IN FOUCS: Building Collaborative Partnerships - 2023

Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/26727

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Subject: search.filters.subject.Dysphagia

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    Translation, cross-cultural adaptation, and validation of Dysphagia Handicap Index (DHI) into Sinhala language.
    (University of Kelaniya, Sri Lanka, 2023) Karunarathne, I.L.P.; Panterliyon, N.A.
    BACKGROUND: Dysphagia Handicap Index (DHI) is one of the self-evaluation instruments used for assessing patients with dysphagia. It is a reflection of the patient's quality of life in physical, emotional, and functional aspects. Although it is well-known and most used among English-speaking people, there is no available Sinhala version to be used in Sri Lankan context. The aim of this study was to translate, cross-culturally adapt and validate the DHI into the Sinhala Language. OBJECTIVE/S: The objectives of this study are to translate and cross-culturally adapt the original version of the DHI from English to Sinhala, to evaluate the internal consistency of the Sinhala Dysphagia Handicap Index (S-DHI) and to evaluate the content validity of the S-DHI. METHODS: This study comprised two phases. Phase 1 translation and cross-cultural adaptation of the DHI. It was explained under five stages such as forward translation of the DHI from English to Sinhala, synthesis of the translation, back translation of DHI from Sinhala to English, expert committee review, and pre-testing. Phase 2 involved evaluating the psychometric properties of the scale that was included testing the reliability and validity of the scale. Purposive sampling was the sampling method. A crosssectional was conducted with 125 adults (above 20 years) with dysphagia (target group) and 125 adults without dysphagia (control group). The target group was recruited from four dysphagia clinics at government hospitals in Sri Lanka (District hospitals of Gampaha, Ragama Rehabilitation, and Wathupitiwala). The control group was recruited from Mahara Niladhari Division. Cronbach’s alpha coefficient was implemented to measure the internal consistency of the DHI. The expert panel performed the content validity, including nine speech and language pathologists with three years working experience with dysphagia disorder. The convergent validityof the DHI was assessed using hypothesis testing. RESULTS: The S-DHI and all subscales (physical, emotional, functional) showed higher internal consistency (Cronbach’s alpha o.975, 0.96, 0.979 0.991) respectively. The S-DHI scores between the target group and the control group were significantly different (p<0.05). Content validation test revealed higher validity scores for the degree of relevance, degree of cultural appropriateness, and degree of simplicity (I-CVI= 0.99, 0.98, 0.98). CONCLUSION/S: The S-DHI has achieved higher internal consistency, convergent validity, and content validity. This scale can be used in both clinical and research settings in Sri Lanka.
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    Determining the proportion of dysphagia in post-stroke patients admitted to a teaching hospital in Sri Lanka.
    (University of Kelaniya, Sri Lanka, 2023) Fonseka, O.D.S.; Dharmarathne, N.I.
    BACKGROUND: Post-stroke dysphagia (PSD) is one of leading cause to increase the number of deaths in stroke patients in worldwide. By today, early identification and detection of post-stroke dysphagia is increased due to its severity. Sri Lanka is low-middle income country (LMIC) and currently there is no study about proportion of post-stroke dysphagia in Sri Lanka. Dysphagia is one of severe complications following stroke. And also, PSD can lead to even death. OBJECTIVE/S: The purposes of the study are to evaluate the proportion of patients with PSD admitted to North Colombo Teaching Hospital, Sri Lanka and to determine the association between communication impairments and post-stroke dysphagia. This is novice research question to Sri Lankan context. METHODS: This analytical cross-sectional study recruited seventeen (n=17) adults age ranging from 18 and above male and female who were consecutively admitted to stroke unit with the diagnosis if ischemic or hemorrhagic stroke during acute period of stroke. Stroke was confirmed by either CT or MRI. Patients who were admitted between 29th of November to 23rd of December 2022 were recruited. GUSS, EAT- 10 were administered to evaluate swallowing. Communication was evaluated when SLT record were not available. Period prevalence was measured to evaluate proportion of post-stroke dysphagia. Chi-square test, Mann-Whitney U test, and Kruskal-Wallis one way ANOVA were used to discover the association between dysphagia and communication impairment and other relevant variables. RESULTS: The proportion of dysphagia following stroke in a teaching hospital in Sri Lanka is 70.58%. Twelve (n=12) were presented with PSD. Mean age was 62.06 (SD=8.86) years. Majority of the sample was male (76.5%). The proportion of dysphagia in ischemic stroke is 52.94%. Association between PSD and communication impairment portrayed statistically significant association (x2 (1) = 5.4 , p=.020). Dysarthria is more prominent communication impairment of the sample (n=14). Overall, 88% of patients having communication impairment. Association between dysarthria and dysphagia (p=.707). CONCLUSION/S: Proportion of post-stroke dysphagia is in critical level and it significantly associates with communication impairments. In order to improve outcomes and minimize post-stroke period complications, immediate evaluation or detection of dysphagia is significant.