Cross-cultural adaptation, validation, and cutoff point of the Italian version of the voice activity and participation profile: Profilo di Attività e Partecipazione Vocale

Abstract

Objectives/hypothesis: The purpose of the study was to investigate the validity of the Profilo di Attività e Partecipazione Vocale (PAPV) and to identify the cutoff point of the total score that discriminates dysphonic from vocally healthy individuals.

Study design: Cross-sectional, nonrandomized, prospective study with controls.

Methods: The PAPV was administered to 239 individuals, 108 with vocal complaint, 131 without vocal complaint, 141 female, 98 male, mean age of 45.8 years. The instrument was submitted to validity, reliability, reproducibility, and responsiveness.

Results: Construct-related validity was evaluated by comparing the scores of the groups with and without voice problem (Job: P < 0.001, self-perceived severity: P < 0.001, daily communication: P < 0.001, social communication: P < 0.001, emotion: P < 0.001, total: P < 0.001). The evaluation of criterion-related validity showed moderate-strong correlation coefficients between the PAPV, Voice Handicap Index, and vocal self-assessment. High alpha coefficients showed good internal consistency (job: 0.910, daily communication: 0.981, social communication: 0.981, emotion: 0.948, total: 0.989). High intraclass correlation coefficient showed good reproducibility (Job: 0.967, self-perceived severity: 0.979, daily communication: 0.990, social communication: 0.950, emotion: 0.976, total: 0.993). Changes after treatment were statistically significant for all PAPV scores (self-assessment P < 0.001, job P < 0.001, daily communication P < 0.001, social communication P = 0.005, emotion P < 0.001, total P < 0.001). The cutoff point with the highest sensitivity (84%) and specificity (100%) was 37.45 points.

Conclusions: The PAPV has undergone important steps required for cultural adaptation and validation process of outcome measures and it may be considered an important instrument to compose the assessment of Italian patients with dysphonia. The cutoff point that discriminates individuals with dysphonia from vocally healthy ones was 37.45 points for its total score.

Keywords: Dysphonia; Quality of life; Translation; Validation; Voice.