Multiprofessional screening protocol for dysphagia in patients with HIV infection: elaboration and content validity

Soutinho, Luise Alexandre Rocha; Machado, Daniel Aragão; Marques, Charles Henrique Dias

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Original Article • CoDAS 34 (2) • 2022 • https://doi.org/10.1590/2317-1782/20212021012 copy

Multiprofessional screening protocol for dysphagia in patients with HIV infection: elaboration and content validity

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

To elaborate and validate a multiprofessional protocol to identify the risk of dysphagia in people with HIV at the time of hospitalization.

Methods

After bibliographic review, the dysphagia screening protocol created was submitted to the analysis of HIV/ Aids expert judges and target audience in the application of this instrument to perform content validity. These evaluators could suggest changes to the protocol, judging clarity, pertinence, and comprehensiveness. The CVI 0.78 was used to confirm the validity of the results.

Results

The protocol was created including aspects related to oral and pharyngeal swallowing, and the final score was calculated based on the risks for clinical complications. The instrument presented CVI above 0.78 for all items in the two validation phases, as well as total CVI of 0.92.

Conclusion

Based on the obtained data, it was possible to create and validate the screening protocol from the point of view of appearance and content, once it presented total CVI above the minimum value stipulated in the validation of the expert judges and the target public, obtaining an adequate result for the protocol. Therefore, we can consider the resolution instrument, with the capacity to fulfill what was proposed.

Keywords
Deglutition Disorders; Protocols; Mass Screening; Acquired Immunodeficiency Syndrome; HIV Infections

Variables	N	(%)
Gender
Female	6	-85.7
Male	1	-14.3
Age
30-40 years old	4	-57.1
41-50 years old	1	-14.3
51 years old or more	2	-28.6
Graduation
Speech-Language Therapy	3	-42.8
Nursing	2	-28.6
Medicine	1	-14.3
Nutrition	1	-14.3
Time of graduation
Up to 15 years	3	-42.8
16-30 years	2	-28.6
31 years or more	2	-28.6
Titration
Master's degree	4	-57.1
Doctorate	3	-42.9
Work area
Teaching	--	--
Assistance	1	-14.3
Teaching and Assistance	6	-85.7
Published articles
Yes	5	-71.4
No	2	-28.6

Instrument items of evaluation	Number of judges in agreement (n = 7)	CVI – I
1 – Do you have dental elements?	6	0.86
2 – Do you use a dental prosthesis?	6	0.86
3 – Do you have any difficulty making movements with your face?	6	0.86
4 – Is it difficult to keep the food/liquid in the mouth? Does it escape or fall through the lips?	7	1.00
5 – Do you take longer to feed than before?	6	0.86
6 – Do you take a long time or find it difficult to eat hard foods?	5	0.71 ^* * Items that obtained CVI - I less than 0.78
7 – After you swallow, are there remains of food in your mouth?	6	0.86
8 - Do you feel that you have a lot of saliva in your mouth or drool frequently?	7	1.00
9 – Do you feel pain when swallowing saliva, food, or liquids?	7	1.00
10 – Do you feel the food/liquid stuck in your throat?	7	1.00
11 – Do you need to swallow several times to feel that the food left your throat?	7	1.00
12 – Do you need to drink liquids to help the food go down?	6	0.86
13 – Do you feel that your voice changes during or after the meal?	6	0.86
14 – Do you cough or clear your throat during a meal?	6	0.86
15 – Do you feel suffocated or have difficulty breathing when eating?	7	1.00
16 – Does the food or drink go to the “wrong place” when you swallow it?	5	0.71*
	CVI – T	0.89

Instrument items of evaluation	Number of judges in agreement (n = 7)	CVI – I
1 – Do you have dental elements?	6	0.86
2 – Do you use a dental prosthesis?	6	0.86
3 – Do you have any difficulty making movements with your face (Facial Paralysis)?	6	0.86
4 – Is it difficult to keep the food/liquid in the mouth? Does it escape or fall through the lips?	7	1.00
5 – Do you eat faster or slower than before the disease?	6	0.86
6 – Do you take a long time or find it difficult to eat solid foods after the illness?	6	0.86
7 – After you swallow, are there remains of food in your mouth?	7	1.00
8 - Do you feel that you have a lot of saliva in your mouth or drool frequently when you are awake?	6	0.86
9 – Do you feel pain when swallowing saliva, food, or liquids?	7	1.00
10 – Do you feel the food/liquid stuck in your throat?	7	1.00
11 – Do you need to swallow several times to help the food go down your throat?	7	1.00
12 – Did you start drinking liquids to help the food go down after the illness?	6	0.86
13 – Do you feel that your voice changes during or after the meal?	6	0.86
14 – Do you cough or clear your throat during a meal?	6	0.86
15 – Do you feel suffocated or have difficulty breathing when eating?	7	1.00
16 – Do you choke often?	7	1.00
	CVI – T	0.92

Variables	N	(%)
Gender
Female	31	(86.1)
Male	5	(13.9)
Age
20 - 30 years old	23	(63.9)
31 - 40 years old	9	(25.0)
41 years old or more	4	(11.1)
Graduation/Job
Medicine	7	(19.4)
Nursing	4	(11.1)
Nursing technician	15	(41.7)
University students	10	(27.8)

Assessment instrument items	Number of judges in agreement (n = 36)	CVI – I
1 – Does it have dental elements?	36	1.00
2 – Do you use a dental prosthesis?	36	1.00
3 – Do you have any difficulty making movements with your face (Facial Paralysis)?	36	1.00
4 – Is it difficult to keep the food/liquid in the mouth? Does it escape or fall through the lips?	36	1.00
5 – Do you eat faster or slower than before the disease?	31	0.86
6 – Do you take a long time or find it difficult to eat solid foods after the illness?	35	0.97
7 – After you swallow, are there remains of food in your mouth?	35	0.97
8 - Do you feel that you have a lot of saliva in your mouth or drool frequently when you are awake?	33	0.92
9 – Do you feel pain when swallowing saliva, food, or liquids?	35	0.97
10 – Do you feel the food/liquid stuck in your throat?	35	0.97
11 – Do you need to swallow several times to help the food go down your throat?	36	1.00
12 – Did you start drinking liquids to help the food go down after the illness?	33	0.92
13 – Do you feel that your voice changes during or after the meal?	31	0.86
14 – Do you cough or clear your throat during a meal?	34	0.94
15 – Do you feel suffocated or have difficulty breathing when eating?	36	1.00
16 – Do you choke often?	36	1.00
	CVI – T	0.96

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[1] Conflict of interests: nothing to declare.