos A amostra foi composta por 86 pré-escolares, na faixa etária de 4 a 5 anos, de ambos os gêneros, sem sinais indicativos de síndromes, distúrbios neurológicos ou de linguagem. A amostra foi dividida em dois grupos: G1- grupo de pré-escolares da rede pública de ensino e G2- grupo de pré-escolares da rede privada de ensino. Todos os pré-escolares foram submetidos à triagem fonoaudiológica e à avaliação do vocabulário expressivo, por meio do Teste de Vocabulário do ABFW. Os dados coletados foram submetidos à análise estatística, utilizando o teste Exato de Fisher e o teste T (p<0,05), considerando as ocorrências de Designações por Vocábulos Usuais, de Não Designações e de Processos de Substituição, por campo conceitual. Resultados O G2 apresentou melhor desempenho que o G1 no teste de vocabulário, havendo diferença significativa para todos os campos conceituais. Entretanto, quando comparado o desempenho dos pré-escolares com os parâmetros do teste, a maioria dos pré-escolares do G1 e do G2 apresentou desempenho adequado. Os processos de substituição mais frequentes foram os de hiperônimos e co-hipônimos próximos. Conclusão Pré-escolares da rede privada de ensino apresentaram melhor desempenho em prova de vocabulário expressivo. Além disso, os processos de substituição ocorreram com mais frequência em pré-escolares da rede pública de ensino, sendo os mais frequentes os de hiperônimo e co-hipônimo próximo.ABSTRACT Introduction Vocabulary performance may vary due to environmental stimuli, and socioeconomic and cultural context. Purpose To compare the performance of expressive vocabulary of children attending public and private schools, aged from four to five years, and analyze the most frequent substitution processes. Methods The sample consisted of 86 preschool children, aged from four to five years, male and female, without signs of syndromes and neurological or language disorders, divided into G1: Group of preschoolers in the Public School, and G2: Group of preschoolers in the Private School. All children were submitted to speech-language screening and expressive vocabulary evaluation through the ABFW Vocabulary Test. Data were submitted to statistical analysis, using Fisher’s Exact Test and T-test (p <0.05), considering the occurrences of Designations by Usual Word, Non-Designations and Substitution Processes according to conceptual fields. Results G2 presented better performance in the vocabulary test than G1, with statistically significant difference for all conceptual fields. However, when comparing pre-school performance with test parameters, most G1 and G2 preschoolers presented adequate performance. The most frequent substitution processes were those of hyperonymy and close co-hyponymy. Conclusion Private school preschoolers present better performance in expressive vocabulary tests. In addition, substitution processes occurred more frequently in preschoolers in the public school system, and the most frequent ones were hyperonymy and co-hyponymy.
       
  • Errata

    • Abstract: RESUMO Introdução O desempenho no vocabulário pode variar em razão de estímulos ambientais e contexto socioeconômico e cultural. Objetivo: Comparar o desempenho em prova de vocabulário expressivo entre pré-escolares da rede pública e privada de ensino, na faixa etária de 4 a 5 anos, e analisar os processos de substituição mais frequentes. Métodos A amostra foi composta por 86 pré-escolares, na faixa etária de 4 a 5 anos, de ambos os gêneros, sem sinais indicativos de síndromes, distúrbios neurológicos ou de linguagem. A amostra foi dividida em dois grupos: G1- grupo de pré-escolares da rede pública de ensino e G2- grupo de pré-escolares da rede privada de ensino. Todos os pré-escolares foram submetidos à triagem fonoaudiológica e à avaliação do vocabulário expressivo, por meio do Teste de Vocabulário do ABFW. Os dados coletados foram submetidos à análise estatística, utilizando o teste Exato de Fisher e o teste T (p<0,05), considerando as ocorrências de Designações por Vocábulos Usuais, de Não Designações e de Processos de Substituição, por campo conceitual. Resultados O G2 apresentou melhor desempenho que o G1 no teste de vocabulário, havendo diferença significativa para todos os campos conceituais. Entretanto, quando comparado o desempenho dos pré-escolares com os parâmetros do teste, a maioria dos pré-escolares do G1 e do G2 apresentou desempenho adequado. Os processos de substituição mais frequentes foram os de hiperônimos e co-hipônimos próximos. Conclusão Pré-escolares da rede privada de ensino apresentaram melhor desempenho em prova de vocabulário expressivo. Além disso, os processos de substituição ocorreram com mais frequência em pré-escolares da rede pública de ensino, sendo os mais frequentes os de hiperônimo e co-hipônimo próximo.ABSTRACT Introduction Vocabulary performance may vary due to environmental stimuli, and socioeconomic and cultural context. Purpose To compare the performance of expressive vocabulary of children attending public and private schools, aged from four to five years, and analyze the most frequent substitution processes. Methods The sample consisted of 86 preschool children, aged from four to five years, male and female, without signs of syndromes and neurological or language disorders, divided into G1: Group of preschoolers in the Public School, and G2: Group of preschoolers in the Private School. All children were submitted to speech-language screening and expressive vocabulary evaluation through the ABFW Vocabulary Test. Data were submitted to statistical analysis, using Fisher’s Exact Test and T-test (p <0.05), considering the occurrences of Designations by Usual Word, Non-Designations and Substitution Processes according to conceptual fields. Results G2 presented better performance in the vocabulary test than G1, with statistically significant difference for all conceptual fields. However, when comparing pre-school performance with test parameters, most G1 and G2 preschoolers presented adequate performance. The most frequent substitution processes were those of hyperonymy and close co-hyponymy. Conclusion Private school preschoolers present better performance in expressive vocabulary tests. In addition, substitution processes occurred more frequently in preschoolers in the public school system, and the most frequent ones were hyperonymy and co-hyponymy.
       
 
 
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