Psychometrics of a Chinese translation of the swallowing questionnaire

Aims of the study. The purpose of this study was to determine the psychomet ric properties of a Chinese version of a swallowing questionnaire. Background/Rationale. Impaired swallowing may lead to serious complications if health care professionals do not accurately assess the problem and prom ptly intervene. The recognition of symptoms indicative of a swallowing prob lem is essential for nurses. The swallowing questionnaire could provide nur ses with a valid instrument to assess patients' impaired swallowing. Designs/Methods. Phase I consisted of experts doing the initial translation into Chinese and back-translations of the questionnaire. Five experts then determined content validity of the Chinese version, and 35 bilingual subje cts determined equivalence of the Chinese translation and English version. Phase II determined concurrent validity and internal consistency using 113 screened medical patients as subjects. Phase III used 105 screened long-ter m care subjects to determine construct validity. Results/Findings. In Phase I, rating on the appropriateness of items on the Chinese version yielding a content validity index of 0.988. The coefficien t of equivalence between the Chinese and English versions of the instrument was 0.81, while per cent agreement for all items on the two versions range d from 0.80-1.00. Phase II established internal consistency with a K-R20 of 0.74, and concurrent validity yielded a correlation between the swallowing questionnaire and the neurological swallowing exam of 0.675 (P < 0.01). Ph ase III determined construct validity with significant positive correlation s found between the swallowing questionnaire and stroke history and mastica tory ability. Significant negative correlations were found between swallowi ng and cognitive status, functional status and albumin. Conclusions, Although useful as a tool for nursing assessment and intervent ion, further work on the swallowing questionnaire such as conducting video fluoroscopy and a swallowing speed test, are recommended to further validat e its accuracy.