Cross-Cultural Adaptation and Validation of the Italian Version of the Dysphagia Handicap Index (I-DHI) View Full Text


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Article Info

DATE

2021-09-28

AUTHORS

Daniela Ginocchio, Aurora Ninfa, Nicole Pizzorni, Christian Lunetta, Valeria Ada Sansone, Antonio Schindler

ABSTRACT

The Dysphagia Handicap Index (DHI) is a valid Health-related Quality of Life (HRQOL) questionnaire for patients with oropharyngeal dysphagia (OD) of heterogeneous etiologies. The study aimed at crossculturally translating and adapting the DHI into Italian (I-DHI) and analyzing I-DHI reliability, validity, and interpretability. The I-DHI was developed according to Beaton et al. 5-stage process and completed by 75 adult OD patients and 166 healthy adults. Twenty-six patients filled out the I-DHI twice, 2 weeks apart, for test–retest reliability purposes. Sixty-two patients completed the Italian-Swallowing Quality of Life Questionnaire (I-SWAL-QoL) for criterion validity analysis. Construct validity was tested comparing I-DHI scores among patients with different instrumentally assessed and self-rated OD severity, comparing patients and healthy participants and testing Spearman’s correlations among I-DHI subscales. I-DHI interpretability was assessed and normative data were generated. Participants autonomously completed the I-DHI in maximum 10 min. Reliability proved satisfactory for all I-DHI subscales (internal consistency: α > .76; test–retest reliability: intraclass correlation coefficient > .96, k = .81). Mild to moderate correlations (− .26 ≤ ρ ≤ − .72) were found between I-DHI and I-SWAL-QoL subscales. Construct validity proved satisfactory as (i) moderate to strong correlations (.51 ≤ ρ ≤ .90) were found among I-DHI subscales; (ii) patients with more severe instrumentally or self-assessed OD reported higher I-DHI scores (p < .05); and (iii) OD patients scored higher at I-DHI compared to healthy participants (p < .05). Interpretability analyses revealed a floor effect for the Emotional subscale only and higher I-DHI scores (p < .05) for healthy participants > 65 years. In conclusion, the I-DHI is a reliable and valid HRQOL tool for Italian adults with OD. More... »

PAGES

1-17

References to SciGraph publications

  • 2021-02-13. Clinical Usefulness of the Korean Version of the Dysphagia Handicap Index: Reliability, Validity, and Role as a Screening Test in DYSPHAGIA
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  • 2002-07. Supraglottic Swallow, Effortful Swallow, and Chin Tuck Did Not Alter Hypopharyngeal Intrabolus Pressure in Patients with Pharyngeal Dysfunction in DYSPHAGIA
  • 2002-12. Interjudge and Intrajudge Reliabilities in Fiberoptic Endoscopic Evaluation of Swallowing (Fees®) Using the Penetration–Aspiration Scale: A Replication Study in DYSPHAGIA
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    27 schema:description The Dysphagia Handicap Index (DHI) is a valid Health-related Quality of Life (HRQOL) questionnaire for patients with oropharyngeal dysphagia (OD) of heterogeneous etiologies. The study aimed at crossculturally translating and adapting the DHI into Italian (I-DHI) and analyzing I-DHI reliability, validity, and interpretability. The I-DHI was developed according to Beaton et al. 5-stage process and completed by 75 adult OD patients and 166 healthy adults. Twenty-six patients filled out the I-DHI twice, 2 weeks apart, for test–retest reliability purposes. Sixty-two patients completed the Italian-Swallowing Quality of Life Questionnaire (I-SWAL-QoL) for criterion validity analysis. Construct validity was tested comparing I-DHI scores among patients with different instrumentally assessed and self-rated OD severity, comparing patients and healthy participants and testing Spearman’s correlations among I-DHI subscales. I-DHI interpretability was assessed and normative data were generated. Participants autonomously completed the I-DHI in maximum 10 min. Reliability proved satisfactory for all I-DHI subscales (internal consistency: α > .76; test–retest reliability: intraclass correlation coefficient > .96, k = .81). Mild to moderate correlations (− .26 ≤ ρ ≤ − .72) were found between I-DHI and I-SWAL-QoL subscales. Construct validity proved satisfactory as (i) moderate to strong correlations (.51 ≤ ρ ≤ .90) were found among I-DHI subscales; (ii) patients with more severe instrumentally or self-assessed OD reported higher I-DHI scores (p < .05); and (iii) OD patients scored higher at I-DHI compared to healthy participants (p < .05). Interpretability analyses revealed a floor effect for the Emotional subscale only and higher I-DHI scores (p < .05) for healthy participants > 65 years. In conclusion, the I-DHI is a reliable and valid HRQOL tool for Italian adults with OD.
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    34 DHI interpretability
    35 DHI reliability
    36 DHI scores
    37 DHI subscales
    38 Dysphagia Handicap Index
    39 HRQOL tools
    40 Handicap Index
    41 Italian adults
    42 Italian version
    43 Italian-Swallowing Quality
    44 Life Questionnaire
    45 OD patients
    46 OD severity
    47 SWAL-QoL subscales
    48 Spearman correlation
    49 adaptation
    50 adult OD patients
    51 adults
    52 al. 5-stage process
    53 analysis
    54 conclusion
    55 construct validity
    56 correlation
    57 criterion validity analysis
    58 cultural adaptation
    59 data
    60 dysphagia
    61 effect
    62 emotional subscale
    63 et al. 5-stage process
    64 etiology
    65 floor effects
    66 health-related quality
    67 healthy adults
    68 healthy participants
    69 heterogeneous etiology
    70 index
    71 interpretability
    72 interpretability analysis
    73 min
    74 moderate correlation
    75 normative data
    76 oropharyngeal dysphagia
    77 participants
    78 patients
    79 process
    80 purpose
    81 quality
    82 questionnaire
    83 reliability
    84 reliability purposes
    85 scores
    86 self-assessed OD
    87 self-rated OD severity
    88 severity
    89 strong correlation
    90 study
    91 subscales
    92 test-retest reliability purposes
    93 tool
    94 valid HRQOL tool
    95 valid health-related quality
    96 validation
    97 validity
    98 validity analysis
    99 version
    100 weeks
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