Development of the Swallowing Activity and Participation Profile (SAPP) – a quality of life questionnaire based on the ICF framework

Abstract

Introduction Quality-of-life (QoL) questionnaires for dysphagia provide valuable insight into the disorder and help to monitor treatment progress and outcomes. Existing questionnaires are often designed with narrow target populations and present with inconveniences during usage, such as long administering time and complex scoring system, and does not address all limitations imposed by swallowing disorders. The Swallowing Activity and Participation Profile (SAPP) aims to adopt the International Classification of Functioning, Disability and Health (ICF) framework to address the shortcomings in currently available QoL questionnaires. This study is ongoing to improve and validate the SAPP in various dysphagic populations. Method The SAPP was initially devised by three speech therapy researchers as a 38-item questionnaire across 5 sections, measured on a 10-point Likert scale. Its psychometric properties were investigated in elderly individuals in nursing facilities and compared with the M.D. Anderson dysphagia Inventory (MDADI). It was then reduced to a 30-item questionnaire across 5 sections measured on a 4-point Likert-scale. New to the final version is an environmental section that addresses the impact of environmental support on QoL. The final SAPP was validated against the Eating Assessment Tool (EAT-10) on 63 elderly individuals in nursing facilities. RESULTS The early version of the SAPP showed good construct validity and convergent validity to the MDADI. Dysphagic individuals had significantly higher scores than those without dysphagia. However test-retest reliability was imperfect. The later version of the SAPP required less time to administer, and demonstrated good construct validity and convergent validity to the EAT-10. CONCLUSION The SAPP is a questionnaire that utilises the ICF framework to evaluate dysphagia-related quality of life. It has demonstrated overall fair psychometric properties in the geriatric population. Further validation of the SAPP in other dysphagic populations is indicated.