Psychometrics of a Chinese translation of the swallowing questionnaire.

AIMS OF THE STUDY: The purpose of this study was to determine the psychometric properties of a Chinese version of a swallowing questionnaire.

BACKGROUND/RATIONALE: Impaired swallowing may lead to serious complications if health care professionals do not accurately assess the problem and promptly intervene. The recognition of symptoms indicative of a swallowing problem is essential for nurses. The swallowing questionnaire could provide nurses with a valid instrument to assess patients' impaired swallowing. DESIGNS/METHODS: Phase I consisted of experts doing the initial translation into Chinese and back-translations of the questionnaire. Five experts then determined content validity of the Chinese version, and 35 bilingual subjects determined equivalence of the Chinese translation and English version. Phase II determined concurrent validity and internal consistency using 113 screened medical patients as subjects. Phase III used 105 screened long-term care subjects to determine construct validity.

RESULTS/FINDINGS: In Phase I, rating on the appropriateness of items on the Chinese version yielding a content validity index of 0.988. The coefficient of equivalence between the Chinese and English versions of the instrument was 0.81, while per cent agreement for all items on the two versions ranged from 0.80--1.00. Phase II established internal consistency with a K-R20 of 0.74, and concurrent validity yielded a correlation between the swallowing questionnaire and the neurological swallowing exam of 0.675 (P < 0.01). Phase III determined construct validity with significant positive correlations found between the swallowing questionnaire and stroke history and masticatory ability. Significant negative correlations were found between swallowing and cognitive status, functional status and albumin.

CONCLUSIONS: Although useful as a tool for nursing assessment and intervention, further work on the swallowing questionnaire such as conducting video fluoroscopy and a swallowing speed test, are recommended to further validate its accuracy.