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Validation and Application of the M.D. Anderson Dysphagia Inventory in Patients Treated for Head and Neck Cancer in Brazil

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Abstract

Analysis of quality of life (QOL) has revealed that preservation of swallowing, speech, and breathing functions has a direct impact on QOL and that these functions are important patient-reported outcomes. The purposes of this study were to adapt and culturally validate the M.D. Anderson Dysphagia Inventory (MDADI) to the Brazilian Portuguese language and to evaluate QOL related to dysphagia in patients treated for head and neck cancer. This was a cross-sectional study that included 72 adult patients with a mean age of 63 years who were treated for head and neck cancer. Construct validity and reliability analyses were performed through the comparison of the MDADI with three other health-related QOL questionnaires administered at the time of enrollment and MDADI application 2 weeks thereafter, respectively. Reliability was established by assuring both internal consistency (Cronbach’s α) and test–retest reliability (intraclass correlation coefficient, ICC). Test–retest reliability for the total score in the MDADI had an ICC greater than 0.795 (p < 0.001). The MDADI had significant statistical correlations with the other questionnaires. Patients treated for head and neck cancer had a mean total score of 83 on the MDADI, which is indicative of minimal limitation in overall QOL. In conclusion, the present study validates the adaptation of the MDADI to the Brazilian Portuguese language and provides another tool to evaluate the impact of dysphagia on the QOL of head and neck cancer patients.

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Acknowledgments

R. L. V. Guedes thanks CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) for financial support.

Conflict of interest

The authors declare that they have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Voice, Speech and Swallowing Rehabilitation Department, A. C. Camargo Hospital, São Paulo, Brazil

    Renata Lígia Vieira Guedes & Elisabete Carrara-de Angelis

  2. Otolaryngology Head and Neck Surgery Department, Emory University Hospital, Atlanta, GA, USA

    Amy Y. Chen

  3. Head and Neck Surgery and Otorhinolaryngology Department, A. C. Camargo Hospital, Rua Professor Antonio Prudente, 211, Liberdade, São Paulo, SP, 01509-900, Brazil

    Luiz Paulo Kowalski & José Guilherme Vartanian

Authors
  1. Renata Lígia Vieira Guedes
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  2. Elisabete Carrara-de Angelis
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  3. Amy Y. Chen
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  4. Luiz Paulo Kowalski
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  5. José Guilherme Vartanian
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Corresponding author

Correspondence to José Guilherme Vartanian.

Appendix

Appendix

Questionário de Disfagia M. D. Anderson (MDADI)

Nome: __________________________________________________________________

Data: ________________

Este questionário pergunta sobre sua habilidade de engolir (deglutir). Estas informações irão nos auxiliar a entender como você se sente em relação à sua deglutição. As questões que seguem foram preparadas por pessoas que têm problema com sua deglutição. Alguns dos itens podem ser relevantes para você.

Por favor, leia cada questão e marque a resposta que melhor reflete sua experiência na última semana.

Minha capacidade de deglutição limita minhas atividades diárias

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

E2. Eu tenho vergonha dos meus hábitos alimentares

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

F1. As pessoas têm dificuldade de cozinhar para mim

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

P2. É mais difícil engolir no fim do dia

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

E7. Sinto-me inseguro quando me alimento

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

E4. Eu estou triste pelo meu problema de deglutição

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

P6. Deglutir é um grande esforço

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

E5. Deixo de sair de casa por causa do meu problema de deglutição

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo( )Discordo totalmente

F5. Meu problema de deglutição tem me causado perda de rendimentos financeiros

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

P7. Eu levo mais tempo pra comer por causa do meu problema de deglutição

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

P3. As pessoas me perguntam, “Porque você não pode comer isto?”

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

E3. Outras pessoas se irritam por causa do meu problema de deglutição

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

P8. Eu tenho tosse quando eu tento beber líquidos

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

F3. Meus problemas de deglutição atrapalham minha vida pessoal e social

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

F2. Eu me sinto à vontade para sair pra comer com meus amigos, vizinhos e parentes

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

P5. Eu limito minha alimentação por causa da minha dificuldade de deglutição

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

P1. Perco peso devido ao meu problema de deglutição

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

E6. Eu tenho baixa auto-estima por causa do meu problema de deglutição

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

P4. Eu sinto que estou conseguindo deglutir uma grande quantidade de alimentos

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

F4. Eu me sinto isolado por causa dos meus hábitos de alimentação

( )Concordo totalmente ( )Concordo ( )Sem opinião ( )Discordo ( )Discordo totalmente

Obrigado por completar este questionário!

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Guedes, R.L.V., Angelis, E.Cd., Chen, A.Y. et al. Validation and Application of the M.D. Anderson Dysphagia Inventory in Patients Treated for Head and Neck Cancer in Brazil. Dysphagia 28, 24–32 (2013). https://doi.org/10.1007/s00455-012-9409-x

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