Psychometric and structural properties of Traditional Chinese version of postoperative oral dysfunction-10 in patients with oral cancer undergoing facial free flap reconstruction surgery.

PURPOSE: Dysphagia is a frequent complication in oral cancer patients after free-flap reconstruction. Although the Postoperative Oral Dysfunction-10 (POD-10) is widely used to assess swallowing dysfunction, no validated Traditional Chinese version exists for Mandarin-speaking Taiwanese patients. This study aimed to translate the POD-10 into Traditional Chinese (TC-POD-10) and evaluate its reliability and validity in Mandarin-speaking Taiwanese patients with oral cancer undergoing free-flap reconstruction.

METHODS

A cross-sectional study was conducted with 100 oral cancer patients post free-flap surgery in a medical center. Internal consistency was tested using Cronbach's alpha. Construct validity was evaluated through exploratory factor analysis (EFA). Criterion validity was assessed by correlating TC-POD-10 with the Chinese Functional Oral Intake Scale (FOIS). Known-group validity was tested using Eating Assessment Tool-10 (EAT-10) scores to distinguish between patients with and without dysphagia. Diagnostic accuracy was determined using the area under the receiver operating characteristic curve (AUC).

RESULTS

The TC-POD-10 demonstrated excellent internal consistency (α = 0.94) and strong correlation with FOIS (r = -0.89, p < 0.001). Patients with dysphagia had significantly higher TC-POD-10 scores (14.6 vs. 10.0, p < 0.001). EFA revealed a single-factor model explaining 65.6% of variance. The tool showed high accuracy (AUC = 0.92), with sensitivity of 89% and specificity of 96% at a cutoff score of 15.

CONCLUSION

The TC-POD-10 is a reliable and valid instrument for assessing dysphagia in Taiwanese oral cancer patients. Its strong psychometric performance supports its clinical use for evaluating and managing swallowing dysfunction.