Translation and Cross-Cultural Adaptation of Sydney Swallow Questionnaire in Urdu and Its Psychometric Properties Among Post-Stroke Dysphagia Patients.

OBJECTIVES

Self-rating questionnaires provide a detailed overview of the symptomatic severity of post-stroke dysphagia in the geriatric population; such assessment tools or the subjective evaluation of post-stroke dysphagia are unavailable for Urdu-speaking patients. Sydney Swallow Questionnaire (SSQ) is a reliable assessment tool used to evaluate the symptoms of dysphagia, especially among geriatric patients with oropharyngeal dysphagia. The purpose of this study was translation and cross-cultural adaptation of the SSQ in Urdu and to assess its psychometric properties among post-stroke dysphagia patients.

METHODS

The SSQ was translated following the WHO Guidelines for Translation and Adaptation. Cognitive interviews and focused group discussions were conducted to evaluate the comprehension level of the questionnaire among Urdu-speaking clinicians. After getting ethical approval from the Shifa Review Board, the final version was administered to 61 patients with post-stroke dysphagia to assess the severity of the problem they faced during swallowing. Psychometric properties, including Cronbach's alpha reliability, test-retest reliability, intra-rater reliability, and scale validity index, were assessed to confirm the standardization of the questionnaire.

RESULTS

The Urdu version of SSQ had a Cronbach's alpha reliability of 0.941 with a p value of 0.000, which was very close to the original questionnaire. Test-retest and inter-rater reliability of SSQ-Urdu (SSQ-U) shows Cronbach's alpha reliability of 0.990 and 0.993, respectively. The final version fulfilled the criteria of psychometric properties, showing a Content Validity Index of 0.862 and a Scale Content Validity Index of 0.8.

CONCLUSIONS

Results of cognitive interviews depicted that the Urdu-translated final version of SSQ was close to the original version, and was easy to comprehend, and well accepted by both clinicians and post-stroke dysphagia patients. The SSQ-U proves to be a valid and reliable tool for assessing dysphagia among post-stroke patients of Pakistan and can be used for academic, clinical, and research purposes.