Advertisement

Dysphagia

, Volume 27, Issue 1, pp 46–52 | Cite as

The Dysphagia Handicap Index: Development and Validation

  • Alice K. SilbergleitEmail author
  • Lonni Schultz
  • Barbara H. Jacobson
  • Tausha Beardsley
  • Alex F. Johnson
Original Article
First Online:

Abstract

Quality-of-life indicators for dysphagia provide invaluable information to the treating clinician regarding the success or failure of swallowing therapy. The purpose of this study was to develop a clinically efficient, statistically robust patient-reported outcomes tool that measures the handicapping effect of dysphagia on emotional, functional, and physical aspects of individual’s lives. 60 statements describing the handicapping effect of dysphagia were collected from patient reports and divided into subscales of physical, emotional, and functional problems. The statements were presented to 77 individuals with dysphagia. Respondents replied never, sometimes, or always to each statement and rated their self-perceived dysphagia severity on a 7-point equal-appearing interval scale. Cronbach’s α was performed to assess the internal consistency validation of the items within the questionnaire. The final questionnaire was reduced to 25 items and administered to 214 individuals with dysphagia and 74 controls. Test–retest was performed on 63 individuals with dysphagia. Cronbach’s α for the initial and final versions was strong at r = 0.96 and r = 0.94, respectively. Significant differences occurred between the dysphagia and control groups. Test–retest reliability was strong. We present a new, easy-to-complete, statistically robust, patient-reported outcomes measure for assessing the handicapping effect of dysphagia.

Keywords

Dysphagia Handicap Quality of life Patient-reported outcomes Deglutition Deglutition disorders 
This is a preview of subscription content, log in to check access.

Notes

Acknowledgment

The authors gratefully acknowledge the staff of the Division of Speech-Language Sciences and Disorders, Department of Neurology, Henry Ford Hospitals and Health Network for their assistance in data collection for this study.

References

  1. 1.
    Gustafsson B, Tibbling L. Dysphagia, an unrecognized handicap. Dysphagia. 1991;6:193–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Logemann J. Evaluation and treatment of swallowing disorders. Boston: College Hill Press; 1983. p. 132–53.Google Scholar
  3. 3.
    Shaker R, Easterling C, Kern M, Nitschke T, Massey B, Daniels S, Grande B, Kazandjian M, Dikeman K. Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening. Gastroenterology. 2002;122:1314–21.PubMedCrossRefGoogle Scholar
  4. 4.
    Fujiu M. Effect of tongue-holding maneuver on posterior pharyngeal wall movement during deglutition. Am J Speech Lang Pathol. 1996;5:23–30.Google Scholar
  5. 5.
    Chen A, Frankowski R, Bishop-Leone J, Hebert T, Leyk S, Lewin J, Goepfert H. The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer. Arch Otolaryngol. 2001;127:870–6.Google Scholar
  6. 6.
    Carrau R, Khidr A, Crawley J, Hillson E, Davis J, Pashos C. The impact of laryngopharyngeal reflux on patient-reported quality of life. Laryngoscope. 2004;114:670–4.PubMedCrossRefGoogle Scholar
  7. 7.
    Dakkak M, Bennett J. A new dysphagia score with objective validation. J Clin Gastroenterol. 1992;14(2):99–100.PubMedCrossRefGoogle Scholar
  8. 8.
    McHorney C, Robbins J, Lomax K, Rosenbeck J, Chignell K, Kramer A, Bricker E. The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia. 2002;17:97–114.PubMedCrossRefGoogle Scholar
  9. 9.
    Nunnally JC. Psychometric theory. 2nd ed. New York: McGraw-Hill; 1978.Google Scholar
  10. 10.
    World Health Organization. International classification of functioning, disability and health. The 54th World Health Assembly, May 22, 2001.Google Scholar
  11. 11.
    McLaughlin G. SMOG grading: a new readability formula. J Read. 1969;12(8):639–46.Google Scholar
  12. 12.
    Doak C, Doak L, Root J. Teaching patients with low literacy skills. 2nd ed. Philadelphia: Lippincott Company; 1996. p. 1–2.Google Scholar
  13. 13.
    Jacobson B, Johnson A, Grywalski C, Silbergleit A, Jacobson G, Benninger M, Newman C. The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol. 1997;6(3):66–70.Google Scholar
  14. 14.
    Newman CW, Weinstein BE, Jacobson GP, Hug GA. The hearing handicap inventory for adults: psychometric adequacy and audiometric correlates. Ear Hear. 1990;11(6):430–3.PubMedCrossRefGoogle Scholar
  15. 15.
    Jacobson GP, Newman CW. The development of the dizziness handicap inventory. Arch Otolaryngol Head Neck Surg. 1990;116(4):424–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Newman CW, Jacobson GP, Spitzer J. Development of the tinnitus handicap inventory. Arch Otolaryngol Head Neck Surg. 1996;122(2):143–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Langmore S. Efficacy of behavioral treatment for oropharyngeal dysphagia. Dysphagia. 1995;10:259–62.PubMedCrossRefGoogle Scholar
  18. 18.
    Langmore S, Schatz K, Olsen N. Fiberoptic endoscopic examination of swallowing safety: a new procedure. Dysphagia. 1988;2:216–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Alice K. Silbergleit
    • 1
    Email author
  • Lonni Schultz
    • 2
  • Barbara H. Jacobson
    • 3
  • Tausha Beardsley
    • 1
  • Alex F. Johnson
    • 4
  1. 1.Division of Speech-Language Sciences and Disorders, Department of NeurologyHenry Ford Hospitals and Health NetworkDetroitUSA
  2. 2.Department of Biostatistics and Research EpidemiologyHenry Ford Hospitals and Health NetworkDetroitUSA
  3. 3.Voice CenterVanderbilt UniversityNashvilleUSA
  4. 4.Communication Sciences and DisordersMGH Institute of Health ProfessionsBostonUSA

Personalised recommendations

Cite article

Buy options