Abstract
BACKGROUND: The Voice Handicap Index (VHI) and the Voice-Related Quality of Life Measure (V-RQOL) are seldom administered to alaryngeal patients who use pneumatic artificial larynx (PAL) and esophageal speech (ES). As such, the specificity of VHI and 10-item VHI (VHI-10) for assessing voice-related changes in such patients is unclear. Accordingly, this study investigated the correlation between scores on the VHI, its shortened version (VHI-10), and the V-RQOL for Mandarin-speaking laryngectomees using PAL and ES, with the aim of establishing which of these instruments is suited to such patients. METHODS: The participants comprised 126 PAL and 26 ES patients from Taiwan who completed the Mandarin VHI and V-RQOL. Fifty-two of these alaryngeal participants then completed both those instruments a second time, between 8 and 64 days later. RESULTS: One item appearing in both the Mandarin long-form VHI and the VHI-10 was excluded because more than half the participants left it unanswered. The correlation of scores on the remaining 29 items on the former with the nine on the latter was high ( r = 0.968), while that between the former and V-RQOL scores was moderate ( r = -0.569), as was the correlation between short-form VHI and Mandarin V-RQOL scores ( r = -0.582). Structural equation modeling was then used as the basis for simplifying the Mandarin long-form VHI into a new 10-item VHI specifically for alaryngeal Mandarin speakers (MA-VHI-10), to eliminate the scoring effect of the original VHI's and VHI-10's work-related item. MA-VHI-10 scores were highly correlated with those on the Mandarin long-form VHI ( r = 0.983). CONCLUSION: The Mandarin versions of long-form VHI, short-form VHI, and MA-VHI-10 are interchangeable for a Mandarin-speaking alaryngeal population. However, neither of the former two instruments should be substituted for the V-RQOL.