Telessaúde em Fonoaudiologia: aplicação de um programa de orientação e prevenção de alterações miofuncionais orofaciais durante a pandemia de COVID-19

Cabral, Amanda de Siqueira; Magalhães, Raíssa Gomes; Viana, Giovanna Régis; Araújo, Nataly Santana de; Silva, Stephanie Ribeiro; Picinato-Pirola, Melissa

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Original Article • CoDAS 35 (3) • 2023 • https://doi.org/10.1590/2317-1782/20232022057en copiar

Telessaúde em Fonoaudiologia: aplicação de um programa de orientação e prevenção de alterações miofuncionais orofaciais durante a pandemia de COVID-19

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivo

Verificar o efeito de um programa de orientação fonoaudiológica virtual, bem como prevenir alterações miofuncionais orofaciais.

Método

Participaram deste estudo 55 voluntários moradores do Distrito Federal com idade entre 18 e 50 anos, sendo 14 homens e 41 mulheres, com idade média de 28 anos. O programa de orientação proposto foi dividido em cinco etapas: 1) elaboração dos materiais a serem utilizados no programa de orientação; 2) preenchimento de questionário semiestruturado por meio da plataforma Google Forms; 3) aplicação do questionário pré-programa de orientação; 4) realização do programa de orientação fonoaudiológica; 5) preenchimento do questionário pós-programa de orientação. Para a análise dos resultados utilizou-se o teste estatístico McNemar considerando a frequência absoluta (N), possibilitando a comparação por meio de amostra pareada. O nível de significância adotado foi de 5%.

Resultados

Observou-se diferenças estatisticamente significativas em 10 das 19 questões propostas nos questionários pré e pós-programa de orientação, evidenciando o efeito da orientação proposta e aquisição de conhecimentos por parte dos voluntários. Além disso, os participantes demonstraram satisfação em relação ao programa e aos conteúdos disseminados.

Conclusão

O programa de orientação com enfoque na promoção da saúde e prevenção de alterações miofuncionais orofaciais aliado à telessaúde trouxe mudanças significativas para a realidade dos participantes, favorecendo a qualidade de vida desses indivíduos e tornando-os agentes transformadores de realidade.

Descritores
Educação em Saúde; Promoção da Saúde; Isolamento Social; Fonoaudiologia; Telessaúde

Theme	Key Words	Number of articles found	Number of articles selected
Sleep	Sleep, Sleep Deprivation, Sleep Hygiene, Multidisciplinary team, Adolescent, Young Adult, Adult, Social isolation, Quarantine.	529	88
Breathing	Breathing, Mouth Breathing, Speech Therapy, Definition.	109	47
Chewing	Chewing, Masticatory Muscles, Stomatognathic System, Stomatognathic System Abnormalities, Myofunctional Therapy, speech therapy, Speech-Language Pathology.	145	30
TMD	Speech Therapy, Temporomandibular Joint Disorders, Temporomandibular Joint (TMJ) Dysfunction Syndrome, Primary Prevention, Anxiety, Hearing.	674	119
Speech and oral habits	Speech, Speech Therapy, habits, deleterious, harmful, oral, speech disorders, bruxism.	553	41

Day	Theme	Type of material	Content
1	Sleep	Video	Definition and function; Sleep physiology (normal versus altered sleep); Main sleep disorders.
2	Sleep	Guidebook and Minute Health (Short Video)	Professionals involved in diagnosis and treatment; Step by step of healthy sleep; Applications to monitor sleep and the immune system.
3	Breathing	Video	Definition physiological process altered breathing; Etiology, Consequences of oral or oronasal breathing; Association between mouth breathing and other orofacial functions.
4	Chewing	Guidebook and Minute Health (Short Video)	Professionals involved in the treatment; Step by step of nasal hygiene; Preventive measures for mouth breathing.
5	Chewing	Video	Definition of chewing; Types of chewing; Factors that interfere in the masticatory pattern; Chewing steps.
6	Chewing	Guidebook and Minute Health (Short Video)	Tips for improving chewing and highlighting the importance of effective chewing; Difference between food consistencies; Professionals involved in the treatment; Relationship between weight loss and chewing.
7	TMD	Video	Definition of the temporomandibular joint (TMJ); Definition of Temporomandibular Disorder (TMD); TMD symptomatology; Morphological and muscular alterations caused by TMD.
8	TMD	Guidebook and Minute Health (Short Video)	TMD diagnosis and treatment; Professionals involved in the treatment; TMD preventive measures; Relationship between anxiety, Stress and ATM; Relationship between TMD and hearing.
9	speech/oral habits	Video	Definition of deleterious oral habits; Frequent deleterious habits and their consequences; Speech definition; Differentiation between voice, chartspeech and language; Most common speech disorders.
10	speech/oral habits	Guidebook and Minute Health (Short Video)	Professionals involved in the treatment; Measures to prevent harmful oral habits; Tips for improving speech.

Q1. Do you think that sleep deprivation can bring about changes such as tiredness, irritation, concentration and memory difficulties, in addition to feeling very sleepy during the day?
() Yes () No () Don’t know
Q2. Do you agree that the treatment of Obstructive Sleep Apnea (OSA) involves lifestyle changes, such as regular physical exercise and nutritional education?

() Yes () No () Don’t know
Q3. Do you think that the speech therapist can help in the treatment of OSA?

() Yes () No () Don’t know
Q4. Do you consider that ideal breathing should be performed by:

() Mouth () Nose () Nose and mouth () Don’t know
Q5. Do you know how nasal cleaning is performed?

() Yes () No () Don’t know
Q6. Which professionals are involved in the treatment of mouth breathing?
() Speech therapist () Nutritionist () Neurologist () Dentist () Otorhinolaryngologist
Q7. Do you think there is a proper way to chew?
() Yes () No () Don’t know
Q8. Do you think that chewing can interfere with facial muscles?
() Yes () No () Don’t know
Q9.Do you think that the speech therapist can help in the treatment of chewing disorders?
() Yes () No () Don’t know
Q10 Earache, pain and popping when opening/closing your mouth and pain when chewing can be symptoms of:
() Temporomandibular Disorder (TMD) () Migraine () Stress () Muscle weakness () Don't know
Q11. Do you think that stress and anxiety can cause pain and muscle tension in the temporomandibular joint region (TMJ)?
() Yes () No () Don’t know
Q12. Do you believe that grinding or clenching your teeth can cause temporomandibular disorders (TMD)?
() Yes () No () Don’t know
Q13. Do you think that TMD treatment needs a multidisciplinary team that includes a speech therapist?
() Yes () No () Don’t know
Q14. Do you think that oral habits (pacifier/bottle usage, nail biting, biting objects) can be harmful?
() Yes () No () Don’t know
Q15. Do you think that oral habits can influence breathing?
() Yes () No () Don’t know
Q16. Do you think that oral habits can influence chewing?
() Yes () No () Don’t know
Q17.Can the use of a pacifier, bottle and thumb sucking cause speech disorders?
() Yes () No () Don’t know
Q18. Is there a difference between voice, speech and language?
() Yes () No () Don’t know
Q19. How satisfied were you with the program?
() Not satisfied () Somewhat satisfied () Indifferen () Satisfied () Very satisfied
Q20. How likely are you to use the tips and information learned from the program in your routine? 1 being unlikely and 5 very likely.
() 1 () 2 () 3 () 4 () 5
Q21. Leave any suggestions, compliments and criticisms here^* * Questions asked only in the post-program questionnaire

		Pre-program		Post-program		P-value
		N	%	N	%	P-value
Q2	Yes No/Don’t know	41	75.0	54	98.0	0.002*
Q2	Yes No/Don’t know	14	25.0	1	2.0	0.002*
Q3	Yes No/Don’t know	41	75.0	54	98.0	0.0009*
Q3	Yes No/Don’t know	14	25.0	1	2.0	0.0009*
Q5	Yes No/Don’t know	12	22.0	47	85.0	<0.001*
Q5	Yes No/Don’t know	43	78.0	8	15.0	<0.001*
Q7	Yes No/Don’t know	48	87.0	55	100.0	0.0156*
Q7	Yes No/Don’t know	7	13.0	0	0.0	0.0156*
Q8	Yes No/Don’t know	50	91.0	53	96.0	0.6875
Q8	Yes No/Don’t know	5	9.0	2	4.0	0.6875
Q9	Yes No/Don’t know	47	85.0	53	96.0	0.0703
Q9	Yes No/Don’t know	8	15.0	2	4.0	0.0703
Q11	Yes No/Don’t know	49	89.0	53	96.0	0.3750
Q11	Yes No/Don’t know	6	11.0	2	4.0	0.3750
Q12	Yes No/Don’t know	42	76.0	52	95.0	0.0009*
Q12	Yes No/Don’t know	13	24.0	3	5.0	0.0009*
Q13	Yes No/Don’t know	42	76.0	54	98.0	0.0039*
Q13	Yes No/Don’t know	13	24.0	1	2.0	0.0039*
Q14	Yes No/Don’t know	54	98.0	55	100.0	1.0000
Q14	Yes No/Don’t know	1	2.0	0	0.0	1.0000
Q15	Yes No/Don’t know	45	82.0	55	100.0	0.0019*
Q15	Yes No/Don’t know	10	18.0	0	0.0	0.0019*
Q16	Yes No/Don’t know	49	89.0	55	100.0	0.0312*
Q16	Yes No/Don’t know	6	11.0	0	0.0	0.0312*
Q17	Yes No/Don’t know	37	67.0	51	93.0	0.0500*
Q17	Yes No/Don’t know	18	33.0	4	7.0	0.0500*
Q18	Yes No/Don’t know	50	91.0	55	100.0	0.0009*
Q18	Yes No/Don’t know	5	9.0	0	0.0	0.0009*

Sociedade Brasileira de Fonoaudiologia Al. Jaú, 684, 7º andar, 01420-002 São Paulo - SP Brasil, Tel./Fax 55 11 - 3873-4211 - São Paulo - SP - Brazil
E-mail: revista@codas.org.br

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[1] Conflict of interests: nothing to declare.