Validation of the Japanese translation of the Swallowing Disturbance Questionnaire in Parkinson’s disease patients

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.

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Fig. 1

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

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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.

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Correspondence to Toshiyuki Yamamoto.

Appendix

Appendix

The questions of the original SDQ are enlisted below:

  1. (1)

    Do you experience difficulty chewing solid food like an apple, cookie, or a cracker?

  2. (2)

    Are there any food residues in your mouth, in your cheeks, under your tongue or stuck to your palate after swallowing?

  3. (3)

    Does food or liquid come out of your nose when you eat or drink?

  4. (4)

    Does chewed-up food dribble from your mouth?

  5. (5)

    Do you feel you have too much saliva in your mouth; do you drool or have difficulty swallowing your saliva?

  6. (6)

    Do you swallow chewed-up food several times before it goes down your throat?

  7. (7)

    Do you experience difficulty in swallowing solid food (i.e., do apples or crackers get stuck in your throat)?

  8. (8)

    Do you experience difficulty in swallowing pureed food?

  9. (9)

    While eating, do you feel as if a lump of food is stuck in your throat?

  10. (10)

    Do you cough while swallowing liquids?

  11. (11)

    Do you cough while swallowing solid foods?

  12. (12)

    Immediately after eating or drinking, do you experience a change in your voice, such as hoarseness or reduced?

  13. (13)

    Other than during meals, do you experience coughing or difficulty breathing as a result of saliva entering your windpipe?

  14. (14)

    Do you experience difficulty in breathing during meals?

  15. (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.

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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

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Keywords

  • Parkinson’s disease
  • Dysphagia
  • Questionnaires
  • Fluoroscopy