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Cultural adaptation and validation of the Norwegian version of the swallowing quality of life questionnaire (SWAL-QOL)

Journal article
Authors Maribeth Caya Rivelsrud
M. Kirmess
Lena Hartelius
Published in Health and Quality of Life Outcomes
Volume 17
Issue 1
Pages 11
ISSN 1477-7525
Publication year 2019
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Institute of Neuroscience and Physiology
Pages 11
Language en
Keywords Deglutition disorders, Oropharyngeal dysphagia, Health-related quality, of life, SWAL-QOL, Translation, Psychometric, Assessment, Treatment, health-related quality, functional oral intake, oropharyngeal dysphagia, outcomes tool, psychometric properties, dutch version, reliability, stroke, adults, prevalence, Health Care Sciences & Services
Subject categories Nursing


Introduction Oropharyngeal dysphagia (OD) is a disorder that can have devastating and long lasting effects on a person's medical, mental and psychosocial well-being, thus negatively impacting quality of life. There is currently no validated dysphagia-specific quality of life instrument in Norway. This project aims to evaluate the psychometric properties of the culturally adapted Norwegian version of SWAL-QOL (Nor-SWAL-QOL). Methods The original SWAL-QOL was translated into Norwegian according the international translation guidelines. A group of 102 persons with OD and a group of 123 healthy controls were recruited to assess the validity and reliability of the Nor-SWAL-QOL. Correlation analysis of the Nor-SWAL-QOL and the Short Form 36 (SF-36) and correlation analysis of OD group and control group Nor-SWAL-QOL subscale scores were computed to determine convergent, discriminant, and known-groups validity which help comprise construct validity. Internal consistency, test-retest reliability and intraclass correlation coefficient (ICC) were computed for reliability. Results Convergent and discriminant validity was demonstrated between Nor-SWAL-QOL subscales and SF-36 domains, and distinguished between persons with and those without oropharyngeal dysphagia on all subscales and on the symptom frequency battery (p < 0.001). Additionally, the Nor-SWAL-QOL differentiated between symptom severity levels within the OD group; those requiring food and liquid modifications and those who are tube fed and not tube fed. Nor-SWAL-QOL showed good reliability with adequate internal consistency (Cronbach's alpha >= 0.70), test-retest reliability (Spearman's rho values 0.68-0.90) and ICC values (0.67-0.89) for all subscales and for the symptom frequency battery. Conclusion Access to valid and reliable dysphagia-specific QoL outcome measures for health care practitioners, dysphagia clinicians and researchers is necessary for comprehensive assessment and treatment outcome measures. The Nor-SWAL-QOL exhibits sufficient psychometric properties for implementation in the Norwegian population.

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