Health Related Quality of Life and Oropharyngeal Dysphagia

Virginie Woisard, Florence Sordes

Abstract


The historical developpement of the “quality of life (QOL)” construct may explain some differences between several kinds of questionnaires of health Related Quality of life (HRQOL) The aim of this paper is to analyse the HRQOL questionnaires used in the field of oropharyngeal dysphagia from a clinical point of view. A systematic search was performed using the electronic databases Pubmed. Only original research articles describing HRQOL questionnaires in oropharyngeal dysphagia were included. Psychometric properties, correlations with generic QOL questionnaires, Severity scales and objective assessments were analysed. Four questionnaires were included: the SWAL-QOL, the MD Anderson Dysphagia Inventory (MDADI), the Deglutition Handicap Index and the Dysphagia Handicap Index (DyHI). Not all criteria for psychometric properties have been adequately met. However, the fundamental properties were validated, i.e. a complete process broadly used in research or clinical practice by the medical community. These questionnaires, such as generic QOL questionnaires, give independent information in the field of oropharyngeal dysphagia. The connections with the severity of the swallowing disorder are moderate and the connections with objective assessment or aetiologic disease are poor. Notwithstanding the appropriate psychometric properties for research, their indication is limited because (1) no rules are defined for missing answers; (2) when hitting the highest score, no study about the interaction between domains is available; (3) there is no study about the effects of depression and socio economic data; (4) there is no information about the reliability after a long period of time. However, in practice, they help identifying patients’ concerns and understanding their emotional state. The historical developpement of the “quality of life (QOL)” construct may explain some differences between several kinds of questionnaires of health Related Quality of life (HRQOL) The aim of this paper is to analyse the HRQOL questionnaires used in the field of oropharyngeal dysphagia from a clinical point of view. A systematic search was performed using the electronic databases Pubmed. Only original research articles describing HRQOL questionnaires in oropharyngeal dysphagia were included. Psychometric properties, correlations with generic QOL questionnaires, Severity scales and objective assessments were analysed. Four questionnaires were included: the SWAL-QOL, the MD Anderson Dysphagia Inventory (MDADI), the Deglutition Handicap Index and the Dysphagia Handicap Index (DyHI). Not all criteria for psychometric properties have been adequately met. However, the fundamental properties were validated, i.e. a complete process broadly used in research or clinical practice by the medical community. These questionnaires, such as generic QOL questionnaires, give independent information in the field of oropharyngeal dysphagia. The connections with the severity of the swallowing disorder are moderate and the connections with objective assessment or aetiologic disease are poor. Notwithstanding the appropriate psychometric properties for research, their indication is limited because (1) no rules are defined for missing answers; (2) when hitting the highest score, no study about the interaction between domains is available; (3) there is no study about the effects of depression and socio economic data; (4) there is no information about the reliability after a long period of time. However, in practice, they help identifying patients’ concerns and understanding their emotional state.

Keywords


Dysphagia; Quality of life; psychometric validation

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