Reliability and Validity of the Chinese Mandarin Version of the Swallowing Quality of Life Questionnaire
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ORIGINAL ARTICLE
Reliability and Validity of the Chinese Mandarin Version of the Swallowing Quality of Life Questionnaire Xiaoxing Lai1 · Hongwei Zhu1 · Hongdi Du1 · Jian Wang2 · Lin Bo1 · Xiaopeng Huo1 Received: 21 April 2020 / Accepted: 24 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Swallowing disorders can adversely affect quality of life (QOL). To develop the Chinese version of the Swallowing Quality of Life Questionnaire (ChSWAL-QOL) and evaluate its reliability and validity, the ChSWAL-QOL was generated by forward translation of the original SWAL-QOL, backward translation, cultural adaptation, and revision using the Delphi method. The ChSWAL-QOL was administered to 376 patients with dysphagia treated at Peking Union Medical College Hospital between November 1, 2017 and December 31, 2018. Reliability was evaluated using Cronbach’s α and test–retest reliability. Content validity was assessed using the content validity index (CVI). Structural validity was evaluated by exploratory factor and confirmatory factor analyses. The 44-item, 11-dimension of ChSWAL-QOL was considered semantically relevant, clearly expressed and easy to understand in a preliminary study. The final analysis included 360 of 376 questionnaires (95.7%). Cronbach’s α was 0.906 for the whole scale and ranged from 0.815 to 1.000 for the individual dimensions, and the test–retest reliability was 0.847, indicating that the ChSWAL-QOL had excellent internal consistency. CVI was 0.964 overall and ranged from 0.870 to 1.000 for the individual dimensions. Exploratory factor analysis identified a dysphagia-related component (psychological burden, feeding duration, swallowing symptoms, eating desire, communication, feeding fear, mental health, and social function) and a generic component (fatigue and sleep) explaining 52.8% and 10.8% of the variance, respectively. The ChSWAL-QOL has excellent reliability and validity. This scale could be used as a tool to assess the QOL of patients with dysphagia in mainland China. Keywords Swallowing disorders · Quality of life · Questionnaire design · Reliability and validity
Introduction * Xiaoxing Lai [email protected] * Xiaopeng Huo [email protected] Hongwei Zhu [email protected] Hongdi Du [email protected] Jian Wang [email protected] Lin Bo [email protected] 1
Department of Health Care, Peking Union Medical College Hospital, Beijing 100730, China
Otolaryngological Department, Peking Union Medical College Hospital, Beijing 100730, China
2
Swallowing is a complex physiological process involving the integrated activity of many muscles and nerves [1]. Dysphagia is a disorder of swallowing that may be caused by a variety of diseases including stroke, multiple sclerosis, Parkinson’s disease, head and neck cancer, and dementia [2]. Swallowing problems are reported to affect 4% of all adults [3], and the prevalence of dysphagia among older people in China was recently estimated to be 13.9% for community-dwelling persons and 26.4% for those in nursing homes [4, 5]. T
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