Lu Dan, Huang Mengjie, Li Zhen, Yiu Edwin M-L, Cheng Ivy K-Y, Yang Hui, Ma Estella P-M
Department of Otorhinolaryngology, Head & Neck Surgery, West China Hospital, Sichuan University, Sichuan, China.
Department of Otorhinolaryngology, Women's & Children's Central Hospital, Chengdu, Sichuan, China.
Int J Pediatr Otorhinolaryngol. 2018 Jan;104:19-24. doi: 10.1016/j.ijporl.2017.10.034. Epub 2017 Oct 25.
OBJECTIVE: The aim of this study was to adapt and validate the English version of pediatric voice handicap index (pVHI) into Mandarin Chinese. METHODS: A cross-sectional study was performed from May 2016 to April 2017. A total of 367 parents participated in this study, and 338 parents completed the translated questionnaire without missing data, including 213 parents of children with voice disorders (patients group), and 125 parents of children without voice disorders (control group). The internal consistency, test-retest reliability, contents validity, construct validity, clinical validity, and cutoff point were calculated.
The most common voice disorder in the patients group was vocal fold nodules (77.9%), followed by chronic laryngitis (18.8%), and vocal fold polyps (3.3%). The prevalence for voice disorders was higher in boys (67.1%) than girls (32.9%). The most common vocal misuse and abuse habit was shouting loudly (n = 186, 87.3%), followed by speaking for a long time (n = 158, 74.2%), and crying loudly (n = 99, 46.5%). The internal consistency for the Mandarin Chinese version of pVHI was excellent in patients group (Cronbach α = 0.95). The inter-class correlation coefficient indicated strong test-retest reliability (ICC = 0.99). The principal-component analysis demonstrated three-factor eigenvalues greater than 1, and the cumulative proportion was 66.23%. The mean total scores and mean subscales scores were significantly higher in the patients group than the control group (p < 0.05). The physical domain had the highest mean score among the three subscales (functional, physical and emotional) in the patients group. The optimal cutoff point of the Mandarin Chinese version of pVHI was 9.5 points with a sensitivity of 80.3% and a specificity of 84.8%.
The Mandarin Chinese version of pVHI was a reliable and valid tool to assess the parents' perception about their children's voice disorders. It is recommended that it can be used as a screening tool for discriminating between children with and without dysphonia.
本研究旨在将英文版儿童嗓音障碍指数（pVHI）改编并验证为中文普通话版本。
于2016年5月至2017年4月进行了一项横断面研究。共有367名家长参与本研究，338名家长完成了翻译后的问卷且无数据缺失，其中包括213名嗓音障碍儿童的家长（患者组）和125名无嗓音障碍儿童的家长（对照组）。计算了内部一致性、重测信度、内容效度、结构效度、临床效度和临界值。
患者组中最常见的嗓音障碍是声带小结（77.9%），其次是慢性喉炎（18.8%）和声带息肉（3.3%）。男孩的嗓音障碍患病率（67.1%）高于女孩（32.9%）。最常见的嗓音误用和滥用习惯是大声喊叫（n = 186，87.3%），其次是长时间说话（n = 158，74.2%）和大声哭泣（n = 99，46.5%）。中文版pVHI在患者组中的内部一致性极佳（Cronbach α = 0.95）。组内相关系数表明重测信度很强（ICC = 0.99）。主成分分析显示三个因子特征值大于1，累积比例为66.23%。患者组的平均总分和平均分量表得分显著高于对照组（p < 0.05）。在患者组的三个分量表（功能、身体和情感）中，身体领域的平均得分最高。中文版pVHI的最佳临界值为9.5分，灵敏度为80.3%，特异度为84.8%。
中文版pVHI是评估家长对其孩子嗓音障碍认知的可靠且有效的工具。建议将其用作区分有声带发音困难和无声带发音困难儿童的筛查工具。
