Total laryngectomy is the main (primary?) treatment method for advanced and recurrent laryngeal and hypopharyngeal cancers. This surgery significantly affects the patient's basic essential functions, which in turn impacts their psychological state. Patients report altered speech patterns as the biggest obstacle after a laryngectomy, which causes communication problems and consequently, avoidance of social situations. Although the presence and extent of the patient's communication problems can be partially assessed using basic techniques (perceptual and/or acoustic analysis), these methods do not include the patient's perspective, which is often different from that of the speech-language pathologist. The patient's opinion, which may be expressed through self-assessment questionnaires on impairment or quality of life, should therefore be included in the planning and evaluation of therapy. Some questionnaires focus only on voice quality or are not adapted to the specificities of laryngectomized individuals and thus do not reflect the exact state of communication. For this purpose, the SECEL questionnaire (Self-Evaluation of Communication Experiences after Laryngectomy) was developed to record the communication experiences of a person after laryngectomy and has so far been translated into several languages.
In this master's thesis, the original SECEL questionnaire was translated into Slovenian and tested for validity and reliability on the Slovenian clinical population. The study included 58 laryngectomized subjects who had undergone surgery at least nine months prior to completing the paper questionnaire. Content validity was confirmed by calculating the Lawshe content validity ratio, which was 0.89 for the entire questionnaire, and construct validity was also demonstrated by an exploratory factor analysis in which the items were divided into three factors. A high degree of reliability was demonstrated by Cronbach's alpha coefficient, which amounted to 0.944 for the entire questionnaire. The coefficient of variation was calculated for each of the subscales and the entire questionnaire. It showed a moderate to high degree of discrimination of the subscales and a moderate degree of discrimination of the entire questionnaire. The calculated discriminability index showed that except one, all items exhibited good discriminability between the participants. The Pearson coefficient was calculated and showed a moderate to high correlation between the subscales. The floor and ceiling effect was also examined but found to be absent. It was also analysed whether the obtained test results varied according to gender, age, communication method, time since surgery and type of speech therapy (individual/group therapy). Although there were some differences between the groups, they were not statistically significant in any case.
The study concluded that the Slovenian version of the SECEL questionnaire is both a reliable and valid instrument and therefore suitable for use in the Slovenian clinical setting.
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