Croatian version of the Screening Index for Voice Disorder questionnaire for early detection of voice disorders in female teachers

Introduction and aim: Female teachers are at risk of voice disorders, which negatively affect professional effectiveness and quality of life. The most effective treatment outcomes are associated with early detection of voice disorders, for which self-assessment questionnaires, such as the Screening Index for Voice Disorder (SIVD), have been shown to be effective. The aim of this study was to create and validate its Croatian version (SIVD-HR) and to examine its potential for predicting the bio-psycho-social consequences of voice disorders quantified by the already adapted and validated Voice Handicap Index (VHI-HR). Subjects and methods: The SIVD-HR contains 12 symptoms whose severity is self-assessed on a Likert scale. A symptom that is always or almost always present is scored with one point, and a higher number of points indicates a higher risk of voice disorders. The SIVD-HR was completed, after informed consent, by 109 female teachers, divided into groups with (VP) and without (BVP) diagnosis of voice disorder obtained up to two years from the time of data collection. Results: The severity of symptoms was assessed as low on average, and their bio-psycho-social impact as mild, but in both cases the assessment of the VP group was significantly less favorable. At least one symptom is (almost)always felt by nearly 50% of teachers in the VP group and only one in eight teachers in the BVP group. Correlations with age, experience and daily workload were not found. The SIVD-HR was shown to be reliable and to have discriminant, convergent and predictive validity. The area under the receiver operating characteristic curve of 0.672 at a cut-off of two or more points, with sensitivity of 46.2% and specificity of 84%, indicate that the SIVD-HR is not accurate enough in identifying teachers with a previously diagnosed voice disorder as at risk, and therefore has limited clinical usefulness. However, the SIVD-HR significantly and strongly predicts the severity of the bio-psycho-social consequences of vocal problems, so it is advisable to validate it on a larger number of vocal professionals. Conclusion: The results suggest that teachers are unaware of the symptoms of voice quality changes and accept their consequences as aggravating circumstances at work, which indicates the need for systematic education of teachers about vocal health.