Marzouki Hani Z, Al Taylouni Nada E, Tonkal Albaraa, Amer Ibrahim, Halawani Lamis K, Khoja Manal, Merdad Mazin
Otolaryngology - Head and Neck Surgery, King Abdulaziz University Hospital, Jeddah, SAU.
Medicine, King Abdulaziz University Hospital, Jeddah, SAU.
Cureus. 2022 Aug 2;14(8):e27609. doi: 10.7759/cureus.27609. eCollection 2022 Aug.
Background Voice and swallowing disorders can create a profound psychosocial impact on the patient's quality of life. The focus of this study is to assess the psychosocial disabling effects on patients after total laryngectomy (TLP) using pre-validated surveys called the Voice Handicap Index 10 (VHI) for voice disorders and the Dysphagia Handicap Index (DHI) for swallowing disorders. Methodology This is a retrospective cohort study that was done on a total of 21 patients. The study was conducted at King Abdulaziz University Hospital between 2017 and 2022. The Cronbach's alpha value was used to evaluate internal consistency reliability. The relationship between DHI, VHI, and demographic and clinical variables was analyzed by correlation analysis. A p-value of <0.05 was considered statistically significant, and all the tests were two-sided. Results The Cronbach's alpha coefficient satisfied the internal consistency reliability for VHI and DHI for both total and their subscale scores. For DHI, the total score and emotional subscale obtained an alpha of greater than 0.9, indicating excellent internal consistency, whereas both physical and functional alpha scores indicated good internal consistency (α = 0.888 and α = 0.863, respectively). For VHI, the total score and physical subscale of the VHI had excellent internal consistency (α = 0.957 and α = 0.937, respectively), while the functional and emotional subscales had good internal consistency (α = 0.865 and α = 0.894, respectively). The total DHI scores, as well as the functional subscale scores, were significant (p = 0.033, p = 0.025, respectively) in terms of self-reported dysphagia severity. A moderately severe group (69.00 ± 19.17) had higher mean total scores, whereas severe individuals had higher subscale mean scores according to self-reported dysphagia severity. Self-reported dysphagia severity was as follows: normal (n = 3, 14.3%), mild (n = 4, 19%), moderate (n = 8, 38.1%), and severe (n = 6, 28.6%). Conclusions The disability caused by voice and swallowing disorders can be evaluated by VHI and DHI which have been statistically validated as reliable tools to assess the effects of dysphagia and dysphonia on quality of life. Patients after laryngectomy have higher mean DHI and VHI overall and functional subscale scores. However, this study failed to establish any relationship between clinical and demographical characteristics of the patients with DHI and VHI index.
嗓音和吞咽障碍会对患者的生活质量产生深远的心理社会影响。本研究的重点是使用预先验证的调查问卷，即用于嗓音障碍的嗓音障碍指数10（VHI）和用于吞咽障碍的吞咽障碍指数（DHI），评估全喉切除术（TLP）后对患者的心理社会致残影响。
这是一项对总共21名患者进行的回顾性队列研究。该研究于2017年至2022年在阿卜杜勒阿齐兹国王大学医院进行。使用克朗巴哈系数（Cronbach's alpha）评估内部一致性可靠性。通过相关分析分析DHI、VHI与人口统计学和临床变量之间的关系。p值<0.05被认为具有统计学意义，所有测试均为双侧。
克朗巴哈系数（Cronbach's alpha）系数满足VHI和DHI总分及其子量表分数的内部一致性可靠性。对于DHI，总分和情感子量表的alpha值大于0.9，表明内部一致性极佳，而身体和功能alpha分数均表明内部一致性良好（分别为α = 0.888和α = 0.863）。对于VHI，总分和身体子量表具有极佳的内部一致性（分别为α = 0.957和α = 0.937），而功能和情感子量表具有良好的内部一致性（分别为α = 0.865和α = 0.894）。就自我报告的吞咽困难严重程度而言，DHI总分以及功能子量表分数具有统计学意义（分别为p = 0.033，p = 0.025）。根据自我报告的吞咽困难严重程度，中度严重组（69.00 ± 19.17）的平均总分较高，而严重个体的子量表平均分数较高。自我报告的吞咽困难严重程度如下：正常（n = 3，14.3%）、轻度（n = 4，19%）、中度（n = 8，38.1%）和重度（n = 6，28.6%）。
嗓音和吞咽障碍导致的残疾可以通过VHI和DHI进行评估，这两种工具已在统计学上被验证为评估吞咽困难和发音障碍对生活质量影响的可靠工具。喉切除术后患者的DHI和VHI总体及功能子量表平均分数较高。然而，本研究未能在患者的临床和人口统计学特征与DHI和VHI指数之间建立任何关系。
