Content validation of a Danish version of “The McGill Ingestive Skills Assessment” for dysphagia management

Abstract

This study addresses the first steps in the cross-cultural adaptation of a Danish version of the McGill Ingestive Skills Assessment (MISA), which quantifies eating and drinking abilities by scoring a meal observation. The original Canadian MISA was translated and adapted into Danish (MISA-DK). For content validation of the MISA-DK, a judgemental quantification process was applied using 13 experts. Thereafter, the MISA-DK was pilot tested by 16 occupational therapists. Finally, the MISA-DK was linked to the International Classification of Functioning, Disability and Health (ICF). Content validity of 43 items was found for 93% in terms of adequacy, 67% in terms of clarity of item description, 86% in terms of clarity of score descriptions, and 93% in terms of relevance. Thirteen of 14 sections of the instruction manual and score sheet were content valid. In light of these results, a revised MISA-DK was produced for the pilot test, which then found content validity for all sections and 98% of the items. The ICF linking resulted in 41 ICF-categories, which may reflect the complexity of eating and drinking as well as a multidimensional structure of the MISA-DK. In conclusion, the MISA-DK is prepared for psychometric testing using classical as well as modern test theory.

Reliability of the Danish version of the McGill Ingestive Skills Assessment for observation-based measures during meals

“…Each item is scored on a three-point ordinal scale, which is summarized to give subscale scores and a total score. Increasing scores indicate increasing ability levels in ingestive skills (10,16).…”

“…Instrumentation MISA-DK. The Danish translation of the MISA was used (16). It is composed of 43 items distributed into six subscales: (i) positioning (four items) addressing the patient's ability to maintain a position that is safe for eating and drinking; (ii) self-feeding skills (seven items) addressing the patient's self-feeding skills, behavior, and judgment; (iii) liquid ingestion (seven items) addressing the patient's oral motor and pharyngeal skills for liquids; (iv) solid ingestion (12 items) addressing the patient's oral motor and pharyngeal skills for solids; (v) texture management-solids (eight items) addressing the patient's ability to manage eight solid food textures; and (vi) texture managementliquids (five items) addressing the patient's ability to manage five liquid textures.…”

“…As the MISA provides evidence-based measurements not just for diagnosis but also for treatment planning and evaluation, it has been considered to be of value for Danish occupational therapists and has been translated into Danish (MISA-DK) (16). Translation and adaptation of assessment instruments involves equivalence (17).…”

“…Translation and adaptation of assessment instruments involves equivalence (17). Conceptual and semantic equivalence of the MISA-DK has been addressed through a comprehensive translation procedure, expert panel judgments, and pilot testing (16). Measurement equivalence in terms of construct validity and internal consistency has also been established (18).…”

Ingestive Skill Difficulties are Frequent Among Acutely-Hospitalized Frail Elderly Patients, and Predict Hospital Outcomes

“…For the assessment of ingestive skill performance, the Danish version of the McGill Ingestive Skills Assessment (MISA) was used (Hansen, Lambert, & Faber, 2011b). The MISA is administered during observation of a natural meal and includes 43 items distributed under five ingestive skill domains: 1) positioning (4 items), addressing the patient's ability to maintain a position that is safe for eating and drinking; 2) self-feeding skills (7 items), addressing the patient's self-feeding skills, behaviour, and judgement; 3) hquid ingestion (7 items), addressing the patient's oropharyngeal skills for liquids; 4) solid ingestion (12 items), addressing the patient's oropharyngeal skills for solids; and 5) texture management (13 items), addressing the patient's capability to manage eight solid food and five liquid textures.…”