title: The Vanderbilt Head and Neck Symptom Survey Brazilian Portuguese version 2.0 (VHNSS 2.0): psychometric properties for patients with head and neck cancer who have undergone radiotherapy.
abstract: BACKGROUND
  Patients who undergo radiotherapy to treat head and neck cancer can present with several symptoms, including oral ones. The symptoms are usually assessed using instruments to evaluate quality of life. However, these instruments do not really assess oral health outcomes and their functional implications. The VHNSS 2.0 instrument was developed to be used with head and neck cancer patients, and has recently been translated and culturally adapted to be used in Brazil. The purpose of the study was to evaluate the psychometric properties of the VHNSS 2.0 Brazilian Portuguese version.
  
  
  METHODS
  Three assessment instruments, the Brazilian Portuguese versions of EORTC QLQ-C30, EORTC H&N 35 and VHNSS 2.0, were answered by 241 head and neck cancer patients, of whom 47 were submitted to the test retest in 5-16 days. The construct validity was assessed through convergent validation (assuming correlations between VHNSS 2.0 and EORTC), and known group analysis (radiotherapy time, site of tumor, staging and surgery). Reliability was evaluated by means of Cronbach's alpha and test retest using the intraclass correlation coefficient.
  
  
  RESULTS
  241 head and neck cancer patients, median age 58.8, were included in this study. Hypothesized correlations were confirmed, the comparison among the groups showed differences in most of the domains. Reliability for the domains of swallowing solids, dry mouth, mouth pain, mucus, voice, pain and taste/smell presented Cronbach's alpha values from 0.858 to 0.735 and for the domains of nutrition, swallowing liquids and teeth, 0.618, 0.620 and 0.670 respectively. The test-retest reliability, for the domains of the VHNSS 2.0, measured using intraclass correlation coefficient, ranged from 0.372 to 0.854.
  
  
  CONCLUSIONS
  The VHNSS 2.0 Brazilian Portuguese version presented good results for the convergent validation and known-group analyses. It also showed reliability for the Cronbach´s alpha and test retest for most domains.
authors.affiliation: Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Stricto Sensu Graduate Program in Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. embarroso@uol.com.br.|Fundação Pio XII, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. embarroso@uol.com.br.|Research and Teaching Institute, 1331, Antenor Duarte Vilella Street, Dr. Paulo Prata, Barretos, São Paulo, 14784-400, Brazil. embarroso@uol.com.br.
authors.forename: Eliane Marçon
authors.initials: EM
authors.lastname: Barroso
authors.affiliation: Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Stricto Sensu Graduate Program in Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. alopescarvalho@uol.com.br.|Head and Neck Department, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. alopescarvalho@uol.com.br.|Fundação Pio XII, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. alopescarvalho@uol.com.br.|Research and Teaching Institute, 1331, Antenor Duarte Vilella Street, Dr. Paulo Prata, Barretos, São Paulo, 14784-400, Brazil. alopescarvalho@uol.com.br.
authors.forename: André Lopes
authors.initials: AL
authors.lastname: Carvalho
authors.affiliation: Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Stricto Sensu Graduate Program in Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. caredupai@gmail.com.|Department of Clinical Oncology, Breast and Gynecology Division, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. caredupai@gmail.com.|Fundação Pio XII, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. caredupai@gmail.com.|Research and Teaching Institute, 1331, Antenor Duarte Vilella Street, Dr. Paulo Prata, Barretos, São Paulo, 14784-400, Brazil. caredupai@gmail.com.
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Paiva
authors.affiliation: Department of Medicine, Vanderbilt University Medical Center, Nashville, USA. barbara.murphy@vanderbilt.edu.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Murphy
authors.affiliation: Research Group on Palliative Care and Health-Related Quality of Life (GPQual), Stricto Sensu Graduate Program in Oncology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. bsrpaiva@gmail.com.|Fundação Pio XII, Barretos Cancer Hospital, Barretos, São Paulo, Brazil. bsrpaiva@gmail.com.|Research and Teaching Institute, 1331, Antenor Duarte Vilella Street, Dr. Paulo Prata, Barretos, São Paulo, 14784-400, Brazil. bsrpaiva@gmail.com.
authors.forename: Bianca Sakamoto Ribeiro
authors.initials: BS
authors.lastname: Paiva
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D003710:Demography; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires