Vergauwen Alice, Van den Steen Leen, Baudelet Margot, Van Nuffelen Gwen
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Antwerp University Hospital, Antwerp, Belgium.
Dysphagia. 2024 Oct 21. doi: 10.1007/s00455-024-10771-6.
Dysphagia is a prevalent complication before, during and after treatment for head and neck cancer (HNC). Besides the medical and societal consequences, dysphagia has a negative impact on functioning, activity, participation and quality of life. These aspects are all affected by the environmental factors (EF). However, patient-reported outcome measures (PROMS) such as the Head-and-Neck Cancer Survivors' Assessment of Mealtimes (HNSAM), which thoroughly assess participation and EF in addition to function and activity, are rare. Therefore, this study aimed to translate and validate the HNSAM into Dutch (D-HNSAM). The HNSAM was translated according to the standardized procedure of translation & back-translation and according to the international cross-cultural adaptation process. A pilot study was then conducted with 10 HNC patients to assess the linguistic features and comprehensibility of the test items. Finally, the D-HNSAM was completed by 50 participants who were at least 6 months post-treatment for HNC. The Performance Status Scale for Head and Neck cancer patients (PSS-HN)- subscales normalcy of diet and eating in public, the Dysphagia Handicap Index (DHI), the Functional Oral Intake scale (FOIS) and the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) were used to examine the psychometric properties of the D-HNSAM. High correlations with related assessment tools and low correlations with unrelated assessment tools were expected. Internal consistency was found to be weak to good. Test-retest reliability, convergent validity and divergent validity were demonstrated except for the EF subscale. The D-HNSAM can detect differences in impact of dysphagia on daily functioning and quality of life. The D-HNSAM is a reliable and clinically valuable PROM for assessing the impact of dysphagia on daily functioning and quality of life in patients with HNC. The unique aspect of this PROM, the subscale EF, has unfortunately weak psychometric properties and requires further refinement.
吞咽困难是头颈癌（HNC）治疗前、治疗期间及治疗后的常见并发症。除了医学和社会影响外，吞咽困难还会对功能、活动、参与度和生活质量产生负面影响。这些方面均受环境因素（EF）影响。然而，像头颈癌幸存者用餐时间评估（HNSAM）这样除功能和活动外还能全面评估参与度和环境因素的患者报告结局测量工具（PROMS）却很少见。因此，本研究旨在将HNSAM翻译成荷兰语（D-HNSAM）并进行验证。HNSAM是按照翻译与回译的标准化程序以及国际跨文化适应流程进行翻译的。随后对10名头颈癌患者进行了一项预试验，以评估测试项目的语言特征和可理解性。最后，50名头颈癌治疗后至少6个月的参与者完成了D-HNSAM。使用头颈癌患者性能状态量表（PSS-HN）的饮食正常和在公共场合进食子量表、吞咽障碍 handicap指数（DHI）、功能性口服摄入量量表（FOIS）以及乌得勒支康复参与评估量表（USER-P）来检验D-HNSAM的心理测量特性。预期与相关评估工具具有高相关性，与不相关评估工具具有低相关性。发现内部一致性从弱到良好不等。除环境因素子量表外，均证明了重测信度、收敛效度和区分效度。D-HNSAM能够检测出吞咽困难对日常功能和生活质量影响的差异。D-HNSAM是一种可靠且具有临床价值的患者报告结局测量工具，用于评估吞咽困难对头颈癌患者日常功能和生活质量的影响。不幸的是，该患者报告结局测量工具的独特方面，即环境因素子量表，其心理测量特性较弱，需要进一步完善。
