Objectives: 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.
Materials and 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
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.
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.