title: Cross-Cultural Adaptation and Validation of the Italian Version of SWAL-QOL.
abstract: The aim of the study was to evaluate the reliability and validity of the Italian SWAL-QOL (I-SWAL-QOL). The study consisted of five phases: item generation, reliability analysis, normative data generation, validity analysis, and responsiveness analysis. The item generation phase followed the five-step, cross-cultural, adaptation process of translation and back-translation. A group of 92 dysphagic patients was enrolled for the internal consistency analysis. Seventy-eight patients completed the I-SWAL-QOL twice, 2 weeks apart, for test-retest reliability analysis. A group of 200 asymptomatic subjects completed the I-SWAL-QOL for normative data generation. I-SWAL-QOL scores obtained by both the group of dysphagic subjects and asymptomatic ones were compared for validity analysis. I-SWAL-QOL scores were correlated with SF-36 scores in 67 patients with dysphagia for concurrent validity analysis. Finally, I-SWAL-QOL scores obtained in a group of 30 dysphagic patients before and after successful rehabilitation treatment were compared for responsiveness analysis. All the enrolled patients managed to complete the I-SWAL-QOL without needing any assistance, within 20 min. Internal consistency was acceptable for all I-SWAL-QOL subscales (α > 0.70). Test-retest reliability was also satisfactory for all subscales (ICC > 0.7). A significant difference between the dysphagic group and the control group was found in all I-SWAL-QOL subscales (p < 0.05). Mild to moderate correlations between I-SWAL-QOL and SF-36 subscales were observed. I-SWAL-QOL scores obtained in the pre-treatment condition were significantly lower than those obtained after swallowing rehabilitation. I-SWAL-QOL is reliable, valid, responsive to changes in QOL, and recommended for clinical practice and outcome research.
authors.affiliation: Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Ginocchio
authors.affiliation: Department of Neurophysiology and Neurorehabilitation, National Institute of Neurology, "C. Mondino" Foundation IRCCS, University of Pavia, Pavia, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Alfonsi
authors.affiliation: Phoniatric Unit, Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Mozzanica
authors.affiliation: Department of Surgical Sciences, University of Turin, Turin, Italy.
authors.forename: Anna Rosa
authors.initials: AR
authors.lastname: Accornero
authors.affiliation: Department of Rehabilitation Medicine, San Giorgio Hospital, University of Ferrara, Ferrara, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Bergonzoni
authors.affiliation: Department of Otorhinolaryngology, University Hospital of Ferrara, Ferrara, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Chiarello
authors.affiliation: Department of Otorhinolaryngology, University Hospital of Ferrara, Ferrara, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: De Luca
authors.affiliation: Audiology-Phoniatrics Unit, Infermi Hospital, Rimini, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Farneti
authors.affiliation: Speech and Swallowing Rehabilitation Service, "Santa Lucia" Foundation IRCCS, Rome, Italy.
authors.forename: Simonelli
authors.initials: S
authors.lastname: Marilia
authors.affiliation: Speech and Swallowing Rehabilitation Service, "Santa Lucia" Foundation IRCCS, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Calcagno
authors.affiliation: Audiology-Phoniatrics Unit, Infermi Hospital, Rimini, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Turroni
authors.affiliation: Phoniatric Unit, Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy. antonio.schindler@unimi.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Schindler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D065246:Culturally Competent Care; D003680:Deglutition Disorders / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D014177:Translations
keywords: Deglutition; Dysphagia; Outcome; Self-assessment; Swallowing disorders