Dysphagia, which refers to difficulties in swallowing, is a common clinical dysfunction with high morbidity in the ageing population. At least four validated questionnaires are available for assessing swallowing-related quality of life. These include the M. D. Anderson Dysphagia Inventory (MDADI), the Swallow Quality-of-Life Questionnaire (SWAL-QOL), the Sydney Swallowing Questionnaire (SSQ) and the Dysphagia Handicap Index (DHI). However, these questionnaires are either designed for some specific dysphagic populations or only focused on the impact of swallowing disorders at the impairment level. The Swallowing Activity and Participation Profile (SAPP) has been developed and validated as a self-reported tool for dysphagic population to assess the effects of swallowing problems on the physical, functional and social aspects of quality of life.
It is common to find the elderly population exhibiting cognitive impairment. Elderly people with cognitive impairment may have difficulties completing the questionnaire by themselves. In such cases, family members or caregivers are often asked to judge how the dysphagic individuals are affected by the swallowing dysfunction. There are, however, most of the previous studies failed to investigate the validity and reliability of such proxy method. Thus, the objective of this study was to verify the reliability of proxy method in assessing swallowing-related quality of life for frail elderly people who are not able to finish the self-reported questionnaire because of their cognitive impairment.
Forty-six elderly individuals (24 males and 22 females) and their respective caregivers (six males and 36 females) participated in this study. All the elderly received a clinical swallowing assessment to confirm the existence and the severity of dysphagia. They were assigned into the dysphagic group and the non-dysphagic group according to the results of swallowing assessment, and then asked to complete a quality of life questionnaire (SAPP) and a swallowing function scale, called Eating Assessment Tool (EAT-10). Their caregivers were invited to complete the same assessment tasks from the perspective of the elderly and to report how they perceived the elderly persons’ swallowing–related quality of life as the proxies.
The scores obtained from the questionnaires filled out by the elderly participants and their caregivers were compared. The findings showed that there was no statistically significant agreement between the elderly and the caregivers. The association between the responses of the elderly and the caregivers on quality of life was not as strong as what was hypothesized at the beginning of this study. However, the test-retest reliability of the instrument of this study was good, as shown by the intra-class correlation coefficient in the elderly group. The current study found that dysphagia had a negative impact on the dysphagic elderly’s emotional well-being, but was not clear if the proxy method could be used as a valid and reliable method for assessing the elderly’s swallowing-related quality of life. Further studies with a larger sample size and a wider range of dysphagia severity are needed. / published_or_final_version / Speech and Hearing Sciences / Master / Master of Philosophy
| Identifer | oai:union.ndltd.org:HKU/oai:hub.hku.hk:10722/202377 |
| Date | January 2014 |
| Creators | He, Weijia, 何維佳 |
| Contributors | Chan, KMK, Yiu, EML |
| Publisher | The University of Hong Kong (Pokfulam, Hong Kong) |
| Source Sets | Hong Kong University Theses |
| Language | English |
| Detected Language | English |
| Type | PG_Thesis |
| Rights | The author retains all proprietary rights, (such as patent rights) and the right to use in future works., Creative Commons: Attribution 3.0 Hong Kong License |
| Relation | HKU Theses Online (HKUTO) |
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