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DYMUS-Hr self-assessment questionnaire (Croatian version) for dysphagia in multiple sclerosis-validity, reliability, and cross-cultural adaptation

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Abstract

Background

The prevalence of dysphagia in the early phases of multiple sclerosis is 30–40%, with an estimated of 30% of cases going undiagnosed cases. Such complications can lead to malnutrition, dehydration, and aspiration pneumonia and have a great impact on the quality of life and psychosocial status of a person with MS. The aim of this study was the validation of dysphagia in multiple sclerosis self-assessment questionnaire (DYMUS) in the Croatian language.

Methods and patients

The cross-cultural adaptation process included a back-forward translation technique of the English language version of DYMUS to the Croatian language, with pilot testing on 30 participants. The validity and reliability of the Croatian version of DYMUS (DYMUS-Hr) was applied to 106 MS patients, with comparison to the Eating Assessment Tool (EAT10), the Water Swallowing Test (WST), and a dichotomous self-assessment question. In the assessment of test-retest reliability, 99 MS patients were included.

Results

Internal consistency of DYMUS-Hr was very good (Cronbach’s alpha—0.837); Cronbach’s alpha was 0.819 for the “dysphagia for solids”, and 0.562 for “dysphagia for liquids” subscale. A significant correlation (p < 0.001) was found between DYMUS-Hr and EAT10 (Spearman’s rho—0.787), and WST (Spearman’s rho—0.483). Construct validity was assessed with the self-assessment question and interpreted with the Mann–Whitney U test. Test-retest reliability showed moderate to substantial Cohen’s Kappa reliability for each item.

Conclusion

DYMUS-Hr is a valid and reliable screening assessment tool for patients with MS. There is a general lack of awareness about dysphagia symptoms among patients with MS; consequently, this disorder receives inadequate attention and often goes untreated.

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Data Availability

The data supporting this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We are grateful to Daria Zadravec, Jelena Mandić, and Melanie Tvrdinić for their work and accomplishments during the translation process of DYMUS. We would like to thank Martina Ćužić for her help during the data analysis.

Funding

The authors received no financial support for the research, authorship, and publication of this article.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Sveti Duh, Zagreb, Croatia

    Jelena Bartolović Vučković, Boris Šimunjak & Tena Šimunjak

  2. Department of Speech and Language Pathology (Z.K.), University of Rijeka, Rijeka, Croatia

    Zdravko Kolundžić

Authors
  1. Jelena Bartolović Vučković
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  3. Boris Šimunjak
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  4. Tena Šimunjak
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Contributions

Jelena Bartolović Vučković and Zdravko Kolundžić designed the study and participated in data collection. Jelena Bartolović Vučković, Zdravko Kolundžić and Boris Šimunjak. contributed to the analysis and interpretation of results Jelena Bartolović Vučković, Zdravko Kolundžić, Boris Šimunjak, and Tena Šimunjak worked on draft manuscript preparation. All authors reviewed the results and approved the final version of the manuscript adhering ICMJE guidelines.

Corresponding author

Correspondence to Jelena Bartolović Vučković.

Ethics declarations

Ethics approval

The study was approved by the University Hospital “Sveti Duh” and General hospital “Požega” Bioethical Board, adhering to the Helsinki Declaration Revision of 2013. It was conducted according to national and institutional regulations and ethical standards. The study was compiled at University Hospital “Sveti Duh,” Zagreb (approval n° 01-1736/11) and General County hospital Požega (approval n° 01-1442/1-2018).

Consent to participate 

Written informed consent adhering to the Helsinki Declaration of 2013, was obtained from all individual participants for data collection and publication of this article.

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All authors declare that they have no conflict of interest.

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Vučković, J.B., Kolundžić, Z., Šimunjak, B. et al. DYMUS-Hr self-assessment questionnaire (Croatian version) for dysphagia in multiple sclerosis-validity, reliability, and cross-cultural adaptation. Neurol Sci 44, 3637–3645 (2023). https://doi.org/10.1007/s10072-023-06850-5

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