The Dysphagia Handicap Index: Development and Validation

Abstract

Quality-of-life indicators for dysphagia provide invaluable information to the treating clinician regarding the success or failure of swallowing therapy. The purpose of this study was to develop a clinically efficient, statistically robust patient-reported outcomes tool that measures the handicapping effect of dysphagia on emotional, functional, and physical aspects of individual's lives. 60 statements describing the handicapping effect of dysphagia were collected from patient reports and divided into subscales of physical, emotional, and functional problems. The statements were presented to 77 individuals with dysphagia. Respondents replied never, sometimes, or always to each statement and rated their self-perceived dysphagia severity on a 7-point equal-appearing interval scale. Cronbach's α was performed to assess the internal consistency validation of the items within the questionnaire. The final questionnaire was reduced to 25 items and administered to 214 individuals with dysphagia and 74 controls. Test-retest was performed on 63 individuals with dysphagia. Cronbach's α for the initial and final versions was strong at r = 0.96 and r = 0.94, respectively. Significant differences occurred between the dysphagia and control groups. Test-retest reliability was strong. We present a new, easy-to-complete, statistically robust, patient-reported outcomes measure for assessing the handicapping effect of dysphagia.

Validation and Cultural Adaptation of the Arabic Version of the Eating Assessment Tool (EAT-10)

“…Some of these tools were developed for studying certain disorders [3,27,28,29,30,31,32,33], while others have been criticized for being long, time-consuming, and for the difficulty in understanding individual items [19,34,35,36,37]. Serving the same purpose of developing a self-assessment tool of swallowing disorders, the Dysphagia Handicap Index was developed and translated into the Arabic language to provide valid and reliable patient-reported outcomes for dysphagia depending on the physical, functional, and emotional domains [38,39]. …”

Escalas de calidad de vida y valoración de los síntomas en disfagia

“…La versión final es un cuestionario de 25 ítems relacionados con aspectos de la deglución en la vida diaria; se encuentra subdividido en 3 dominios, cada ítem puede ser calificado en "nunca", "algunas veces" y "siempre" y se extrapola a una escala de 0 a 4 (siendo cero= nunca, dos=algunas veces y cuatro=siempre) y tiene que ver con: aspectos emocionales (7 ítems relacionados con consecuencias psicosociales), funcionales (9 ítems relacionados con consecuencias re spiratorias y nutricionales) y físicos (9 ítems con síntomas relacionados a la deglución). Se encontró que el DHI diferencia los individuos con disfagia y los controles, que tiene una alta validez interna y fiabilidad test-retest; es sensible a las diferencias significativas en el score basado en la severidad clínica de la disfagia (17).…”

Utilização de protocolos de qualidade de vida em disfagia: revisão de literatura

“…The score ranges from 0 to 100, and the lower the score, the more negative is the effect of dysphagia in QoL 5,9 . But Dysphagia Handicap Index (DHI) questionnaire 12 consists of 25 items divided into emotional, physical, functional and one global subcategories, besides the self-assessment of the degree of difficulty in swallowing referred by the subject, which may vary from normal to severe. It evaluates the effects of dysphagia on QoL in subjects with different underlying diseases and may also be used in subjects with lower levels of education.…”

“…As a complement, assists the professional speech and language therapist in preparing its conduct, monitoring of motivation for therapy, as well as it serves as a parameter to note the success of the rehabilitation process of the dysphagic subject 2,12 . SWAL-QOL 11 protocol is an important selfassessment tool that allows elucidate the impact on QoL of the subjects resulting from the changes made at the time of feeding 8 .…”