[Validation of a self-assessment questionnaire for swallowing disorders (Deglutition Handicap Index)].

OBJECTIVES: The aim of this study is the psychometric validation of a self-assessment questionnaire about swallowing disorders among adults, insisting on the validity of its content. MATERIAL AND
METHOD: Created on the model of the "Voice Handicap Index", this questionnaire is composed of 30 statements on deglutition related aspects in daily life (5 point-rating scale). It is subdivided in three domains of 10 items: physical (S) (symptoms related to swallowing), functional (F) (nutritional and respiratory consequences) and emotional (E) (psychosocial consequences). Our first goal was to verify wether the different domains of the questionnaire were well related to what we wished to quantify or not. Therefore, regarding the domain S we compared the physiopathological mechanisms assessed by videofluoroscopy examination, for the domain F its results compared to the nutritional status and for domain E a scale of quality of life.
RESULTS: 96 patients with dysphagia and 53 normal subjects were included in the study. The internal consistency reliability was correct (Cronbach's alpha= 0.9), For the domain S the difference between the normal subjects and the patients was statically significant. Our hypothesis regarding the domains were confirmed but not specifically. The domain S is related to the physiopathological mechanisms but also to the degree of severity. There are some correlations between the domain F and the nutritional status but also the results of the videofluoroscopy and the scale of quality of life. The domain E presents a fair correlation with the quality of life but it's related too much to physiopathological mechanisms, the duration of meal and the severity. As a conclusion, the results of this study allows to resume the validation without modification in the questionnaire. We are thinking, because of its similarity with the "Voice Handicap Index", to name it the "Deglutition Handicap Index".