Development and Validation of the Voice Fatigue Handicap Questionnaire (VFHQ): Clinical, Psychometric, and Psychosocial Facets

Abstract

Development and validation of the vocal fatigue handicap questionnaire (VFHQ), a self-administered brief instrument for the assessment of functional, emotional, and physical vocal fatigue (VF). "Outcomes research" with item generation, item reduction, and psychometric evaluation of instrument's key properties involving different subsamples of patients in content generation and item-selection pilot testing, followed by a main validation study. Questionnaire content generation and item reduction by selection of 30 items from an initial pool of 60 during pilot testing, followed by psychometric assessment of VFHQ's internal consistency, test-retest reliability, construct validity, criterion validity, and clinical efficacy in a main validation study with 87 patients with voice disorders. Internal consistency was evaluated by means of Cronbach-alpha coefficients; construct and criterion validity through multiple regression analyses; test-retest reliability by administering 35 questionnaires to pathologic respondents after a 15days' time-interval from first questionnaire administration; clinical efficacy, (ie, instrument's usefulness and responsiveness) by administering 20 questionnaires to patients with voice disorders before and after clinical intervention. Statistical analyses established VFHQ's high internal consistency, reliability, construct, and criterion validity, as well as efficacy, and usefulness in therapeutic practice for the assessment of clinical and psychosocial consequences of VF (spoken voice). VFHQ is a useful tool for the assessment of VF, which is able to quantify its functional, emotional, and physical components.