中国音乐学院学生嗓音卫生相关知识、态度与实践模式调查

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中文摘要

目的： 评估中国大陆音乐学院学生的嗓音卫生知识、态度、嗓音相关实践及教育需求。将自我报告的嗓音症状、既往临床医生诊断的嗓音疾病及症状管理行为作为次要结局进行评估。
方法： 本横断面研究采用自填式在线问卷和便利抽样。共纳入315名音乐学院学生。问卷包括六个部分，评估参与者特征、嗓音疾病史与症状、嗓音卫生知识、态度、嗓音相关实践及教育需求。进行了相关性分析、多因素线性回归，以及针对九种嗓音相关实践的独立多因素logistic回归模型分析。
结果： 知识评分中位数为8分（四分位距[IQR]，7-9），态度评分中位数为7分（IQR，5-8）。频繁耳语回答的正确率最低（26.0%），回答“不知道”的比例最高（40.0%）。知识与态度评分呈弱正相关（Spearman ρ=0.143，p=0.011）。44.1%的参与者报告频繁清嗓，41.3%报告唱歌前热身，27.9%报告唱歌后放松。知识评分每增加1分，唱歌前热身的几率更高（校正比值比[aOR]=1.28，95%置信区间[CI]，1.11-1.47；错误发现率校正后p=0.006），但知识评分与七种潜在有害实践均无关联。近期嗓音症状每增加一项，所有七种潜在有害实践的几率均更高（aOR范围，1.25-1.97；所有错误发现率校正后p≤0.016）。作为次要发现，196名参与者（62.2%）报告至少一项近期嗓音症状，但其中仅21名参与者（10.7%）曾到学校医疗机构或医院就诊。总体而言，273名参与者（86.7%）表示有兴趣获取更多嗓音卫生信息。
结论： 音乐学院学生总体上表现出良好的嗓音卫生知识与态度，但仍存在特定知识缺口，且知识向适当嗓音相关实践的转化有限。这些发现为音乐学院环境中开展有针对性的、以实践为导向的嗓音健康内容以及更清晰的就医路径确定了优先事项。

英文摘要

OBJECTIVE: To assess vocal hygiene knowledge, attitudes, voice-related practices, and educational needs among conservatory students in mainland China. Self-reported voice symptoms, previous clinician-diagnosed voice disorders, and symptom-management behaviours were evaluated as secondary outcomes.
METHODS: This cross-sectional study used a self-administered online questionnaire and convenience sampling. A total of 315 conservatory students were included. The questionnaire comprised six sections assessing participant characteristics, voice disorder history and symptoms, vocal hygiene knowledge, attitudes, voice-related practices, and educational needs. Correlation analyses, multivariable linear regression, and separate multivariable logistic regression models for nine voice-related practices were performed.
RESULTS: The median knowledge score was 8 (interquartile range [IQR], 7-9), and the median attitude score was 7 (IQR, 5-8). Frequent whispering had the lowest correct-response rate (26.0%) and the highest proportion of "Do not know" responses (40.0%). Knowledge and attitude scores were weakly positively correlated (Spearman's ρ = 0.143, p = 0.011). Frequent throat clearing was reported by 44.1% of participants, whereas 41.3% reported warming up before singing and 27.9% reported cooling down afterwards. Each one-point increase in knowledge score was associated with higher odds of warming up before singing (adjusted odds ratio [aOR] = 1.28, 95% confidence interval [CI], 1.11-1.47; false discovery rate-adjusted p = 0.006), but knowledge score was not associated with any of the seven potentially harmful practices. Each additional recent voice symptom was associated with higher odds of all seven potentially harmful practices (aOR range, 1.25-1.97; all false discovery rate-adjusted p ≤ 0.016). As secondary findings, 196 participants (62.2%) reported at least one recent voice symptom, but only 21 of these participants (10.7%) sought care from a school medical institution or hospital. Overall, 273 participants (86.7%) expressed interest in obtaining further vocal hygiene information.
CONCLUSION: Conservatory students demonstrated generally favourable vocal hygiene knowledge and attitudes, but specific knowledge gaps and limited translation of knowledge into appropriate voice-related practices remained. These findings identify priorities for targeted, practice-oriented vocal health content and clearer healthcare-seeking pathways in conservatory settings.