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24 Yun et al. / Validation of the Korean Voice Handicap Index (K-VHI) and the Clinical Usefulness of Korean VHI-10 ABSTRACT Validation of the Korean Voice Handicap Index (K-VHI) and the Clinical Usefulness of Korean VHI-10 1) Young-Sun Yun a,b,, HyangHee Kim a,c, Young-Ik Son d, Hong Sik Choi e a Graduate Program in Speech and Language Pathology, Yonsei University, Seoul, Korea b Department of Otorhinolaryngology, Voice & Speech Clinic in Head & Neck Center, Samsung Medical Center, Seoul, Korea c Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea d Department of Otorhinolaryngology-Head & Neck Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea e Department of Otorhinolaryngology, the Institute of Logopedics and Phoniatrics, Yonsei University College of Medicine, Seoul, Korea Background & Objectives: The purpose of this study was to validate the Korean Voice Handicap Index (VHI) and VHI-10, and to evaluate the clinical usefulness of VHI-10. Methods: One hundred fifty-six Korean adult patients, all of whom had symptoms of dysphonia without laryngeal cancer, as well as 66 normal Korean adults participated in this study. The survey was conducted using VHI (30 items) and IPVI s first item. Results: With regard to the reliability of VHI-30, Pearson correlations in test-retests were very high (r =.971, p <.01). Cronbach s α for internal consistency was.969. The control group received significantly lower scores than did the patient group. With regard to concurrent validity, the Spearman correlation between the VHI-30 and IPVI s was high (r =.664, p <.01). With regard to the construct validity, 30 VHI items were divided into three components via factor analysis. For VHI-10, statistical analyses revealed high reliability and validity values. The correlations of total scores between VHI-30 and VHI-10 was high (r =.968, p <.01). The mean ratio of total scores between VHI-10 and VHI-30 was VHI-10 had a single component according to the results of factor analysis. Discussion & Conclusion: The validity and reliability of VHI-30 and VHI-10 questionnaires are maintained even after translation into Korean. The VHI-10 items are more sensitive than the VHI-30 items, consistent with the results of previous studies. (Korean Journal of Communication Disorders 2008;13; ) Key Words: voice disorders, VHI (Voice Handicap Index), VHI-10, quality of life, validation. 1) Some of the data of this paper was excerpted from the doctoral dissertation of the first author, Yun (2007). Received April 20, 2008; final revision received May 20, 2008; accepted June 6, Correspondence to Young-Sun Yun, PhD, Department of Otorhinolaryngology, Samsung Medical Center, Ilwon-dong, Kangnam-gu, Seoul, Korea, voiceyun@hanmail.net, tel.: The Korean Academy of Speech-Language Pathology and Audiology 239

25 Korean Journal of Communication Disorders 2008;13; References Alves, C. B., Loughran, S., MacGregor, F. B., Dey, J. I., & Bowie, L. J. (2002). Bioplastic medialization therapy improves the quality of life terminally ill patients with vocal cord palsy. Clinical Otolaryngology, 27, Amir, O., Tavor, Y., Leibovitzh, T., Ashkenazi, O., Michael, O., & Primov-Fever, A. (2006). Evaluating the validity of the Voice Handicap Index-10 among Hebrew speakers. Otolarynglogy- Head and Neck Surgery, 135, Bach, K. K., Belafsky, P. C., Wasylik, K., Postma, G. N., & Koufman, J. A. (2005). Validity and reliability of Glottal Function Index. Archives of Otolaryngology-Head and Neck Surgery, 131, Boone, D. R., McFarlane, S. C., & Von Berg, S. L. (2005). The voice and voice therapy (7th ed.). Needham Heights, MA: Allyn & Bacon. Choi, D. Y., Choi, S. M., Lim, G. C., & Nam, S. Y. (2002). Usefulness of Voice Handicap Index in patient's hoarseness. Korean Journal of Otolaryngology, 45, Deary, I. J., Wilson, J. A., Carding, P. N., & MacKenzie, K. (2003). VoiSS: A patient-derived Voice Symptoms Scale. Journal of Psychosomatic Research, 54, Franic, D. M., Bramlett, R. E., & Bothe, A. C. (2005). Psychometric evaluation of disease specific quality of life instruments in voice disorders. Journal of Voice, 19, Fulljames, N., & Harris, S. (2006). Voice outcome measures: Correlations with patient s assessment of their condition and the effectiveness of voice therapy. Logopedics Phoniatrics Vocology, 31, Guimaraes, I., & Abberton, E. (2004). An investigation of the Voice Handicap Index with speakers of Portuguese: Preliminary data. Journal of Voice, 18, Hakkesteegt, M. M., Wieringa, M. H., Gerritsma, E. J., & Feenstra, L. (2006). Reproducibility of the Dutch version of the Voice Handicap Index. Folia Phoniatrica et Logopaedica, 58, Hogikyan, N. D., & Sethuraman, G. (1999). Validation of an instrument to measure Voice- Related Quality of Life (V-RQOL). Journal of Voice, 13, Hogikyan, N. D., Wodchic, W. P., Spark, C., & Kileny, P. R. (2001). Longitudinal effects of botulinum toxin injections on Voice-Related Quality of Life (V-RQOL) for patients with adductory spasmodic dysphonia. Journal of Voice, 15, Hsiung, M. W., Lu, P., Kang, B. H., & Wang, H. W. (2003). Measurement and validation of the Voice Handicap Index in voice-disordered patients in Taiwan. Journal of Laryngology and Otology, 117, Jacobson, B. H., Johnson, A., Grywalski, C., Silbergleit, A., Jacobson, G., & Benninger, M. S. (1997). The Voice Handicap Index (VHI): Development and validation. American Journal of Speech Language Pathology, 3, Karnell, M. P., Melton, S. D., Childes, J. M., Coleman, T. C., Dailey, S. A., & Hoffman, H. T. (2007). Reliability clinician based (GRBAS and CAPE-V) and patient-based (V-RQOL and IPVI) documentation of voice disorders. Journal of Voice, 21, Lam, P. K. Y., Chan, K. M., Ho, W. K., Kwong, E., Yiu, E. M., & Wei, W. I. (2006). Cross-cultural adaptation and validation of the Chinese Voice Handicap Index The Laryngosocpe, 116, Park, S. S. (2004). The effect of vocal hygiene for the female elementary school teachers. Unpublished master s thesis. Ewha Womans University, Seoul. Rosen, C. A., Lee, A. S., Osborne, J., Jullo, T., & Murry, T. (2004). Development and validation of the Voice Handicap Index-10. Laryngosocpe, 114, Rosen, C. A., Murry, T., Zinn, A., Zullo, T., & Sonbolian, M. (2000). Voice Handicap Index change following treatment of voice disorders. Journal of Voice, 14, Seong, T. J. (2004). Theory and practice in item production and analysis (2nd ed.). Seoul: Hakjisa. Siupsinskiene, N., Adamonis, K., & Toohill, R. J. (2007). Quality of life in laryngopharyngeal reflux patients. The Laryngoscope, 117, Spector, B. C., Netterville, J. L., Billante, C., Clary, J., Reinisch, L., & Smith, T. L. (2001). Quality of life assessment in patients with unilateral vocal cord paralysis. Otolaryngology Head and Neck Surgery, 125, Wilson, J. A., Webb, P. N., Carding, I. N., Steen, I. N., MacKenzie, K., & Deary, I. J. (2004). The Voice Symptom Scale (VoiSS) and the Vocal Handicap Index (VHI): A comparison of struc- 240

26 Yun et al. / Validation of the Korean Voice Handicap Index (K-VHI) and the Clinical Usefulness of Korean VHI-10 ture and content. Clinical Otolaryngology and Allied Sciences, 29, Wingate, J. M., Ruddy, B. H., Lundy, D. S., Lehman, J., Casiano, R., & Collins, S. P. (2005). Voice Handicap Index results for older patients with adductor spasmodic dysphonia. Journal of Voice, 19, Woisard, V., Bodin, S., & Puech, M. (2004). The Voice Handicap Index: Impact ot the translation in French on the validation. Revue de Laryngologie-Otologie-Rhinologie, 125, World Health Organization (1980). International classification of impairments disabilities, and handicap: A manual of classification relation to the consequences of disease. Geneva: Author. 241

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