title: Patient-reported symptom questionnaires in laryngeal cancer: voice, speech and swallowing.
abstract: OBJECTIVE
  To validate questionnaires on voice, speech, and swallowing among laryngeal cancer patients, to assess the need for and use of rehabilitation services, and to determine the association between voice, speech, and swallowing problems, and quality of life and distress.
  
  
  METHODS
  Laryngeal cancer patients at least three months post-treatment completed the VHI (voice), SHI (speech), SWAL-QOL (swallowing), EORTC QLQ-C30, QLQ-HN35, HADS, and study-specific questions on rehabilitation.
  
  
  RESULTS
  Eighty-eight patients and 110 healthy controls participated. Cut off scores of 15, 6, and 14 were defined for the VHI, SHI, and SWAL-QOL (sensitivity > 90%; specificity > 80%). Based on these scores, 56% of the patients reported voice, 63% speech, and 54% swallowing problems. VHI, SHI, and SWAL-QOL scores were associated significantly with quality of life (EORTC QLQ-C30 global quality of life scale) (r = .43 (VHI and SHI) and r = .46 (SWAL-QOL)) and distress (r = .50 (VHI and SHI) and r = .58 (SWAL-QOL)). In retrospect, 32% of the patients indicated the need for rehabilitation at time of treatment, and 81% of these patients availed themselves of such services. Post-treatment, 8% of the patients expressed a need for rehabilitation, and 20% of these patients actually made use of such services.
  
  
  CONCLUSIONS
  Psychometric characteristics of the VHI, SHI, and SWAL-QOL in laryngeal cancer patients are good. The prevalence of voice, speech, and swallowing problems is high, and clearly related to quality of life and distress. Although higher during than after treatment, the perceived need for and use of rehabilitation services is limited.
authors: VU University Medical Center, Dept of Otolaryngology - Head and Neck Surgery, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
authors: R N P M
authors: RN
authors: Rinkel
authors: VU University Medical Center, Dept of Otolaryngology - Head and Neck Surgery, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: im.verdonck@vumc.nl.
authors: I M
authors: IM
authors: Verdonck-de Leeuw
authors: VU University Medical Center, Dept of Otolaryngology - Head and Neck Surgery, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
authors: N
authors: N
authors: van den Brakel
authors: VU University Medical Center, Dept of Otolaryngology - Head and Neck Surgery, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
authors: R
authors: R
authors: de Bree
authors: VU University Medical Center, Dept of Otolaryngology - Head and Neck Surgery, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
authors: S E J
authors: SE
authors: Eerenstein
authors: VU University Medical Center, Dept of Otolaryngology - Head and Neck Surgery, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
authors: N
authors: N
authors: Aaronson
authors: VU University Medical Center, Dept of Otolaryngology - Head and Neck Surgery, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
authors: C R
authors: CR
authors: Leemans
mesh_terms: D000368:Aged; D003679:Deglutition; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000503:physiopathology*; D008297:Male; D011594:Psychometrics; D013060:Speech; D011795:Surveys and Questionnaires; D014831:Voice
keywords: Head and neck cancer; Laryngeal cancer; Quality of life; Speech; Swallowing; Voice