Abstract
Dysphagia is a very common symptom in people of advanced age and with neurological diseases, although it often remains undiagnosed. At present, there are few assessment tools adapted for the Spanish-speaking population; of the few existing, most of them follow a self-reporting format, which requires a well-preserved cognitive state in the patient in order to be tested. Therefore, the main aim of this study was to design and validate an instrument for screening dysphagia without food, which could have a quick application and did not compromise the patient’s safety. A secondary aim was to study the test’s ability to examine this symptom in people with cognitive disorders. The study was carried out with 206 participants divided into three groups: people with dysphagia and with preserved cognitive abilities, people with dysphagia and with altered cognitive abilities, and people without dysphagia and with preserved cognitive skills (control group). Participants were assessed with the designed Oropharyngeal Dysphagia Screening Test for Patients and Professionals and other dysphagia tests. The results revealed appropriate psychometric features: reliability and validity both for screening dysphagia directly with the patients or if the tester is the professional caregiver responsible for feeding (in cases of altered cognitive abilities). As conclusion, the Oropharyngeal Dysphagia Screening Test for Patients and Professionals is an instrument of easy use and of short duration that has shown adequate results of reliability and validity, thus being useful for the screening of dysphagia in Spanish-speaking populations.
Similar content being viewed by others
References
Dziewas R, Beck AM, Clavé P, et al. Recognizing the importance of dysphagia: stumbling blocks and stepping stones in the twenty-first century. Dysphagia. 2017;32:78–82.
Cichero JAY, Lam P, Steele CM, et al. Development of International terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management: the IDDSI Framework. Dysphagia. 2017;32:293–314.
Clavé P, Arreola V, Velasco M, Quer M, Castellví JM, Almirall J, et al. Diagnosis and treatment of functional oropharyngeal dysphagia. Features of interest to the digestive surgeon. Cir Esp. 2007;82(2):62–76.
Melgaard D, Rodrigo-Domingo M, Mørch M. The prevalence of oropharyngeal dysphagia in acute geriatric patients. Geriatrics. 2018;3:15.
Michel A, Vérin E, Gbaguidi X, Druesne L, Roca F, Chassagne P. Oropharyngeal dysphagia in community-dwelling older patients with dementia: prevalence and relationship with geriatric parameters. JAMDA. 2018;19(9):770–4.
Fontes-Luchesi K, Porto De Toledo I, Figueiredo-Mourao L. Dysphagia in Parkinson’s disease: prevalence, impact and management challenges. J Otolaryngol ENT Res. 2017;6(5):00176.
Onesti E, Schettino I, Gori MC, Frasca V, Ceccanti M, Cambieri C, Ruoppolo G, Inghilleri M. Dysphagia in Amyotrophic Lateral Sclerosis: impact on patient behavior, diet adaptation, and riluzole management. Front Neurol. 2017;8:94.
Sherman V, Flowers H, Kapral MK, Nicholson G, Silver F, Martino R. Screening for Dysphagia in adult patients with stroke: assessing the accuracy of informal detection. Dysphagia. 2018;3(5):662–9.
Hutcheson KA, Nurgalieva Z, Gunn GB, Giordano S, Zhao H, Bhayani M, Lewis C. Two-year prevalence of dysphagia and related outcomes in head and neck cancer survivors: an updated SEER-Medicare analysis. Int J Radiat Oncol. 2018;100(5):1394.
García-Peris P, Parón L, Velasco C, et al. Long-term prevalence of oropharyngeal dysphagia in head and neck cancer patients: impact on quality of life. Clin Nutr. 2007;26(6):710–7.
Ferrero-López MI, García-Gollarte JF, Botella-Trelis JJ, Juan-Vidal O. Detection of dysphagia in the institutionalised elderly. Rev Esp Geriatr Gerontol. 2012;47(4):143–7.
Al-Khaled M, Matthis C, Binder A, Mudter J, Schattschneider J, Pulkowski U, Strohmaier T, Niehoff T, Zybur R, Eggers J, Valdueza JM, Royl G. Dysphagia in patients with acute ischemic stroke: early dysphagia screening may reduce stroke-related pneumonia and improve stroke outcomes. Cerebrovasc Dis. 2016;42:81–9.
Smithard DG, O’Neill PA, Parks C, Morris J. Complications and outcome after acute stroke. Does dysphagia matter? Stroke. 1996;27:1200–4.
Mann G, Hankey GJ, Cameron D. Swallowing function after stroke: prognosis and prognostic factors at 6 months. Stroke. 1999;30:744–8.
Wirth R, Pourhassan M, Streicher M, Hiesmayr M, Schindler K, Sieber CC, Volkert D. The impact of dysphagia on mortality of nursing home residents: results from the nutrition Day Project. J Am Med Dir Assoc. 2018;18(30):156–30157.
Almirall J, Rofes L, Serra-Prat M, Icart R, Palomera E, Arreola V, Clavé P. Oropharyngeal dysphagia is a risk factor for community-acquired pneumonia in the elderly. Eur Resp J. 2012;52(2):1–22. https://doi.org/10.1183/09031936.00019012.
Serra-Prat M, Palomera M, Gomez C, et al. Oropharyngeal dysphagia as a risk factor for malnutrition and lower respiratory tract infection in independently living older persons: a population-based prospective study. Age Ageing. 2012;41(3):376–81.
Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, et al. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919–24.
Burgos R, Sarto B, Segurola H, Romagosa A, Puiggrós C, Vázquez C, Cárdenas G, Barcons N, Araujo K, Pérez-Portabella C. Traducción y validación de la versión en español de la escala EAT-10 (Eating Assessment Tool-10) para el despistaje de la disfagia. Nutr Hosp. 2012;27(6):2048–54.
McHorney CA, Bricker DE, Kramer AE, Rosenbek JC, Robbins JA, 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 JA, Kramer AE, Rosenbeck JC, Chignell K. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: II. Item reduction and preliminary scaling. Dysphagia. 2000;15:122–33.
McHorney CA, Robbins JA, Lomax K, Rosenbeck JC, Chignell K, Kramer AE, et al. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: III—Documentation of reliability and validity. Dysphagia. 2002;17:97–114.
Zaldibar-Barinaga M, Miranda-Artieda M, Zaldibar-Barinaga A, Pinedo-Otaola S, Erazo-Presser Tejada-Ezquerro PP, de Vida C. Versión española del Swallowing Quality of Life Questionnaire: Fase inicial de adaptación transcultural [Spanish version of the Swallowing Quality of Life Questionnaire: Initial transcultural adaptation phase]. Rehabilitación. 2013;47(3):136–40.
Chen AY, Frankowski R, Bishop-Leone J. The development and validation of a Dysphagia-Specific Quality-of-Life Questionnaire for patients with head and neck cancer. Arch Otolaryngol Head Neck Surg. 2001;127:870–6.
Gutiérrez-Achury AM, Ruales-Suárez K, Giraldo-Cadavid LF, Rengifo-Varona ML. Escalas de calidad de vida y valoración de los síntomas en disfagia. Rev Med. 2015;23(1):52.
Clave P, Arreola V, Romea M, et al. Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clin Nutr. 2008;27:806–15.
Nogueira D, Ferreira P, Reis E, Lopes I. Measuring outcomes for dysphagia: validity and reliability of the European Portuguese Eating Assessment Tool (P-EAT-10). Dysphagia. 2015;30(5):511–20.
Demir N, Arslan S, İnal Ö, Karaduman A. Reliability and validity of the Turkish Eating Assessment Tool (T-EAT-10). Dysphagia. 2016;31(5):644–9.
Folstein M, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychol Res. 1975;12(3):189–98.
Lobo A, Escobar V, Ezquerra J, Seva Díaz A. The “Mini-Examen Cognoscitivo”: a simple and practical test to detect intellectual dysfunctions in psychiatric patients. Rev Psiq Psicol Med. 1980;14(5):39–57.
Lobo A, Saz P, Marcos G, Día JL, de la Cámara C, Ventura T, et al. Revalidación y normalización del Mini-Examen Cognoscitivo (primera versión en castellano del Mini-Mental Status Examination) en la población general geriátrica [Revalidation and normalization of the Mini-Cognitive Exam (first version in Spanish of the Mini-Mental Status Examination) in the general geriatric population]. Med Clin (Barc). 1999;112(1978):767–74.
Field A. Discovering statisctics using SPSS. London: SAGE; 2009.
Crocker L, Algina J. Introduction to classical modern test theory. New York: Holt, Rinehart and Winston; 1986.
Acknowledgements
The research reported in this work is partially funded by the Junta de Andalucía research groups—HUM 820 and HUM129, FEDER Funding. We are grateful to the participants, their families, and staff from the associations involved.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that there is no conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Annex I
Annex I
Note Translation to English is provided in two versions: one for the self-reporting version, which can be answered by the patient (P) in those cases of people with preserved cognitive state and other for the version for professional caregivers (C), which can be used in the case of patients with altered cognitive state. The Spanish version allows the use of the same sentence for the two cases (P and C).
Rights and permissions
About this article
Cite this article
Quirós, S., Serrano, F. & Mata, S. Design and Validation of the Oropharyngeal Dysphagia Screening Test for Patients and Professionals: A Preliminary Study. Dysphagia 35, 52–65 (2020). https://doi.org/10.1007/s00455-019-09999-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00455-019-09999-4