Cross-Cultural Adaptation and Validation of the Persian Version of the M. D. Anderson Dysphagia Inventory

Sharifi, Fardin; Qoreishi, Zahra Sadat; Bakhtiyari, Jalal; Ebadi, Abbas; Houshyari, Mohammad; Azghandi, Samira

doi:10.1055/s-0043-1776725

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International Archives of Otorhinolaryngology

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Original Research • Int Arch Otorhinolaryngol 28 (2) • 2024 • https://doi.org/10.1055/s-0043-1776725 copy

Cross-Cultural Adaptation and Validation of the Persian Version of the M. D. Anderson Dysphagia Inventory

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Dysphagia is a common issue in patients with head and neck cancer (HNC) and is known to negatively impact their quality of life. To evaluate the impact of dysphagia on the quality of life of HNC patients, the M. D. Anderson Dysphagia Inventory (MDADI) questionnaire was developed.

Objective

The present study aimed to culturally adapt and validate the MDADI for Persian-speaking individuals. The MDADI is a self-administered questionnaire designed to assess the impact of dysphagia on the quality of life of HNC patients.

Methods

The original MDADI questionnaire was translated into Persian using the forward-backward method, following the guidelines of the World Health Organization (WHO) for cultural adaptation. The content validity of the Persian version, MDADI-P, was assessed by 10 speech-language pathologists using the content validity index (CVI). Seventy-five HNC patients completed the MDADI-P to evaluate its convergent validity, which was determined by comparing the results with the Short-Form 36 (SF-36) questionnaire. Internal consistency and test-retest reliability were assessed using Cronbach α coefficient and intraclass correlation (ICC), respectively.

Results

The scale content validity index (S-CVI) for the MDADI-P was 0.90, indicating good content validity. The MDADI-P demonstrated satisfactory internal consistency (Cronbach α coefficient = 0.728) and test-retest reliability (ICC = 0.91). The total MDADI-P score exhibited a significant correlation with the physical and mental components of the SF-36 (0.456 and 0.349, respectively, p < 0.05).

Conclusion

The findings of the present study confirm the suitability of the MDADI-P in terms of content validity, construct validity, internal consistency, and test-retest reliability.

Keywords
M. D. Anderson dysphagia inventory; dysphagia; head and neck cancer; quality of life

Variable	Category	N (%)
Gender	Male	59 (78.7)
Gender	Female	16 (21.3)
Age (years old)	Range	20–88
	Median	57
	Mean ± SD	53 ± 1.88
Site of lesion	Oral cavity	21 (28)
	Pharynx	15 (20)
	Larynx	21 (28)
	Others	18 (24)
Treatments	Surgery	7 (9.3)
	Radiotherapy	14 (18.7)
	Chemotherapy	4 (5.3)
	Surgery and radiotherapy	20 (26.7)
	Radiotherapy and chemotherapy	15 (20)
	Surgery and radiotherapy and chemotherapy	9 (12)
	None	6(8)

QUESTION	Subscale	Kappa (CI)	Result
1	Global	1	Excellent
2	Emotional	0.9	Excellent
3	Functional	0.66	Good
4	Physical	0.79	Excellent
5	Emotional	0.79	Excellent
6	Emotional	1	Excellent
7	Physical	1	Excellent
8	Emotional	0.79	Excellent
9	Functional	0.79	Excellent
10	Physical	1	Excellent
11	Physical	1	Excellent
12	Emotional	0.9	Excellent
13	Physical	0.9	Excellent
14	Functional	1	Excellent
15	Functional	0.9	Excellent
16	Physical	1	Excellent
17	Physical	1	Excellent
18	Emotional	1	Excellent
19	Physical	0.79	Excellent
20	Functional	0.66	Good

	Standard deviation	ICC	95%CI
Global	13.8	0.56	0.42-0.73
Emotional	10.22	0.84	0.681-0.924
Functional	12.57	0.91	0.82-0.95
Physical	8.34	0.85	0.7-0.92
Total	7.90	0.91	0.81-0.91

MDADI SF-36	Global	Emotional	Functional	Physical	Total
Physical functioning	0.194	0.367^* * p < 0.05.	0.327^* * p < 0.05.	0.405^* * p < 0.05.	0.467^* * p < 0.05.
Social functioning	- 0.1	0.05	0.09	0.223	0.156
Physical role	0.02	- 0.105	- 0.04	0.08	- 0.028
Emotional role	0.43	- 0.145	0.07-	0.225	0.013
Mental health	0.112	0.267^* * p < 0.05.	0.285^* * p < 0.05.	0.142	0.292^* * p < 0.05.
Vitality	0.233^* * p < 0.05.	0.166	0.172	0.209	0.233^* * p < 0.05.
Body pain	0.040	0.196	0.222	0.295^* * p < 0.05.	0.304^* * p < 0.05.
General health	0.201	0.396^* * p < 0.05.	0.361^* * p < 0.05.	0.319^* * p < 0.05.	0.455^* * p < 0.05.
Physical components	0.222	0.332^* * p < 0.05.	0.327^* * p < 0.05.	0.413^* * p < 0.05.	0.456^* * p < 0.05.
Mental components	0.179	0.206	0.250^* * p < 0.05.	0.359^* * p < 0.05.	0.349^* * p < 0.05.
Total	0.186	0.268^* * p < 0.05.	0.297^* * p < 0.05.	0.433^* * p < 0.05.	0.427^* * p < 0.05.

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[1] Address for correspondence Jalal Bakhtiyari, Speech Therapy Department, Tehran University of Medical Sciences, Tehran, Iran (e-mail: Bakhtiyari.slp@gmail.com).