Validation and Reliability of the Italian Version of the Speech Handicap Index

Abstract

Background: Speech problems negatively affect the quality of life of patients with oral and oropharyngeal cancer. An appropriate self-rating questionnaire named Speech Handicap Index (SHI) was developed for these individuals. The aim of this study was the cross-cultural adaptation and the validation of the Italian version of the SHI. Methods: Fifty-two patients surgically treated for oral or oropharyngeal cancer and 100 healthy individuals without speech articulation disorders were included in the study. An Italian version of the SHI was cross-culturally adapted. Internal consistency, test-retest reliability, construct, and clinical and group validity were calculated. Results: Cronbach’s alpha coefficient was 0.977. The test-retest reliability was excellent (r between 0.883 and 0.998). There was a good correlation between the total SHI score and the overall speech quality item (p < 0.001), and between the former and speech intelligibility and articulation scales (p < 0.001). The SHI was able to distinguish between patients and healthy subjects (p < 0.001). There was a statistically significant correlation between the total SHI score and tumor stage (p = 0.003). Conclusions: The Italian version of the SHI showed high values of reliability and validity scores. It is a good instrument to evaluate the impact of speech impairment in patients with oral and oropharyngeal cancer.