咽喉相关症状与嗓音：一种咽喉问题自我评估工具的开发
Throat related symptoms and voice: development of an instrument for self assessment of throat-problems.
作者信息
Lyberg-Åhlander Viveka, Rydell Roland, Eriksson Jacqueline, Schalén Lucyna
机构信息
Department of Logopedics, Phoniatrics and Audiology, Lund University, S-221 85 Lund, Sweden.
ENT-Department, Lund University Hospital, S-221 85 Lund, Sweden.
出版信息
BMC Ear Nose Throat Disord. 2010 May 27;10:5. doi: 10.1186/1472-6815-10-5.
BACKGROUND
Symptoms from throat (sensation of globus; frequent throat clearing; irritated throat) are common in patients referred to voice clinics and to ENT specialists. The relation to symptoms of voice discomfort is unclear and in some cases patients do not have voice problems at all. Instruments for patients' self-reporting of symptoms, and assessment of handicap, such as the Voice Handicap Index (VHI), are in common use in voice clinics. Symptoms from throat are however only marginally covered.
PURPOSE
To develop and evaluate an instrument that could make the patients' estimation of symptoms from the throat possible. Further to facilitate the consideration of the relation between throat- and voice problems with the Throat subscale together with a Swedish translation of the Voice Handicap Index. Finally to try the VHI with the Throat subscale: the VHI-T, for test-retest reliability and validity.
METHODS
A subscale with 10 throat related items was developed for appliance with the VHI. The VHI was translated to Swedish and retranslated to English. The questionnaire was tried in two phases on a total of 23+144 patients and 12+58 voice healthy controls. The reliability was calculated with Cronbach's alpha, ICC and Pearson's correlation coefficient. The validity was estimated by independent T-test.
RESULTS
The difference in VHI-T scores between the patients and the voice-healthy controls was significant (p = < 0,01) and there was a good correlation of the test- retest occasions. The reliability testing of the entire questionnaire showed an alpha value of r = 0,90 and that for the Throat subscale separately a value of r = 0,87 which shows a high degree of reliability.
CONCLUSIONS
For the estimation of self-perceived throat and voice problems the scale on throat related problems together with the present Swedish translation of the Voice Handicap Index, (VHI) the VHI-Throat, proves to be a valid and reliable instrument. The throat subscale seems to help revealing a category of symptoms that are common in our patients. These are symptoms that have not earlier been possible to cover with the questionnaires designed for use in the voice clinic.
背景
在转诊至嗓音诊所和耳鼻喉科专家处的患者中，咽喉症状（咽部异物感、频繁清嗓、咽喉不适）很常见。其与嗓音不适症状的关系尚不清楚，在某些情况下患者根本没有嗓音问题。在嗓音诊所中，常用于患者症状自我报告及功能障碍评估的工具，如嗓音障碍指数（VHI），对咽喉症状的覆盖程度却很低。
目的
开发并评估一种能够让患者对咽喉症状进行评估的工具。进一步通过咽喉子量表以及嗓音障碍指数的瑞典语翻译，促进对咽喉问题与嗓音问题之间关系的考量。最后，试用带有咽喉子量表的VHI（VHI-T），以检验重测信度和效度。
方法
为配合VHI使用，开发了一个包含10个与咽喉相关条目的子量表。将VHI翻译成瑞典语，然后再回译成英语。该问卷分两个阶段在总共23 + 144名患者和12 + 58名嗓音健康对照者中进行试用。采用克朗巴哈系数、组内相关系数（ICC）和皮尔逊相关系数计算信度。通过独立样本t检验评估效度。
结果
患者与嗓音健康对照者的VHI-T得分差异显著（p = < 0.01），且重测结果具有良好的相关性。整个问卷的信度测试显示α值r = 0.90，咽喉子量表单独的α值r = 0.87，表明具有高度信度。
结论
对于自我感知的咽喉和嗓音问题的评估，与目前嗓音障碍指数（VHI）的瑞典语翻译相结合的咽喉相关问题量表，即VHI-咽喉量表，被证明是一种有效且可靠的工具。咽喉子量表似乎有助于揭示一类在我们的患者中常见的症状。这些症状是此前用于嗓音诊所的问卷无法涵盖的。
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