The aim of this work was to evaluate the psychometric properties of the Dutch version of the Swallowing Quality-of-Life Questionnaire (DSWAL-QOL). A cross-sectional survey of 295 dysphagic patients and 124 healthy controls was studied to evaluate the validity and reliability of the DSWAL-QOL, and 50 patients were recruited for the test–retest reliability. Construct validity was validated through principal component analysis and a correlation study between the DSWAL-QOL and the SF-36. The psychometric properties of the DSWAL-QOL were found to be largely similar to those of the original SWAL-QOL, except the Sleep scale; the composite Symptoms score reaffirms its validity in this study. The DSWAL-QOL was able to differentiate between dysphagic and nondysphagic patients and is sensitive to disease severity as measured by known-groups validity, based on different food and liquid textures. The DSWAL-QOL is a clinically valid and reliable tool for assessing the quality of life in Dutch-speaking dysphagic patients, regardless of the cause or severity of the dysphagia.
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Brunier GM, Graydon J. The influence of physical activity on fatigue in patients with ESRD on hemodialysis. ANNA J. 1993;20(4):457–61. discussion 62, 521.
Delate T, Coons SJ. The discriminative ability of the 12-item short form health survey (SF-12) in a sample of persons infected with HIV. Clin Ther. 2000;22(9):1112–20.
Marks GB, Dunn SM, Woolcock AJ. An evaluation of an asthma quality of life questionnaire as a measure of change in adults with asthma. J Clin Epidemiol. 1993;46(10):1103–11.
Wang B, Gladman DD, Urowitz MB. Fatigue in lupus is not correlated with disease activity. J Rheumatol. 1998;25(5):892–5.
Ward MM. Clinical measures in rheumatoid arthritis: which are most useful in assessing patients? J Rheumatol. 1994;21(1):17–27.
Batalden PB, Nelson EC, Roberts JS. Linking outcomes measurement to continual improvement: the serial “V” way of thinking about improving clinical care. Jt Comm J Qual Improv. 1994;20(4):167–80.
Guyatt GH, Berman LB, Townsend M, Pugsley SO, Chambers LW. A measure of quality of life for clinical trials in chronic lung disease. Thorax. 1987;42(10):773–8.
Guyatt G, Mitchell A, Irvine EJ, Singer J, Williams N, Goodacre R, et al. A new measure of health status for clinical trials in inflammatory bowel disease. Gastroenterology. 1989;96(3):804–10.
The DCCT Research Group. Reliability and validity of a diabetes quality-of-life measure for the diabetes control and complications trial (DCCT). The DCCT Research Group. Diabetes Care. 1988;11(9):725–32.
Drossman DA, Li Z, Leserman J, Patrick DL. Ulcerative colitis and Crohn’s disease health status scales for research and clinical practice. J Clin Gastroenterol. 1992;15(2):104–12.
Laupacis A, Muirhead N, Keown P, Wong C. A disease-specific questionnaire for assessing quality of life in patients on hemodialysis. Nephron. 1992;60(3):302–6.
Laupacis A, Pus N, Muirhead N, Wong C, Ferguson B, Keown P. Disease-specific questionnaire for patients with a renal transplant. Nephron. 1993;64(2):226–31.
Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol. 1993;46(12):1417–32.
U.S. Department of Health and Human Services FDA Center for Drug Evaluation and Research; U.S. Department of Health and Human Services FDA Center for Biologics Evaluation and Research; U.S. Department of Health and Human Services FDA Center for Devices and Radiological Health. Guidance for industry: patient-reported outcome measures: use in medical product development to support labeling claims: draft guidance. Health Qual Life Outcomes. 2006;4:79.
McHorney CA, Bricker DE, Kramer AE, Rosenbek JC, Robbins J, Chignell KA, et al. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: I. Conceptual foundation and item development. Dysphagia. 2000;15(3):115–21.
McHorney CA, Bricker DE, Robbins J, Kramer AE, Rosenbek JC, Chignell KA. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: II. Item reduction and preliminary scaling. Dysphagia. 2000;15(3):122–33.
McHorney CA. Generic health measurement: past accomplishments and a measurement paradigm for the 21st century. Ann Intern Med. 1997;127(8 Pt 2):743–50.
Nunnally JC, Bernstein IH. Psychometric theory. 3rd ed. New York: McGraw-Hill; 1994.
Manning WG, Newhouse JP, Ware JE. Rand Corporation. The status of health in demand estimation: beyond excellent, good, fair, and poor. Santa Monica: Rand; 1980.
McHorney CA, Robbins J, Lomax K, Rosenbek JC, Chignell K, Kramer AE, et al. The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia. 2002;17(2):97–114.
Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42.
Wainer H, Braun HI. Educational testing service. Test validity. Hillsdale: Lawrence Erlbaum Associates; 1988.
Bogaardt HC, Speyer R, Baijens LW, Fokkens WJ. Cross-cultural adaptation and validation of the Dutch version of SWAL-QoL. Dysphagia. 2009;24(1):66–70.
Hunt SM, Alonso J, Bucquet D, Niero M, Wiklund I, McKenna S. Cross-cultural adaptation of health measures. European group for health management and quality of life assessment. Health Policy. 1991;19(1):33–44.
Razavi D, Gandek B. Testing Dutch and French translations of the SF-36 Health Survey among Belgian angina patients. J Clin Epidemiol. 1998;51(11):975–81.
Streiner DL, Norman GR. Health measurement scales: a practical guide to their development and use. 3rd ed. New York: Oxford University Press; 2003.
Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med. 1993;118(8):622–9.
Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA. 1995;273(1):59–65.
DeVellis RF. Scale development: theory and applications. 2nd ed. Thousand Oaks: Sage Publications; 2003.
McDowell I, Newell C. Measuring health: a guide to rating scales and questionnaires. 2nd ed. New York: Oxford University Press; 1996.
Child D. The essentials of factor analysis. 3rd ed. New York: Continuum; 2006.
Dunteman GH. Principal Components Analysis (Quantitative applications in the social sciences). Newbury Park: Sage Publications; 1989.
McHorney CA, Tarlov AR. Individual-patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res. 1995;4(4):293–307.
Everitt B, Palmer CR. Encyclopaedic companion to medical statistics. 2nd ed. Chichester: Wiley; 2011.
Bland JM, Altman DG. Cronbach’s alpha. BMJ. 1997;314(7080):572.
McGraw KO, Wong SP. Forming inferences about some intraclass correlations coefficients. Psychol Methods. 1996;1(1):30–46.
Hattie J, Cooksey RW. Procedures for assessing the validities of tests using the “known-groups” method. Appl Psychol Meas. 1984;8.
Field AP. Discovering statistics using SPSS (and sex, drugs and rock ‘n’ roll), 3rd ed. Los Angeles: Sage Publications; 2009.
Ekberg O, Hamdy S, Woisard V, Wuttge-Hannig A, Ortega P. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia. 2002;17(2):139–46.
Martino R, Beaton D, Diamant NE. Perceptions of psychological issues related to dysphagia differ in acute and chronic patients. Dysphagia. 2010;25(1):26–34.
Finizia C, Rudberg I, Bergqvist H, Ryden A. A cross-sectional validation study of the Swedish version of SWAL-QOL. Dysphagia. 2012. doi:10.1007/s00455-011-9369-6.
Chevalier H, Los F, Boichut D, Bianchi M, Nutt DJ, Hajak G, et al. Evaluation of severe insomnia in the general population: results of a European multinational survey. J Psychopharmacol. 1999;13(4 Suppl 1):S21–4.
Somers A, Robays H, Audenaert K, Van Maele G, Bogaert M, Petrovic M. The use of hypnosedative drugs in a university hospital: has anything changed in 10 years? Eur J Clin Pharmacol. 2011;67(7):723–9.
Warie H, Petrovic M, Somers A, Mariman A, Robays H, Pevernagie D. The use of hypnosedative drugs in a university hospital setting. Acta Clin Belg. 2003;58(4):225–32.
Lam PM, Lai CK. The validation of the Chinese version of the swallow quality-of-life questionnaire (SWAL-QOL) using exploratory and confirmatory factor analysis. Dysphagia. 2011;26(2):117–24.
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Vanderwegen, J., Van Nuffelen, G. & De Bodt, M. The Validation and Psychometric Properties of the Dutch Version of the Swallowing Quality-of-Life Questionnaire (DSWAL-QOL). Dysphagia 28, 11–23 (2013). https://doi.org/10.1007/s00455-012-9408-y
- Quality of life
- Outcome measurements
- Deglutition disorders