Abstract
Purpose
The Swallowing Disturbance Questionnaire (SDQ) was developed as a self-rated screening tool for dysphagia in patients with Parkinson’s disease (PD). We developed the Japanese version of this questionnaire (SDQ-J), according to the cross-cultural adaptation guidelines, and examined its reliability.
Methods
Subjects were 61 Japanese patients with PD (mean age, 67.0 ± 9.2 years) who answered the SDQ-J before undergoing videofluoroscopic examination of swallowing (VF). We compared the findings of the questionnaire with the patients’ aspiration status during VF.
Results
Cronbach’s alpha coefficient for the 15 questions of the SDQ-J was 0.84. According to the SDQ-J, 15 patients (24.6%) were diagnosed with dysphagia, while 9 patients (14.8%) aspirated liquid during VF. The sensitivity and specificity of the SDQ-J in predicting aspiration were 77.8 and 84.6%, respectively; therefore, the SDQ-J significantly predicted aspiration during VF (P < 0.01). The positive predictive value (PPV) and negative predictive value (NPV) for the SDQ-J were 0.46 and 0.96, respectively.
Conclusions
The SDQ-J appears to be a reliable and useful screening tool for Japanese PD patients with aspiration. As the NPV was higher than the PPV in the SDQ-J, this questionnaire could potentially be used for early identification of severe dysphagia in patients with PD.
Abbreviations
- PD:
-
Parkinson’s disease
- VF:
-
Videofluoroscopic examination of swallowing
- SDQ:
-
Swallowing Disturbance Questionnaire
- SDQ-J:
-
Japanese version of the SDQ
- H&Y:
-
Hoehn–Yahr
- PPV:
-
Positive predictive value
- NPV:
-
Negative predictive value
- SLP:
-
Speech and language pathologist
- FEES:
-
Fiberoptic endoscopic evaluation of swallowing
References
Leow, L. P., Huckabee, M. L., Anderson, T., & Beckert, L. (2010). The impact of dysphagia on quality of life in ageing and Parkinson’s disease as measured by the swallowing quality of life (SWAL-QOL) questionnaire. Dysphagia, 25(3), 216–220.
Manor, Y., Giladi, N., Cohen, A., Fliss, D. M., & Cohen, J. T. (2007). Validation of a swallowing disturbance questionnaire for detecting dysphagia in patients with Parkinson’s disease. Movement Disorders, 22(13), 1917–1921.
Evatt, M. L., Chaudhuri, K. R., Chou, K. L., Cubo, E., Hinson, V., Kompoliti, K., et al. (2009). Dysautonomia rating scales in Parkinson’s disease: Sialorrhea, dysphagia, and constipation–critique and recommendations by movement disorders task force on rating scales for Parkinson’s disease. Movement Disorders, 24(5), 635–646.
Calne, D. B., Snow, B. J., & Lee, C. (1992). Criteria for diagnosing Parkinson’s disease. Annals of Neurology, 32(Suppl), S125–S127.
Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191.
Hanley, J. A., & McNeil, B. J. (1982). The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology, 143(1), 29–36.
Leopold, N. A., & Kagel, M. C. (1997). Laryngeal deglutition movement in Parkinson’s disease. Neurology, 48(2), 373–376.
Bushmann, M., Dobmeyer, S. M., Leeker, L., & Perlmutter, J. S. (1989). Swallowing abnormalities and their response to treatment in Parkinson’s disease. Neurology, 39(10), 1309–1314.
Yamamoto, T., Kobayashi, Y., & Murata, M. (2010). Risk of pneumonia onset and discontinuation of oral intake following videofluorography in patients with Lewy body disease. Parkinsonism & Related Disorders, 16(8), 503–506.
Lam, K., Lam, F. K., Lau, K. K., Chan, Y. K., Kan, E. Y., Woo, J., et al. (2007). Simple clinical tests may predict severe oropharyngeal dysphagia in Parkinson’s disease. Movement Disorders, 22(5), 640–644.
Manor, Y., Balas, M., Giladi, N., Mootanah, R., & Cohen, J. T. (2009). Anxiety, depression and swallowing disorders in patients with Parkinson’s disease. Parkinsonism & Related Disorders, 15(6), 453–456.
Acknowledgments
The authors thank Y. Manor (Tel-Aviv Sourasky Medical Center) for the permission to use the SDQ and proofreading the back translation. This work was supported by a TMC Young Investigator Fellowship from the National Center of Neurology and Psychiatry (NCNP), Japan, and by an Intramural Research Grant (22–Y2) for Neurological and Psychiatric Disorders that was also awarded by the NCNP.
Author information
Authors and Affiliations
Corresponding author
Appendix
Appendix
The questions of the original SDQ are enlisted below:
-
(1)
Do you experience difficulty chewing solid food like an apple, cookie, or a cracker?
-
(2)
Are there any food residues in your mouth, in your cheeks, under your tongue or stuck to your palate after swallowing?
-
(3)
Does food or liquid come out of your nose when you eat or drink?
-
(4)
Does chewed-up food dribble from your mouth?
-
(5)
Do you feel you have too much saliva in your mouth; do you drool or have difficulty swallowing your saliva?
-
(6)
Do you swallow chewed-up food several times before it goes down your throat?
-
(7)
Do you experience difficulty in swallowing solid food (i.e., do apples or crackers get stuck in your throat)?
-
(8)
Do you experience difficulty in swallowing pureed food?
-
(9)
While eating, do you feel as if a lump of food is stuck in your throat?
-
(10)
Do you cough while swallowing liquids?
-
(11)
Do you cough while swallowing solid foods?
-
(12)
Immediately after eating or drinking, do you experience a change in your voice, such as hoarseness or reduced?
-
(13)
Other than during meals, do you experience coughing or difficulty breathing as a result of saliva entering your windpipe?
-
(14)
Do you experience difficulty in breathing during meals?
-
(15)
Have you suffered from a respiratory infection (pneumonia, bronchitis) during the past year?
Questions 1–14 have following options and scores; Never, 0 point; Seldom (once a month or less), 1 point; Frequently (1–7 times a week), 2 points; Very Frequently (more than 7 times a week), 3 points. For the 15th question, “Yes” is 2.5 points and “No” is 0.5 points.
Rights and permissions
About this article
Cite this article
Yamamoto, T., Ikeda, K., Usui, H. et al. Validation of the Japanese translation of the Swallowing Disturbance Questionnaire in Parkinson’s disease patients. Qual Life Res 21, 1299–1303 (2012). https://doi.org/10.1007/s11136-011-0041-2
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11136-011-0041-2