Woisard V, Lepage B
CHU Toulouse, Larrey Hospital, Voice and Deglutition Unit, ENT & Head and Neck Department, TSA 30030, 31059 Toulouse cedex 09, France.
Rev Laryngol Otol Rhinol (Bord). 2010;131(1):19-22.
The aim of this study is to contribute to the psychometric validation of the self-administrated dysphagia-specific quality of life questionnaire, the Deglutition Handicap Index. Created on the model of the "Voice Handicap Index". this questionnaire consists of 30 statements on deglutition related aspects in daily life (5 point-rating scale). It is subdivided in three domains of 10 items: physical (symptoms), functional (nutritional and respiratory consequences) and emotional (psychosocial consequences).
57 patients were included suffering of any kind of swallowing disorders. 17 questionnaires were eliminated because 1 to 3 items were not anchored. A test retest performed in an interval of 2 weeks, allowed the measure of the intraclasse correlation coefficient and the limits of agreement with Bland and Altman graphics.
The intraclasse correlation coefficient was respectively 0.77 (0.64-0.90), 0.87 (0.79-0.94), 0.90 (0.84-0.96), 0.91 (0.85-0.96) for the Physical, Functional, Emotional and Total Scores. The limits of agreement are 9 points for the subscales and 20 points for the total score.
The DHI has been validated in term of content, concurrent and construct validity. The reliability was satisfied in term of internal consistency. It is now validated for the temporal reliability. The DHI is the solely specific quality of life questionnaire related to deglutition available for all kind of oropharyngeal swallowing disorders in adults available in clinical practice.
本研究旨在为吞咽困难特异性生活质量自评问卷——吞咽障碍指数的心理测量学验证提供依据。该问卷以“嗓音障碍指数”为模型创建，由30条关于日常生活中吞咽相关方面的陈述组成（采用5级评分量表）。它分为三个领域，每个领域10项：身体（症状）、功能（营养和呼吸后果）和情感（心理社会后果）。
纳入57例患有任何类型吞咽障碍的患者。由于1至3项未锚定，17份问卷被剔除。在2周的间隔内进行重测，以测量组内相关系数以及用布兰德和奥特曼图表示的一致性界限。
身体、功能、情感和总分的组内相关系数分别为0.77（0.64 - 0.90）、0.87（0.79 - 0.94）、0.90（0.84 - 0.96）、0.91（0.85 - 0.96）。各分量表的一致性界限为9分，总分的一致性界限为20分。
吞咽障碍指数在内容效度、同时效度和结构效度方面均得到验证。在内部一致性方面可靠性良好。目前在时间可靠性方面也得到了验证。吞咽障碍指数是临床实践中唯一可用于评估成人各种口咽吞咽障碍的特异性生活质量问卷。
