Bruneel Laura, Bettens Kim, Van Lierde Kristiane
Ghent University, Department of Rehabilitation Sciences, Speech-language Pathology/Audiology, Research Group, Ghent, Belgium.
Ghent University, Department of Rehabilitation Sciences, Speech-language Pathology/Audiology, Research Group, Ghent, Belgium.
Int J Pediatr Otorhinolaryngol. 2019 May;120:112-117. doi: 10.1016/j.ijporl.2019.02.018. Epub 2019 Feb 8.
In health-care, current efforts focus on providing patient-centered care. Specifically for patients with velopharyngeal insufficiency, and by extent patients with cleft palate, the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) questionnaire (Skirko et al., 2012; 2013) allows the clinician to map the impact of speech and swallowing difficulties on the patient's health-related quality of life (HRQoL). The current study evaluated the hypothesized association between this speech-related HRQoL measure and perceptually and instrumentally assessed speech variables, to provide evidence for the construct validity of the Dutch version of the VELO questionnaire.
Thirty participants, twenty-five patients with cleft palate and five controls, were enrolled. Perceptual speech assessment was conducted following the recently developed Belgian Dutch outcome tool for perceptual speech assessment in patients with cleft palate. In addition, nasalance values and the Nasality Severity Index (NSI) 2.0 were determined. The relationship between these speech outcomes and the scores on the VELO parent report was determined using Spearman rank-order correlation coefficients.
Moderate to strong correlations were found between the total score on the VELO parent report and five speech variables: the VPC-SUM score (r = -0.476), speech understandability (r = -0.657), passive CSC's (r = -0.654), speech acceptability (r = -0.591) and the need for C(L)P-related speech therapy (r = -0.711). Furthermore, these variables were associated with at least one subscale of the VELO questionnaire.
Correlations between speech outcomes and the Dutch version of the VELO questionnaire provide evidence for the construct validity of this version of the instrument. Furthermore, insights in these associations may lead the way to efficient therapy approaches, targeting speech features with the greatest impact on the patient's health-related quality of life.
在医疗保健领域，当前的努力集中在提供以患者为中心的护理。特别是对于腭咽闭合不全患者，以及在一定程度上对于腭裂患者，腭咽闭合不全对生活结局的影响（VELO）问卷（斯基尔科等人，2012年；2013年）使临床医生能够描绘出言语和吞咽困难对患者健康相关生活质量（HRQoL）的影响。本研究评估了这种与言语相关的HRQoL测量与通过感知和仪器评估的言语变量之间的假设关联，为VELO问卷荷兰语版本的结构效度提供证据。
招募了30名参与者，其中25名腭裂患者和5名对照者。按照最近开发的比利时荷兰语腭裂患者感知言语评估结果工具进行感知言语评估。此外，还测定了鼻化率值和鼻化严重程度指数（NSI）2.0。使用斯皮尔曼等级相关系数确定这些言语结果与VELO家长报告得分之间的关系。
在VELO家长报告的总分与五个言语变量之间发现了中度到强的相关性：VPC-SUM得分（r = -0.476）、言语可懂度（r = -0.657）、被动CSC（r = -0.654）、言语可接受性（r = -0.591）以及对C（L）P相关言语治疗的需求（r = -0.711）。此外，这些变量与VELO问卷的至少一个子量表相关。
言语结果与VELO问卷荷兰语版本之间的相关性为该版本工具的结构效度提供了证据。此外，对这些关联的深入了解可能会为有效的治疗方法指明方向，针对对患者健康相关生活质量影响最大的言语特征。
