The Mandarin Voice Handicap Index for Laryngectomees With Pneumatic Artificial Laryngeal and Esophageal Speech

Abstract

Purpose The Voice Handicap Index (VHI) questionnaire assesses the impact of total laryngectomy on voice-related quality of life. This study evaluates the Mandarin VHI, including its internal consistency, test–retest reliability, content validity, and differences in scores for Mandarin alaryngeal patients with pneumatic artificial laryngeal (PA) and esophageal (ES) speech. Method Translation and validation of the VHI questionnaire was performed through the forward–backward translation technique. This study used a sample of 78 PA and 23 ES participants from Taiwan who completed the Mandarin VHI. Forty-two of the alaryngeal participants completed the Mandarin VHI twice over a period of 7–63 days. Results The measurement of the internal consistency of the Mandarin VHI showed a high Cronbach's alpha coefficient for the total score (.975) and the functional (.930), physical (.939), and emotional (.938) subscales. Based on the results of the intraclass correlation coefficients, good test–retest reliability for the total and domain scores was found (intraclass correlation coefficient = .827–.863). Conclusion The Mandarin VHI was validated as an instrument with proper internal consistency and reliability, which supports the Mandarin VHI as a valid instrument for the self-evaluation of handicaps related to voice problems in PA and ES speakers.

Correlations among the Mandarin Voice Handicap Index, its shortened version, and the Voice-Related Quality of Life Measure for laryngectomees

“…Administering broad-based quality-of-life questionnaires to Mandarin-speaking alaryngeal patients is important, insofar as the impact of undergoing a total laryngectomy on the life of an individual does not necessarily have a direct relationship with the magnitude of the voice-related problems she/he experiences. 1,3,21,22 Prior research has used the VHI, VHI-10, or V-RQOL for this purpose. To align with those VHI, VHI-10, and V-RQOL studies, this one evaluated the validity of the physical, functional, and emotional aspects of the Mandarin long-form VHI and Mandarin short-form VHI, and the validity of the social-emotional and physical functioning aspects of the Mandarin V-RQOL for alaryngeal patients, as well as differences between PAL and ES patients’ perceived voice handicaps.…”

“…During that 4-year time frame, data from 101 of the participants who filled out the VHI and from 104 who filled out the V-RQOL were published separately. 21,22 The current study continued collecting data derived from both those instruments until the number of participants reached 152.…”

“…The VHI, V-RQOL, and VHI-10 used in the present study were all in Mandarin, and the former two were published in the authors' previous studies. [1][2][3]21,22 The VHI's three dimensions assess the functional, physical, and emotional domains, respectively (Supplementary Appendix A, http://links.lww.com/JCMA/ A150). 1,21 Each of these three dimensions includes 10 items.…”

“…7 In the absence of such alternatives, the VHI, VHI-10, and V-RQOL—all of which are voice-related measures—are often adopted to assess the impact of voice problems on alaryngeal patients. 10–23…”

“…7 In the absence of such alternatives, the VHI, VHI-10, and V-RQOL-all of which are voice-related measures-are often adopted to assess the impact of voice problems on alaryngeal patients. [10][11][12][13][14][15][16][17][18][19][20][21][22][23] Understanding the relationship between these voice-related instruments will facilitate clinicians' assessments of the impact of laryngectomies on patients' quality of life. Prior statistical results have indicated a strong correlation between scores on the VHI and V-RQOL in groups of 65, 132, and 150 patients with voice disorders, [24][25][26] as well as in a group of 54 alaryngeal patients using valved speech.…”