Oda Chihiro, Yamamoto Toshiyuki, Fukumoto Yutaka, Nakayama Keigo, Sato Masako, Murata Miho, Kobayashi Yoko
Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry; Department of Rehabilitation Medicine, Showa University School of Medicine.
Department of Neurology.
Patient Prefer Adherence. 2017 Feb 1;11:193-198. doi: 10.2147/PPA.S126052. eCollection 2017.
We developed, and examined the reliability and validity of, a Japanese version of the Dysphagia Handicap Index (DHI; DHI-J), which is a self-reported measure to assess the quality of life (QOL) of individuals with dysphagia.
The DHI-J was developed via the back-translation method: the DHI was translated into Japanese and then translated back into English by a native English speaker. The back translation was discussed with and approved by the DHI's lead author. A total of 229 patients (119 males, 110 females; median age: 66 years) who underwent videofluorography at our hospital between January and December 2013 and 65 controls (23 males, 42 females; median age: 44 years) were included in the study. All the subjects completed the DHI-J and self-reported their dysphagia severity. Twenty-three patients repeated the procedure 1 week later. Patients' swallowing function was classified as "normal", "moderately impaired", or "severely impaired", and the DHI-J total scores were compared between the severity groups.
The internal consistency of the DHI-J was high (Cronbach's =0.95), as was the test-retest reliability of the 23 patients who answered the questionnaire twice (intraclass correlation coefficient =0.98, <0.01). The DHI-J total score and its three subscale scores were significantly higher among the patients than among controls. A significant correlation (=0.85) was observed between the DHI-J total score and self-reported dysphagia severity score. Regarding the comparison of DHI-J scores by severity groups, the DHI-J total scores significantly differed between the normal and moderately impaired groups, and the normal and severely impaired groups. However, the moderately and severely impaired groups showed no significant difference in scores.
The DHI-J is a reliable and valid questionnaire for assessing the QOL of patients with dysphagia. However, we did not survey patients with cerebrovascular diseases; thus, the questionnaire must be validated for that patient group.
我们开发了吞咽障碍生活质量指数日语版（DHI-J），并检验了其信度和效度。DHI-J是一种通过自我报告来评估吞咽障碍患者生活质量（QOL）的方法。
DHI-J通过回译法开发：先将DHI翻译成日语，然后由一位以英语为母语的人士再译回英语。回译内容经DHI的主要作者讨论并批准。2013年1月至12月期间在我院接受电视荧光吞咽造影检查的229例患者（119例男性，110例女性；中位年龄：66岁）和65例对照者（23例男性，42例女性；中位年龄：44岁）纳入本研究。所有受试者均完成DHI-J并自我报告吞咽困难严重程度。23例患者在1周后重复该流程。将患者的吞咽功能分为“正常”“中度受损”或“重度受损”，并比较不同严重程度组之间的DHI-J总分。
DHI-J的内部一致性较高（Cronbach'sα=0.95），23例两次回答问卷的患者的重测信度也较高（组内相关系数=0.98，P<0.01）。患者的DHI-J总分及其三个子量表得分均显著高于对照者。DHI-J总分与自我报告的吞咽困难严重程度得分之间存在显著相关性（r=0.85）。关于按严重程度组比较DHI-J得分，正常组与中度受损组、正常组与重度受损组之间的DHI-J总分存在显著差异。然而，中度受损组和重度受损组之间的得分无显著差异。
DHI-J是评估吞咽障碍患者生活质量的可靠且有效的问卷。然而，我们未对脑血管疾病患者进行调查；因此，该问卷必须在该患者群体中进行验证。
