Adaptation of the voice handicap index to the laryngectomized patient

Objective: The aim of our study was to adapt the VHI to the tracheo-oesophageal voice patients and to evaluate its coherence and reproducibility.
Method: Firstly, 9 items from the original VHI, identified in a former study as lacking pertinence to the patient group, were rejected.
Secondly, the 21 items left were modified and 9 new items were created based on a review of the literature and on the opinion of clinicians.
Lastly, following the opinion of laryngectomised patients we created and added another 10 items to the scale, resulting in 39 items.
The reliability and reproducibility of this new scale were investigated on a population of 18 laryngectomised patients.
Results: The statistical analyses permitted us to reduce the scale to 30 items.
The mean scores obtained on the new adapted VHI are respectively 17.7 ± 10.2 (SD) for the functional scale, 11.5 ± 7.1 for the emotional scale, 17.0 ± 7.3 for the physical scale and 46.2 ± 20.4 for the global score. The test-retest correlations for the global score and for the three sub scales are strong and very significant (Global: r = 0.808; F: r = 0.803; E: r = 0.712, P: r = 0.883, p<0.001). The test-retest stability is thus excellent.
The results of the tracheo-oesophageal voice subjects on this scale are revealing a moderate impact of their vocal impairment in their daily life.