Translation, Validity, and Reliability of the Persian Version of the Aging Voice Index.

OBJECTIVES: The Aging Voice Index (AVI) was developed to study quality of life in older adults with voice disorders. The purpose of this study was to translate the original English version of the AVI to Persian version of Aging Voice Index (P-AVI) and validate the P-AVI for the Persian-speaking older adults with voice disorders. METHODS: A cross-sectional, descriptive, and methodological study was performed to translate and validate the Persian version of the AVI. The translation was performed in accordance with recommendations from the World Health Organization. Eighty-five treatment-seeking patients with voice disorders and 20 older adults without voice complaints were recruited for this study. Psychometric properties were investigated, including: different types of validity (content validity, construct validity, and criterion-related validity), reliability (test-retest and internal consistency), and item analysis of the Persian version of AVI. The relationship between total score of P-AVI and age, sex, and voice pathology were determined using multiple linear regression. RESULTS: A panel of three speech pathologists performed the content validity of the P-AVI and reached agreement on all of the items. Construct validity was confirmed by a significant difference in the mean of total score of the P-AVI was identified between the particiapnts with voice disorders and those with no voice complaints (P < 0.001). There was high correlation between the total scores of the participants in the Persian version of the AVI and the Persian version of the voice-related quality of life (r = 0.86, P < 0.001). All reliability measures were found to be good with scores higher than 0.8. To assess the need for item reduction, a Cronbach's alpha coefficient remained constant with the elimination of each item; therefore, all no items were removed. Age and voice pathology were not predictive for the total P-AVI score, but a weak effect was identified for sex and the total score of P-AVI (F = 18.75, P < 0.001) with an R2 of 0.21. CONCLUSIONS: The Persian version of AVI is a valid and reliable questionnaire designed specifically for older adults that speech-language pathologists and otolaryngologists can use to objectively assess the impact of voice disorders in aging Persian-speaking patients.

Voice Component Relationships with High Reflux Symptom Index Scores in Muscle Tension Dysphonia.

OBJECTIVE: To analyze the Reflux Symptom Index (RSI) and the Voice-Related Quality of Life (V-RQOL) scores based on the perceptual and analytical parameters in primary MTD patients with no reflux. STUDY DESIGN: Cross-sectional study. METHODS: One hundred and eighteen participants, that is, sixty patients with normal voices and fifty-eight patients with primary MTD were recruited in this study. The diagnosis of primary MTD was made by perceptual voice analysis, neck palpation, video-laryngoscopic examination, and exclusion of other etiologies. Acoustic analysis and the GRBAS (Grade, Roughness, Breathiness, Asthenia, and Strain) scale were evaluated for all participants. The V-RQOL and RSI questionnaires were then given to all participants. RESULTS: This study included 118 participants of 29 males (48.3%) and 31 females (51.7%) in the normal group. MTD group also included 27 males (46.6%) and 31 (53.4%) female patients. Mean (SD) RSI and V-RQOL scores were 12.35 (3.84) and 11.09 (2.20) for the normal group, and 22.87 (6.97) and 22.89 (7.94) for the MTD group (P = .000). In the MTD group, V-RQOL had a positive correlation with jitter for /i/ and /u/, Noise to Harmonic Ratio (NHR) for /i/, /a/, and /u/, and Grade, Roughness, and Strain of GRBAS scale (P < .05). In addition, RSI had a positive correlation with Strain in the MTD group (P < .05). CONCLUSION: MTD patients in the absence of laryngopharyngeal reflux findings may have high RSI scores. Hence, patients with high RSI scores and disproportionate acoustic and perceptual analysis would require a thorough evaluation of MTD. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E1573-E1579, 2021.

Translation and Validation of the Voice Catastrophization Index for Persian-Speaking Patients with Dysphonia.

PURPOSE: Catastrophization refers to the cognitive distortion that is experienced by patients with several diseases who suffer from pain. There is some evidence that catastrophization may be found in patients with voice disorders. The Voice Catastrophization Index (VCI) was developed in English to measure catastrophization in patients with dysphonia. The goal of this research was to translate and validate the Persian version of the VCI (P-VCI) for use with Persian-speaking people in Iran and elsewhere. METHODS: This was a prospective and cross-sectional study. First, the questionnaire was translated, then its various psychometric properties were investigated. RESULTS: There was a significant difference in mean P-VCI score between participants with and without dysphonia (p < 0.001). Test-retest reliability for the total score of P-VCI was excellent (ICC = 0.94, p < 0.001), as was its internal consistency, as determined by Cronbach's alpha coefficient (α = 0.956). Confirmatory factor analysis revealed that some of the indices show a good fit for the 3-subscale model. There was a moderate correlation in criterion-related validity between the P-VCI and Voice Activity Participation Profile - Persian version (r = 0.644, p < 0.001). CONCLUSIONS: The translated test exhibited satisfactory psychometric properties. The P-VCI is a valid and reliable tool for the assessment of catastrophization in persons with voice disorders.

Cross-cultural Adaptation and Validation of the Persian Version of Voice Disability Coping Questionnaire (P-VDCQ): Introducing a New Instrument.

OBJECTIVES: Coping is one of the important concepts in psychology, which is pertinent to how persons with illness manage the stress of that condition. Voice Disability Coping Questionnaire (VDCQ) is an assessment tool for quantifying coping strategies in those with voice disability. The purpose of the present study was to investigate reliability and validity of the Persian version of VDCQ (P-VDCQ). METHOD: Translation procedure was performed according to the World Health Organization guidelines, and then 138 persons (88 persons with voice disorders and 50 controls) completed the questionnaire. Psychometric properties of the P-VDCQ were investigated. RESULTS: There was a significant difference between the mean value of patients with dysphonia and that of the control group. The results of test-result reliability indicated that there is a high correlation between repeated administration of the questionnaire (intraclass correlation coefficient = 89.7). Also, a high Cronbach's alpha coefficient (α = 0.94) revealed a good internal consistency. Participants' scores in this instrument had a moderate correlation with their scores on Voice Activity Participation Profile-Persian version (r = 0.41, P < 0.001). CONCLUSION: The P-VDCQ is a reliable and a valid instrument that can be used to investigate coping strategies of patients with dysphonia in clinical settings and for research purposes.

How Do Voice Perceptual Changes Predict Acoustic Parameters in Persian Voice Patients?

INTRODUCTION: Perceptual and acoustic analyses are essential tools that help voice therapists comprehensively assess voice quality. While perceptual evaluations are subjective and are influenced by external and culturally driven factors, acoustic analysis is an objective and reliable means of evaluating voice. The goals of this study were (1) to determine which acoustic parameters were predicted by perceptual voice quality and (2) to assess the effect of a short period of training on the reliability of perceptual voice analyses for Persian speakers. METHOD: This was a cross-sectional study. Subjects were 20 patients with various voice disorders. Voice samples were obtained during text reading and /a/ prolongation. Fifteen expert voice clinicians completed perceptual evaluations on voice samples using the Grade, Roughness, Breathiness, Asthenia, and Strain scale. We repeated this process after a short period of perceptual voice evaluation training. Acoustic analysis was completed using the Praat program. We used the intraclass correlation coefficient (ICC) for reliability measurement of the perceptual evaluation results and ordinal regression procedures to analyze all data. Significance level was set at P < 0.05. RESULTS: Both intrarater and interrater reliability increased after training, for all five parameters. The ICC for grade increased to 0.95 after training. Grade and roughness significantly predicted fundamental frequency (F0) (P = 0.021 and P = 0.030, respectively) and harmonic-to-noise ratio (HNR) (P = 0.019 and P = 0.016, respectively). Breathiness significantly predicted shimmer (P = 0.013). CONCLUSION: Training had a positive effect and increased the reliability of perceptual voice evaluation. For Persian listeners, changes in F0, increases in HNR, and shimmer were perceptually associated with poor voice quality.