Unité de la voix et de la déglutition, service d'ORL et de chirurgie cervicofaciale, hôpital Larrey, CHU de Toulouse, TSA 30030, 31100 Toulouse, France.
Unité de la voix et de la déglutition, service d'ORL et de chirurgie cervicofaciale, hôpital Larrey, CHU de Toulouse, TSA 30030, 31100 Toulouse, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2017 Dec;134(6):399-403. doi: 10.1016/j.anorl.2017.06.010. Epub 2017 Aug 18.
The present prospective study sought to draw up and validate a self-assessment questionnaire for disability following head and neck cancer treatment.
The Carcinologic Handicap Index (CHI) was designed empirically based on the Voice Handicap Index. It comprises 9 dimensions, self-assessed by the patient: pain, swallowing, feeding, respiration, phonation, hearing, vision, olfaction-gustation, and psychosocial. For each dimension, 4 items are scored in terms of frequency, providing dimension and global scores. The CHI was tested on 86 head and neck cancer patients (pathologic group: male predominance; mean age, 59 years) and 18 control subjects, for validation.
Global internal coherence was 0.905 (Cronbach alpha); content validity (r, between questionnaire scores and corresponding visual analog scales) ranged between 0.6 and 0.8 except for the vision dimension and for total score compared to general health rating on VAS (r≤0.5: i.e., the pathology did not directly impair vision and was only one factor among others affecting general health status); temporal validity was satisfactory (r>0.7; P<0.0001) except on the respiration dimension (r=0.624, probably due to fluctuation in pulmonary congestion). Impact on swallowing, feeding and respiration varied with lesion site. There were no significant differences between patients and controls on the pain, hearing and vision dimensions.
The CHI showed acceptable psychometric qualities and can be considered as an authentic clinical tool for health professionals, assessing the impact of ENT pathology on quality of life, mainly in the functional domains directly affected by the pathology or treatment.
本前瞻性研究旨在制定和验证头颈部癌症治疗后残疾的自我评估问卷。
根据嗓音障碍指数，经验设计了癌症患者生活质量测定量表（CHI）。它由 9 个维度组成，由患者自我评估：疼痛、吞咽、进食、呼吸、发声、听力、视力、嗅觉-味觉和心理社会。对于每个维度，有 4 个项目根据频率进行评分，提供维度和总体评分。该量表在 86 例头颈部癌症患者（病理组：男性为主；平均年龄 59 岁）和 18 例对照者中进行了测试，以进行验证。
总体内部一致性为 0.905（克朗巴赫 α）；内容效度（r，问卷评分与相应视觉模拟量表之间的相关性）在 0.6 到 0.8 之间，除了视力维度和总评分与视觉模拟量表的一般健康评分相比（r≤0.5：即病变不会直接损害视力，只是影响一般健康状况的诸多因素之一）；时间有效性令人满意（r>0.7；P<0.0001），除了呼吸维度（r=0.624，可能是由于肺部充血波动所致）。对吞咽、进食和呼吸的影响因病变部位而异。患者和对照组在疼痛、听力和视力维度上没有显著差异。
CHI 具有可接受的心理测量学特性，可以被视为一种真实的临床工具，用于评估 ENT 病理学对生活质量的影响，主要是在受病理学或治疗直接影响的功能领域。
