The Vanderbilt Head and Neck Symptom Survey Brazilian Portuguese version 2.0 (VHNSS 2.0): psychometric properties for patients with head and neck cancer who have undergone radiotherapy

BACKGROUND: Patients who undergo radiotherapy to treat head and neck cancer can present with several symptoms, including oral ones. The symptoms are usually assessed using instruments to evaluate quality of life. However, these instruments do not really assess oral health outcomes and their functional implications. The VHNSS 2.0 instrument was developed to be used with head and neck cancer patients, and has recently been translated and culturally adapted to be used in Brazil. The purpose of the study was to evaluate the psychometric properties of the VHNSS 2.0 Brazilian Portuguese version. METHODS: Three assessment instruments, the Brazilian Portuguese versions of EORTC QLQ-C30, EORTC H&N 35 and VHNSS 2.0, were answered by 241 head and neck cancer patients, of whom 47 were submitted to the test retest in 5–16 days. The construct validity was assessed through convergent validation (assuming correlations between VHNSS 2.0 and EORTC), and known group analysis (radiotherapy time, site of tumor, staging and surgery). Reliability was evaluated by means of Cronbach’s alpha and test retest using the intraclass correlation coefficient. RESULTS: 241 head and neck cancer patients, median age 58.8, were included in this study. Hypothesized correlations were confirmed, the comparison among the groups showed differences in most of the domains. Reliability for the domains of swallowing solids, dry mouth, mouth pain, mucus, voice, pain and taste/smell presented Cronbach’s alpha values from 0.858 to 0.735 and for the domains of nutrition, swallowing liquids and teeth, 0.618, 0.620 and 0.670 respectively. The test–retest reliability, for the domains of the VHNSS 2.0, measured using intraclass correlation coefficient, ranged from 0.372 to 0.854. CONCLUSION: The VHNSS 2.0 Brazilian Portuguese version presented good results for the convergent validation and known-group analyses. It also showed reliability for the Cronbach´s alpha and test retest for most domains.