Made available in DSpace on 2015-07-22T20:50:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-01-26 / Objetivo: verificar e comparar as crenças e atitudes frente à perda auditiva e proteção auditiva auto-declaradas por funcionários entre duas indústrias do ramo sucroalcooleiro, com e sem participação em um programa de conservação em saúde auditiva.Método: Participaram do estudo 120 funcionários da usina A que receberam o treinamento específico em saúde auditiva e 87 funcionários da usina B, que não receberam o mesmo treinamento. Foi utilizado o questionário “Crenças e atitudes sobre proteção auditiva e perda auditiva”, elaborado por pesquisadores do NIOSH (1996), o qual foi aplicado após o treinamento em saúde auditiva, que é uma das etapas do Programa de Saúde Auditiva - PCA, desenvolvido pela usina A. Para a usina B, o questionário foi aplicado em dias marcados com o setor de engenharia de segurança do trabalho, não seguindo, portanto a seqüência do treinamento em saúde auditiva, uma vez que esta empresa ainda não desenvolve o PCA. A idade média dos funcionários da usina A foi de 31,8 anos e para usina B 30,5 anos. O tempo de exposição médio a ruído dos voluntários da usina A e B foi de 10 anos. A maior parte dos funcionários de ambas as usinas trabalhavam expostos a ruído superior a 85 dBA, com até 10 anos de tempo de exercício. Resultados: Das 10 temáticas avaliadas no questionário destacam-se três: a melhor percepção de susceptibilidade de adquirir uma perda auditiva (p<0,001), melhor percepção de obstáculos de uma ação preventiva quando relacionado ao conforto do uso do protetor auditivo (p=0,022) e melhor percepção da auto-eficácia relacionada ao sucesso frente as ações recomendadas para proteção da saúde auditiva(0,005) observadas na Usina A quando comparadas a usina B. Apenas um funcionário da usina A afirmou não fazer uso de protetor auricular. O escore total das respostas ao questionário da usina A foi maior (p= 0,010) e estatisticamente significantes , em relação aquele da usina B. Conclusão: Através do presente estudo, verificou-se que a aplicação do questionário “Crenças e atitudes sobre a proteção auditiva e perda auditiva”, nos permitiu conhecer a realidade mais próxima dos funcionários quanto ao seu conhecimento sobre a saúde auditiva que demonstrou o cumprimento mínimo das normas regulamentadoras do Ministério do Trabalho. Ao se comparar os resultados entre as usinas com e sem programa de conservação auditiva, foi possível concluir que a usina sucroalcooleira A, que implementou um PCA, desde 2006, apresentou melhor percepção com diferença estatística significante, comparada à usina B em relação às temáticas T1,T4 e T10 referentes à: percepção de susceptibilidade de adquirir uma perda auditiva, percepção de obstáculos para uma ação preventiva:conforto; e auto-eficácia. / the hearing loss and hearing protection for employees between two industries of the sugarcane branch, with and without participation in a program of conservation in hearing health. Methodology: 120 employees had participated of the study in the sugarcane industry A whom had received the specific training in hearing health and 87 employees from the sugarcane industry B, whom they had not received the same training. The questionnaire was used “Beliefs and attitudes on hearing protection and hearing loss”, elaborated for researchers of the NIOSH (1996), which was applied after the training in hearing health, that is one of the stages of the Program of Hearing Health - PCA, developed for the sugarcane industry A. For the sugarcane industry B, the questionnaire was applied in days marked with the sector of engineering in security of the work, not following, therefore, the sequence of the training in hearing health, however, this company not yet develops the PCA. The average age of the employees in the sugarcane industry A was of 31, 8 years and for sugarcane industry B was 30, 5 years. The average of years of study in the sugarcane industries A and B were of 10 years. Most of the employees both the industries had high risk of hearing loss for exposition to the loud noise above 85db, with interval of 0 the 10 years, as working in the same function for the majority of the employees in the two industries. However, an employee of the sugarcane industry A affirmed that He didn´t use any hearing protector. Results: Nevertheless, 10 thematic evaluated in the questionnaire, the best perception of susceptibilities was observed in the sugarcane industry A to acquire a hearing loss (p<0,001), perception of obstacles of an injunction when related to the comfort of the use of the hearing protector (p=0,022) and better perception of the auto-effectiveness related to the success front the actions recommended for protection of the hearing health (0,005), as well as for a total score(p=0,010) when compared sugarcane industry B that does not develop the PCA. Conclusion: Through this study it was found that the questionnaire "Beliefs and attitudes about hearing protection and hearing loss", allowed us to know the reality closer to employees about their hearing health knowledge that has demonstrated compliance with minimum standards regulating the Ministry of Labour. Comparing the results between plants with and without a hearing conservation program, it was concluded that the sugarcane mill, which implemented a PCA, since 2006, had a relation to thematic T1, T4 and T10 regarding: perceived susceptibility of acquiring a hearing loss, perceived barriers to preventive action, comfort, and self-efficacy. / TEDE

ABSTRACT Thus far, literature is scant in assessing the ability of children with conductive hearing impairment to understand everyday speech. This assessment is important in determining the functional ability of children with conductive hearing impairment. In order to identify the hearing ability of children with conductive hearing impairment, many assessments to date have used speech stimuli, such as syllables, words and sentences, to measure how well children perform. In general, these tests are useful in measuring speech recognition ability, but are not adequate in measuring the functional ability of children to understand the conversations they encounter in their daily lives. In addition, many of these tests are not designed to be interesting or engage the children whom they are assessing. The University of Queensland Understanding of Everyday Speech (UQUEST) Test was developed to address the above issues by providing a stimulating speech perception assessment for children aged 5 to 10 years. This overall objectives of this thesis were to: (1) determine the applicability of a computer-based, self-driven assessment of speech comprehension, the UQUEST, (2) establish normative UQUEST data for school children, (3) compare the UQUEST results in children with and without histories of otitis media in understanding everyday speech, and (4) measure speech understanding in noise by children with minimal conductive hearing impairment. A total of 1094 children were assessed using the UQUEST. All children were native speakers of English and attended schools in the Brisbane Metropolitan and Sunshine Coast regions within the state of Queensland, Australia. All children were firstly assessed using otoscopic examination, pure tone audiometry testing and tympanometry. Children with sensorineural hearing impairment were excluded from the study. Following the initial audiological assessments, the UQUEST was administered to all participants. Three experiments were performed on three cohorts of children selected from the pool of 1094 children. Experiment 1 aimed to assess whether the UQUEST is a feasible speech perception assessment tool for school children and to establish normative data in a sample of normally hearing children. ix In this experiment, participants were a total of 99 children (55 boys / 44 girls), attending Grade 3 and grade 4 (41/58, mean age = 8.3 yr, range = 7 – 10 yr, SD = 0.7). The results showed that the UQUEST is a feasible test of speech understanding in children aged 7 to 10 years. In general, the UQUEST scores decreased as the signal-to-noise-ratio (SNR) decreased from 10 to 0 dB. Normative data based on the scores of six passages of equal difficulty were established for the 0 dB and 5 dB SNR conditions. In addition, the children appeared to be captivated with the UQUEST task and the attention of all the children was sustained throughout the duration of the test. Experiment 2 determined whether children with histories of otitis media (experimental group) performed worse on the UQUEST in comparison to those children without histories of otitis media (OM). A total of 484 children (246 boys / 238 girls), attending Grade 3 (272, mean age = 8.25 yr, SD = 0.43) and Grade 4 (212, mean age = 9.28 yr, SD = 0.41), were assessed. Children were grouped according to the number of episodes of otitis media as per parental report (control: < 4 episodes; mild history group: 4-9 episodes; and moderate history group: > 9 episodes OM). All children had normal hearing as determined by otoscopy, pure tone audiometry screening and tympanometry results. Results showed no significant difference in UQUEST scores between the control group in comparison to the experimental groups. However, children with a history of OM demonstrated varying speech comprehension abilities. Some children had severe difficulty with the speech comprehension task, suggesting that in cases with extensively reported episodes of OM, performance on the UQUEST was compromised. Experiment 3 determined the prevalence of conductive hearing loss in the Australian primary school population and investigated the ability of school children with minimal conductive hearing loss to understand everyday speech under noisy conditions. Based on a sample of 1071 children (mean age = 7.7 yr; range = 5.3 - 11.7 yr), 10.2% of children were found to have conductive hearing loss in one or both ears. To evaluate the binaural speech comprehension ability of children, a sample of 542 children were divided into four groups according to their audiological assessment results: Group 1: 63 children (34 boys, 29 girls, mean age = 7.7 yr, SD = 1.5) who failed the pure tone audiometry and tympanometry tests in both ears; Group 2: 38 children (17 x boys, 21 girls, mean age = 7.5 yr, SD = 1.2) who passed pure tone audiometry and tympanometry in one ear but failed both tests in the other ear; Group 3 (control group): 357 children (187 boys, 170 girls, mean age = 7.8 yr, SD = 1.3) who passed pure tone audiometry and tympanometry in both ears; Group 4: 84 children (41 boys, 43 girls, mean age = 7.2 yr, SD = 1.3) who passed pure tone audiometry in both ears, but failed tympanometry in one or both ears. The results showed that Group 1 had the lowest mean scores of 60.8% - 69.3% obtained under noise conditions. Their scores were significantly lower than the corresponding scores of 69.3% - 75.3% obtained by children in Group 4; 70.5% - 76.5% obtained by children with unilateral conductive hearing loss (Group 2); and 72.0% - 80.3% obtained by their normally hearing peers (Group 3). This study confirmed that young children, who are known to have poorer speech understanding in noise than adults, show further disadvantage when a bilateral conductive hearing loss is present In summary, the UQUEST has been found to be a useful tool to measure children‟s understanding of everyday speech. This test could be successfully used as a measure of speech comprehension in background noise in children. The UQUEST met expectations of being an interesting and engaging test for children aged 5-10 years. In addition, the UQUEST scores showed that children performed worse when challenged by the more difficult noise conditions incorporated in the test design. The findings from this thesis demonstrated that, at the group level, children with histories of OM did not perform any differently from those without significant histories of OM. However, at the individual level, children with significant OM histories had degraded functional performance with low UQUEST scores. Lastly, this thesis provided much needed speech comprehension data obtained from children with minimal conductive hearing impairment and provided evidence that young children were more affected by the co-occurrence of environmental noise and bilateral conductive hearing loss than their normally hearing peers in understanding everyday speech.