Development of dysphagia screening questionnaire for Thai older adults

Abstract

Background: Oropharyngeal dysphagia is a common condition in the older person and can lead to serious complications. In Thailand, there is currently no standardized dysphagia screening tool for gathering preliminary information about clients for early evaluation and intervention. Objective: This study aimed to develop a dysphagia risk screening tool for older persons and investigate its psychometric properties. This study examined the content validity, criterion validity, and test-retest of the Geriatric Dysphagia Risk Screening Tool (GDRST). Materials and methods: 26 questions were developed from literature review and expert opinion. Five expert occupational therapists examined content validity. The Index of Congruence (IOC) was calculated from five experts, and the items that showed IOC scores of over 0.5 were incorporated into the target screening tool. Thirty older adults who had a risk of dysphagia (Mean±SD, 66.13±4.66 years) participated in the study. The internal consistency was assessed using Cronbach’s alpha. An intraclass correlation coefficient (ICC) was used to examine the test-retest reliability of the screening tool. The criterion validity of the GDRST was evaluated by investigating the relationships between a score of the Functional Oral Intake Scale (FOIS) and the Swallowing Quality Assessment Form for Occupational Therapists (SQAOT) using Spearman’s correlation coefficients. Results: Based on the literature review and occupational therapy expert opinions, the screening tool covers three domains, including the cognition domain, oral phase swallowing ability domain, and pharyngeal phase swallowing ability domain. Content validity IOC scores were between 0.6 and 1.0 for all items. The internal consistency of the GDRST was high, with 0.971 Cronbach’s alpha for the test. The screening tool had excellent test-retest reliability on all items (p<0.05). The score of the GDRST was significantly correlated with the score of FOIS (r=-0.468, p=0.009), and SQAOT (r=-0.705, p=0.000). Conclusion: The GDRST demonstrated excellent reliability and validity against the clinical assessment. It was simple to administer and could be beneficial for screening older people in the community for dysphagia.