title: Protective and risk factors associated with voice strain among teachers in Castile and Leon, Spain: recommendations for voice training.
abstract: OBJECTIVE
  The aim of this research was to know the protective and risk factors associated with voice strain in teachers.
  A total of 675 teachers from Castille and León, Spain took part in the research within an age range between 23 and 66 years (from nursery school to university). A cross-sectional, descriptive, and analytic design was applied to data from a self-administered questionnaire.
  
  
  RESULTS
  The research showed that 16.4% had suffered some voice disorder and a remarkable percentage had never received any kind of voice training. The bivariate and multivariate analyses show that the size of the classroom, being a primary school teacher, teaching physical education, the noise caused by the students in the classroom, the struggle to keep the order within the class, raising the voice, and bad sleep are risk factors in the voice disorders. Each learning stage features a different risk factor, namely in nursery school, the noise caused by the pupils; in primary education, raising the voice; and in secondary education, the struggle to keep the order within the class. All these risk factors are linked with each other.
  
  
  CONCLUSIONS
  The preventive measures must provide adequate answers to the voice requirements for every subject and stage, and these preventive measures must be based on the educational psychology principles to help the teachers deal with the problems originated by the lack of authority or the noise made by the students, using the proper voice techniques.
authors: University of Burgos, c/ Villadiego s/n, Burgos, Spain. Electronic address: subillos@ubu.es.
authors: Silvia
authors: S
authors: Ubillos
authors: University of Burgos, c/ Villadiego s/n, Burgos, Spain.
authors: Javier
authors: J
authors: Centeno
authors: University of Burgos, c/ Villadiego s/n, Burgos, Spain.
authors: Jaime
authors: J
authors: Ibañez
authors: University of Deusto, Avenida de las Universidades, Bilbao, Spain.
authors: Ioseba
authors: I
authors: Iraurgi
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005178:Faculty; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors; D012574:Schools; D013030:Spain / Q000453:epidemiology; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014831:Voice / Q000502:physiology*; D014832:Voice Disorders / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D014833:Voice Quality; D014834:Voice Training; D055815:Young Adult
keywords: Phoniatric pathology; Protective and risk factors; Teachers; Voice training