Speech handicap index: cross-cultural adaptation and validation in European Portuguese speakers with oral and oropharyngeal cancer

Abstract

Introduction

To date, no valid outcome measure has been developed in European Portuguese (EP) to assess the opinion of the patients with oral and oropharyngeal cancer about the speech impact in his/her related quality of life.

Objectives

This study aimed to cross-culturally adapt the speech handicap index (SHI) in EP and contribute to its validation in oral and oropharyngeal cancer patients.

Materials and methods

A cross-sectional study was carried out in two phases: (i) SHI translation, back-translation, expert analysis, and pilot study; (ii) application of the EP version of the SHI (EP-SHI) to 95 patients with oral and oropharyngeal cancer and 83 gender- and age-matched healthy individuals. A total of 23 randomly chosen patients were asked to re-fill the EP-SHI questionnaire after 3 weeks. The psychometric properties (feasibility, practicability, reliability, and validity) were assessed.

Results

The EP-SHI version brought together expert consensus and the acceptability of 75% of the participants in the pilot study. The EP-SHI questionnaire is feasible (no missing data and floor effect < 7%), practical (an average of 5.5 min to complete), possesses internal consistency reliability (Cronbach’s alpha ≥ 0.90), test-retest reliability (interclass correlation coefficient, ICC ≥ 0.90), significantly strong convergent validity with EP-voice handicap index (VHI) (rô≥0.94), distinguishes patients from healthy speakers and within the patients’ group according to individual speech rating and glossectomy surgery.

Conclusions

The EP-SHI is a culturally relevant, valid and reliable patient reported outcome measure (PROM), and therefore, it is appropriate to be recommended for used with oral and oropharyngeal cancer patients.

Keywords:

• Speech
• speech handicap index
• oral and oropharyngeal cancer
• validation
• cross-cultural adaptation

Acknowledgements

The authors are grateful to the subjects who have volunteered to participate in the study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Isabel Guimarães

Isabel Guimarães-Speech and Language Therapist, PhD in Experimental Phonetics, Lecturer & Researcher. Research Project contribution: Conception (Design); Execution (Statistical analysis; Manuscript preparation and writing).

Ana Raquel Sousa

Ana Raquel Sousa-Speech and Language therapists, Master. Research Project contribution: Conception (Design; Data gathering and statistical editing); Execution (Review and critique of the manuscript).

Maria Filomena Gonçalves

Maria Filomena Gonçalves-Speech and Language Therapist. Research Project Contribution: Data gathering and Manuscript review and critique.