Benninger M S, Ahuja A S, Gardner G, Grywalski C
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, Michigan 48202, USA.
J Voice. 1998 Dec;12(4):540-50. doi: 10.1016/s0892-1997(98)80063-5.
This study was designed to evaluate a disease-specific outcome measure for patients with selected voice disorders and to relate this instrument to a standardized quality of life measurement. In addition, the study attempts to document the degree of handicap for dysphonia patients globally, between different vocal pathologies, and in comparison to other chronic diseases. In this prospective, observational study, 260 adult patients evaluated for alterations of voice completed a general quality of life measure (the Medical Outcomes Trust Short Form 36-Item[SF-36]) and a voice-specific instrument (Voice Handicap Index [VHI]) pretreatment. The highest correlation was between the social functioning score of the SF-36 and the total score of the VHI and the physical, emotional, and functional subscales (p < 0.001) of the VHI. Significant correlation was also obtained for the SF-36 domains mental health (p < 0.01), general health (p < 0.01), and role functioning emotional (p < 0.017) with the three VHI domains and the total VHI score. Patients had significantly lower scores than the general U.S. population in five of the eight domains of SF-36. Patients with vocal fold paralysis had the highest level of pretreatment disability as measured on both the VHI and SF-36 among voice patients. The patients with dysphonia had a lower level of physical functioning than the patients with chronic sinusitis (p < 0.01), reflecting a greater handicap. In addition, the dysphonia group had lower levels of social functioning than the angina (p < 0.01) and sciatica (p < 0.01) groups and a lower score for mental health than the angina group (p < 0.01). The SF-36 correlates with the VHI in the domains of social functioning, mental health, and role functioning emotional. The baseline handicap for voice disorders represents a significant disability even in comparison to conditions such as angina pectoris, sciatica, and chronic sinusitis.
本研究旨在评估针对特定嗓音障碍患者的疾病特异性结局指标，并将该工具与标准化的生活质量测量方法相关联。此外，该研究试图记录嗓音障碍患者在全球范围内、不同嗓音病理学之间以及与其他慢性疾病相比的残疾程度。在这项前瞻性观察研究中，260名接受嗓音改变评估的成年患者在治疗前完成了一项一般生活质量测量（医学结局信托简短形式36项问卷[SF - 36]）和一项嗓音特异性工具（嗓音障碍指数[VHI]）。SF - 36的社会功能得分与VHI的总分以及VHI的身体、情感和功能子量表之间的相关性最高（p < 0.001）。SF - 36的心理健康（p < 0.01）、总体健康（p < 0.01）和角色功能情感（p < 0.017）领域与VHI的三个领域及VHI总分也存在显著相关性。在SF - 36的八个领域中，患者在其中五个领域的得分显著低于美国普通人群。在嗓音患者中，声带麻痹患者在VHI和SF - 36上测量的治疗前残疾水平最高。嗓音障碍患者的身体功能水平低于慢性鼻窦炎患者（p < 0.01），这反映出更大的残疾程度。此外，嗓音障碍组的社会功能水平低于心绞痛组（p < 0.01）和坐骨神经痛组（p < 0.01），心理健康得分低于心绞痛组（p < 0.01）。SF - 36在社会功能、心理健康和角色功能情感领域与VHI相关。嗓音障碍的基线残疾即使与心绞痛、坐骨神经痛和慢性鼻窦炎等疾病相比也代表着显著的残疾。
