Development of Short-Form of the Speech Handicap Index and Its Application to Tongue Cancer Patients

Abstract

Objectives: The Speech Handicap Index (SHI) is one of the self-report assessments and questionnaires to assess speech problem of patients with oral or oropharyngeal cancer. Although SHI is a reliable and valid questionnaire for assessing the speech problem, it is a time-consuming test with 30 items. Therefore, the current study developed a short-form of the SHI and evaluated its reliability and validity in tongue cancer patients. Methods: The study was comprised of two steps. For Step I, the SHI with 30 items was administered to 56 participants with tongue cancer and we performed Rasch analysis to select items. Then, two experts agreed upon 15 items which would best manifest degrees of quality of life in patients with various speech disorders (not limited to cancer patients). The resulting SHI-15 was comprised of 8 items of the speech function subdomain and 7 items of the psychosocial subdomain. In Step II of the study, both the SHI-30 (30-item full version) and SHI-15 were administered to 35 patients with tongue cancer and 35 healthy individuals to evaluate the reliability and validity of the SHI-15. Results: The SHI-15 had high internal consistency and test-retest reliability. With the high correlation between the SHI-30 and the SHI-15, SHI-15 demonstrated itself to be a viable alternative tool to the SHI-30. In addition, the SHI-15 was proven to have high sensitivity and specificity in differentiating between the patient and healthy groups. Conclusion: This study is significant in that it shows the time-efficient SHI-15 can be a useful tool for evaluating a patient’s self-perception of his or her speech, psychosocial function, and degree of speech problems. The SHI-15 can be utilized in a routine evaluation protocol in a clinical setting to maximize patients’ quality of life related to speech problems.