Speech handicap index in patients with oral and pharyngeal cancer: Better understanding of patients' complaints

Background. A Speech Handicap Index (SHI) questionnaire with 30 items on speech problems was developed and validated in 92 patients with cancer of the oral cavity or pharynx and 110 healthy subjects. Methods. All subjects completed the SHI and the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Head & Neck module (QLQ-H&N35). Twenty-nine patients completed the SHI twice to assess test-retest reliability. Results. Factor analysis identified 2 well-defined subscales, assessing speech function and psychosocial functioning related to speech. Internal consistency and test-retest reliability were high. Construct validity was evidenced by its ability to distinguish between patient subgroups formed on the basis of tumor grade. A cut-off score of 6 points was defined to identify patients with speech problems. Conclusions. Results of this initial psychometric study indicate that the SHI is a reliable and valid questionnaire for assessing speech problems. Additional research is needed to evaluate responsiveness of the questionnaire to changes in speech-related problems over time. (c) 2008 Wiley Periodicals, Inc.