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Validation and Psychometric Properties of the German Version of the SWAL-QOL

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Abstract

The SWAL-QOL questionnaire is a common tool for evaluating patients’ dysphagia-specific quality of life. A validated German version is not available. This study aimed to establish a German version of the SWAL-QOL (G-SWAL-QOL) using a standardized translation procedure and to systematically evaluate its psychometric properties. The original SWAL-QOL was translated into German following international translation guidelines. A pilot study (45 subjects) confirmed comprehensibility of the G-SWAL-QOL. A consecutive series of 158 subjects (103 patients with dysphagia; 55 healthy controls) was then recruited to assess validity and reliability of the G-SWAL-QOL. Construct validity was analyzed through a correlation analysis with both (i) the Anderson Dysphagia Inventory (ADI-D) and (ii) the Short Form 36 (SF-36). Internal consistency and test–retest reliability were evaluated to determine reliability. All questions of the G-SWAL-QOL were comprehensible, except one which was subsequently revised. Construct validity of the G-SWAL-QOL was demonstrated by moderate to high correlations with the ADI-D (Spearman’s rho 0.36 – 0.88). The G-SWAL-QOL was able to differentiate between patients with dysphagia and healthy controls (p < 0.001) and was sensitive to disease severity measured by different food textures. Reliability of the G-SWAL-QOL was good to excellent for both internal consistency (Cronbach’s α > 0.7 for all domains, except eating desire [α = 0.69]) and test–retest reliability (Spearman’s rho ≥ 0.68 for all domains; ICC > 0.8 for all domains). The G-SWAL-QOL is a valid and reliable measuring tool for dysphagia-specific quality of life in German-speaking persons.

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Acknowledgements

This study was supported by the IZKF Promotionskolleg Tübingen (to EK and MS, IZKF 2016-1-07), the National Health and Medical Research Council of Australia (Career Development Fellowship, ID 1082910, to APV), and the Alexander von Humboldt Foundation (to APV).

Funding

A/Prof Vogel receives funding from the National Health and Medical Research Council, Australia (Career Development Fellowship ID 1082910), is funded by Australian Research Council Grants (LP130100026, DP130101900), receives funding from the Alexander von Humboldt Foundation, and receives institutional support from The University of Melbourne. Dr. Synofzik received honoraria from Actelion pharmaceuticals, unrelated to the current study.

Author information

Authors and Affiliations

  1. Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany

    Eva-Maria Kraus, Natalie Rommel, Lisa H. Stoll, Adam P. Vogel & Matthis Synofzik

  2. Therapiezentrum, University Hospital Tübingen, Tübingen, Germany

    Natalie Rommel & Lisa H. Stoll

  3. Neurology and Rehabilitation, Kliniken Schmieder, Gailingen am Hochrhein, Germany

    Andreas Oettinger

  4. Centre for Neuroscience of Speech, The University of Melbourne, 550 Swanston Street, Parkville, Melbourne, VIC, 3010, Australia

    Adam P. Vogel

  5. Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany

    Matthis Synofzik

  6. Center for Neurology, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany

    Matthis Synofzik

Authors
  1. Eva-Maria Kraus
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  2. Natalie Rommel
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  3. Lisa H. Stoll
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  4. Andreas Oettinger
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  5. Adam P. Vogel
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  6. Matthis Synofzik
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Contributions

EMK contributed to the design of the study, collection, analysis, and interpretation of the data, and drafting of the manuscript. NR contributed to the design of the study, collection of the data, and revision of the manuscript for intellectual content, and supervised students. LHS contributed to the design of the study, collection of the data, and revision of the manuscript for intellectual content. AO contributed to the design of the study, collection of the data, and revision of the manuscript for intellectual content. APV conceptualized the study and contributed to the design of the study, analysis and interpretation of the data, and revision of the manuscript for intellectual content. He also supervised students, led the research team, and obtained funding for the research. MS conceptualized the study and contributed to the design of the study, collection, analysis, and interpretation of the data, and revision of the manuscript for intellectual content. He also supervised students, led the research team, and obtained funding for the research.

Corresponding authors

Correspondence to Adam P. Vogel or Matthis Synofzik.

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Conflict of interest

Kraus, Rommel, Stoll, and Oettinger have declared no conflict of interest.

Ethical Approval

This study was approved by the ethics committee of the university of Tübingen (Az. 003/2015BO2).

Informed Consent

Informed written consent was obtained from all subjects.

Additional information

Adam P. Vogel and Matthis Synofzik are the joint last authors.

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Kraus, EM., Rommel, N., Stoll, L.H. et al. Validation and Psychometric Properties of the German Version of the SWAL-QOL. Dysphagia 33, 431–440 (2018). https://doi.org/10.1007/s00455-017-9872-5

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  • DOI: https://doi.org/10.1007/s00455-017-9872-5

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