The relationship between health-related quality of life and speech in patients with cleft palate

Laura Bruneel; Kim Bettens; Kristiane Van Lierde

doi:10.1016/j.ijporl.2019.02.018

The relationship between health-related quality of life and speech in patients with cleft palate

Int J Pediatr Otorhinolaryngol. 2019 May:120:112-117. doi: 10.1016/j.ijporl.2019.02.018. Epub 2019 Feb 8.

Authors

Laura Bruneel¹, Kim Bettens², Kristiane Van Lierde³

Affiliations

¹ Ghent University, Department of Rehabilitation Sciences, Speech-language Pathology/Audiology, Research Group, Ghent, Belgium. Electronic address: laubrune.bruneel@ugent.be.
² Ghent University, Department of Rehabilitation Sciences, Speech-language Pathology/Audiology, Research Group, Ghent, Belgium.
³ Ghent University, Department of Rehabilitation Sciences, Speech-language Pathology/Audiology, Research Group, Ghent, Belgium; University of Pretoria, Faculty of Humanities, Department of Speech-Language Pathology and Audiology, Pretoria, South Africa.

PMID: 30776568
DOI: 10.1016/j.ijporl.2019.02.018

Abstract

Introduction: In health-care, current efforts focus on providing patient-centered care. Specifically for patients with velopharyngeal insufficiency, and by extent patients with cleft palate, the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) questionnaire (Skirko et al., 2012; 2013) allows the clinician to map the impact of speech and swallowing difficulties on the patient's health-related quality of life (HRQoL). The current study evaluated the hypothesized association between this speech-related HRQoL measure and perceptually and instrumentally assessed speech variables, to provide evidence for the construct validity of the Dutch version of the VELO questionnaire.

Materials and methods: Thirty participants, twenty-five patients with cleft palate and five controls, were enrolled. Perceptual speech assessment was conducted following the recently developed Belgian Dutch outcome tool for perceptual speech assessment in patients with cleft palate. In addition, nasalance values and the Nasality Severity Index (NSI) 2.0 were determined. The relationship between these speech outcomes and the scores on the VELO parent report was determined using Spearman rank-order correlation coefficients.

Results: Moderate to strong correlations were found between the total score on the VELO parent report and five speech variables: the VPC-SUM score (r_s = -0.476), speech understandability (r_s = -0.657), passive CSC's (r_s = -0.654), speech acceptability (r_s = -0.591) and the need for C(L)P-related speech therapy (r_s = -0.711). Furthermore, these variables were associated with at least one subscale of the VELO questionnaire.

Discussion and conclusion: Correlations between speech outcomes and the Dutch version of the VELO questionnaire provide evidence for the construct validity of this version of the instrument. Furthermore, insights in these associations may lead the way to efficient therapy approaches, targeting speech features with the greatest impact on the patient's health-related quality of life.

Keywords: Cleft palate; Health-related quality of life; Speech.

MeSH terms

Belgium
Child
Child, Preschool
Cleft Palate / complications
Cleft Palate / physiopathology*
Female
Humans
Male
Quality of Life*
Reproducibility of Results
Severity of Illness Index
Speech / physiology*
Speech Disorders / complications
Speech Disorders / diagnosis*
Speech Disorders / therapy
Speech Therapy / methods
Surveys and Questionnaires / statistics & numerical data
Velopharyngeal Insufficiency / diagnosis