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Chan, Roger W; Lee, Yung Hsi; Liao, Chia-En; Jen, Jung Hsuan; Wu, Chia-Hsin; Lin, Feng-Chuan; Wang, Chi-Te
Journal of speech, language, and hearing research, 08/2022, Volume: 65, Issue: 8Journal Article
Purpose: This study attempted to develop and to preliminarily validate the Mandarin Chinese version of the Vocal Fatigue Index (VFI) as a standardized self-assessment questionnaire tool for potential clinical applications. Method: The experimental procedure involved (a) cross-cultural adaptation of the VFI into the Mandarin Chinese version (CVFI), (b) evaluation by an expert panel, (c) back translation, (d) pilot testing, and (e) validation of the questionnaire by three participant groups: 50 with voice disorders, 50 occupational voice users (at-risk group), and 50 with normal voice (control group). Internal consistency, test--retest reliability, content validity, and convergent validity of the CVFI were examined, and discriminatory ability (diagnostic accuracy) for distinguishing between the groups was evaluated. Results: Results showed high internal consistency (Cronbach's alpha greater than or equal to 0.8817 for the total CVFI scores for all groups), high test-retest reliability (intraclass correlation coefficients greater than or equal to 0.9072, p < 0.001 for the total CVFI scores for all groups), high content validity (total content validity index = 0.9368), and high convergent validity (Pearson r greater than or equal to 0.8155, p < 0.001 between the total CVFI scores and Factors 1 and 2 scores). Significant differences between the three groups were found in all scores. Receiver operating characteristic analysis revealed a high diagnostic accuracy for distinguishing between the disorders group and the normal group (area under the curve greater than or equal to 0.927, p < 0.001 for the total CVFI scores and Factors 1 and 2 scores), with cutoff scores of greater than or equal to 36 (total CVFI score), greater than or equal to 23.5 (Factor 1 score), greater than or equal to 7.5 (Factor 2 score), and greater than or equal to 6.5 (Factor 3 score). Conclusions: These findings suggested that the CVFI could be a reliable and valid self-assessment tool for the clinical evaluation of vocal fatigue in Mandarin Chinese-speaking populations. A full-scale validation study of the CVFI is recommended to verify these results.
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