Organic and functional dysphonias: comparison of Self-Assessment protocols by confirmatory factor analysis

Abstract

Objective

This study aims to see if the effects of the sub-domains of the Voice Handicap Index-10 (VHI-10) and Voice Related Quality of Life (VRQoL) differ in organic (OD) and functional dysphonia (FD).

Method

A total of 162 patients completed the validated Turkish versions of the Voice Handicap Index-10 (VHI-10) and Voice-Related Quality of Life (VRQoL). Physical (pVHI-10), emotional (eVHI-10) and functional (fVHI-10) sub-domains of VHI-10 and physical-functional (PF-VRQoL), socio-emotional (SE-VRQoL) dimensions of VRQoL were assessed. Confirmatory factor analysis (CFA) was used to compare the sub-domains of these questionnaires between diagnostic categories.

Results

The total and sub-domain scores of both VHI-10 and VRQoL were not statistically different between the two etiologic categories of dysphonia (MANOVA, p > .05). The total VHI-10 and total VRQoL scores were significantly and moderately correlated in both the OD and FD groups. During CFA, 4 models were constructed for the OD and FD groups for VHI-10 and VRQoL factors. There was no significant difference between OD and FD groups in terms of path coefficients of sub-domains (z test, p > .05).

Conclusion

In terms of VHI-10 and VRQoL, the sub-domains of each questionnaire are equally important in both organic and functional dysphonia. Functional disorders do not depend only on “emotional” factors, and neither do organic problems. Factor analysis should be included when performing a study on patient-reported outcome measures.

Keywords:

• Dysphonia
• voice disorders
• factor analysis
• quality of life
• voice assesments/measures

Acknowledgment

The authors are grateful to all patients for their kind participation in the study.

Ethical approval

Institutional ethical approval was obtained with a number of OMUKAEK 2020/667.

The study was conducted at Ondokuz Mayıs University School of Medicine Department of Otolaryngology.

The authors declare that they have no conflicts of interest. All procedures performed in this study involving human participants were conducted in accordance with the 1964 Declaration of Helsinki and its later amendments.

First and second authors were equally contributed to this work.

Informed consent

The authors transfer all copyright ownership of the manuscript to the Logopedics Phoniatrics Vocology and Taylor and Francis Online Publishing in the event the work is published.

Previous presentation

This research was presented as oral presentation in 13th Congress of the European Laryngological Society in 28 May 2021.

Disclosure statement

The authors declare there are no conflicts of interest – financial or otherwise – related to the material presented herein.