Development and Psychometric Validation of the Korean Version of the Velopharyngeal Insufficiency Effects on Life Outcomes
Seung Eun Jung, Seunghee Ha, Youkyung Bae, Soon Man Kwon, Tae Suk Oh, Jonathan R. SkirkoObjective
To develop and validate a culturally adapted Korean version of the Velopharyngeal Insufficiency Effects on Life Outcomes (K-VELO) for children with cleft palate with or without cleft lip (CP ± L).
Design
Methodological study including linguistic validation and psychometric evaluation.
Setting
: Tertiary cleft centers in South Korea.
Participants
: A total of 74 children and 78 parents completed the K-VELO; 72 children and 62 parents also completed perceptual speech evaluations. For test–retest reliability, 23 participants (11 children, 12 parents) completed the questionnaire twice within 2–4 weeks.
Interventions
: Application of World Health Organization and International Society for Pharmacoeconomics and Outcomes Research guidelines for patient-reported outcome measure (PROM) translation, including forward/back translation, reconciliation, expert review, and cognitive interviewing, followed by psychometric evaluation.
Main Outcome Measure(s)
Internal consistency, test–retest reliability, content validity (Item-Level Content Validity Index [I-CVI]), discriminant validity (non-VPI vs. VPI groups), criterion validity (correlation with perceptual speech measures), and parent–child agreement.
Results
The K-VELO-Y and K-VELO-P showed strong internal consistency in most domains. Test–retest reliability was adequate for the youth version and robust for the parent version. All items demonstrated excellent content validity. Discriminant validity showed significantly lower quality-of-life scores in the VPI group than in the non-VPI group across most domains. K-VELO scores correlated significantly with hypernasality, articulation errors, and speech intelligibility, supporting criterion validity. Moderate parent–child agreement supported generalizability across informants.
Conclusions
The K-VELO is a reliable and valid PROM for assessing the multidimensional quality-of-life impact of velopharyngeal insufficiency in Korean children with CP ± L and is applicable in Korean cleft-care settings.