Reliability and Validity of the Arabic Version of the Voice Fatigue Handicap Questionnaire

This study aimed to translate and culturally adapt the Voice Fatigue Handicap Questionnaire (VFHQ) into Arabic and validate its reliability.

This cross-sectional study involved 130 participants: 65 patients with dysphonia and 65 controls, conducted at a tertiary university hospital over 12 months. The VFHQ was translated into Arabic based on the ISPOR Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes. Reliability was assessed using Cronbach's alpha and test-retest intraclass correlation coefficients (ICCs), while construct validity was evaluated by comparing scores between patients with dysphonia and healthy controls.

The total Arabic Voice Fatigue Handicap Questionnaire (A-VFHQ) score showed excellent internal consistency, with a Cronbach's alpha of 0.932. Item-deletion analyses showed that alpha remained high when each item was removed individually (0.926-0.932). The reliability of all subscales ranged from 0.792 to 0.919. The scores for the 30 items, three subscales (functional, emotional, and physical), and total A-VFHQ score did not differ significantly between the test and retest (P > 0.05). The intraclass correlation coefficients were strong for the functional (0.763), emotional (0.819), and physical (0.939) subscales, as well as for the total A-VFHQ score (0.893). Finally, the scores for all 30 items, the three subscales, and the total A-VFHQ were significantly higher among the patients than the controls (P < 0.001).

The A-VFHQ demonstrated excellent internal consistency, high test-retest reliability, and strong construct validity within the present sample. These findings support its use as a promising instrument for assessing voice fatigue among Arabic-speaking individuals.