Cross-Cultural Adaptation and Validation of the Voice Handicap Index in the Quebec French Population (VHI-QF)

doi:10.1016/j.jvoice.2019.04.010

Journal of Voice

Volume 34, Issue 5, September 2020, Pages 811.e1-811.e6

https://doi.org/10.1016/j.jvoice.2019.04.010 Get rights and content

Summary

Background and Objectives

The Voice Handicap Index (VHI) is a widely recognized, self-administered questionnaire, designed to evaluate patients' perception of voice-related disability. It takes into consideration the physical, functional and emotional impacts of dysphonia. The VHI has been translated and validated in many languages, including European French. The purpose of our study is to translate, adapt and validate a new version of the VHI in Quebec French.

Methods

The original VHI was translated into Quebec French (QF) by forward and backward translations by four professional translators, including a speech-language pathologist. The content validity of the resulting VHI-QF was examined in focus groups with six patients and seven speech-language pathologists. Another sample of 154 patients with voice disorders and 150 healthy controls allowed evaluation of the new questionnaire's convergent and discriminant validity, and internal consistency. Satisfaction toward the questionnaire was also evaluated for all patients, as well Test-retest reliability and responsiveness for a sub-sample.

Results

The VHI-QF showed a moderate correlation with dysphonia severity level, indicating adequate convergent validity. Both total and subscale scores also exhibited adequate ability to discriminate between patients and controls (discriminant validity), high internal consistency, and good test-retest reliability. The analysis of pre- and post-treatment VHI-QF scores revealed adequate responsiveness to voice treatment. Patients were overall satisfied with the questionnaire.

Conclusion

The VHI-QF is a valid, reliable and clinically useful self-reported tool to evaluate the severity and change of voice disorders in Quebec French population. Therefore this questionnaire can be used in clinical and research contexts.

Section snippets

INTRODUCTION

Voice disorder assessment can be a clinical challenge even for most experienced clinicians. Part of the challenge originates from the difficulty to evaluate the overall impact of a voice disorder in a patient's daily life. The effectiveness of an intervention is also difficult to evaluate at follow-up. Many validated questionnaires on voice problems in daily life exists, including the 30-item Voice Handicap Index (VHI)¹ and his shortened version, the VHI-10,² the 28-item Voice Activity and

Ethical consideration

The research protocol was approved by the ethics committee CHU de Québec, #2017-3152 for the collection of the patient's data. The data on healthy adults were collected as part of a larger research project on voice aging that was approved by the Institutional Ethical Committee of the Institut Universitaire en Santé Mentale de Québec (#192-2017). Informed consent was obtained from the study participants, and data were collected in an anonymized database. Control participants were compensated for

Results

The mean age of the patient group (n = 154) was 50.3 (SD = 16.8) years, ranging from 18 to 88 years. The group was composed of 107 women (69.5 %) and 47 men (30.5 %). Thirty-six of them (23.4 %) were professional voice users. The mean age of the control group (n = 150) was 53.5 (SD = 20.1) years ranging from 20 to 98 years of age. The group was composed of 87 (58.0 %) women and 63 (42.0 %) men. None of them was a professional voice user but 50% of the sample took part in group singing

Discussion

This study aimed to create a cross-culturally adapted version of the VHI for the Quebec French population, and to validate this version, based on a rigorous methodology following published guidelines.⁸ For the adaptation process, the Critical Appraisal Skills Program⁸ suggests that (1) the translation should be made by more than 3 people, (2) at least one “lay person” should be involved, (3) at least one voice expert should be involved, (4) a panel should be involved, (5) a back-translation

CONCLUSION

A robust method was used to adapt cross-culturally and to validate the VHI to the Quebec French population. The resulting questionnaire—VHI-QF—is a useful self-assessment tool to evaluate the severity and change of perceived voice handicap in the Quebec French population. It is therefore a reliable tool that can be used by otolaryngologists, speech-language pathologists, or even other professionals, such as physicians, in the context of evaluation and follow-up of vocal disorders in a clinical

Financial or nonfinancial disclosure and conflict of interests

None to declare.

Acknowledgments

We want to thank all participants for their contribution to this project, as well as the speech-language pathologists and patients who took part in the focus groups.

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: Funding: Data on the control participants were collected as part of a larger project funded by grants from The Drummond Foundation, the Social Sciences and Humanities Research Council of Canada (SSHRC), and the Canadian Foundation for Innovation (FCI) to P. Tremblay, who also holds a career award from the Fonds Québécois de la Recherche—Santé (FRQ-S Junior 2). The funding agencies were not involved in study design; in the collection, analysis, and interpretation of data; or in the writing of the report.

View full text

Cross-Cultural Adaptation and Validation of the Voice Handicap Index in the Quebec French Population (VHI-QF)

Summary

Background and Objectives

Methods

Results

Conclusion

Section snippets

INTRODUCTION

Ethical consideration

Results

Discussion

CONCLUSION

Financial or nonfinancial disclosure and conflict of interests

Acknowledgments

J Voice

Otolaryngol Head Neck Surg

J Voice

J Voice

J Chiropr Med

J Clin Epidemiol

Acta Otorrinolaringol

The Voice Handicap Index (VHI): development and validation

Am J Speech Lang Pathol

Development and validation of the voice handicap index-10

Laryngoscope

Voice activity and participation profile assessing the impact of voice in daily activities

J Speech Lang Hear Res