Development of an ICF-based swallowing-related quality of life questionnaire : head-and-neck cancer survivor assessment of mealtimes

Abstract

This study developed and validated a swallowing-related quality of life (QoL) questionnaire based on the International Classification of Functioning, Disability and Health (ICF) framework, Head-and-Neck cancer Survivor Assessment of Mealtimes (HNSAM). HNSAM was developed according to qualitative studies involved in-depth interviews with head-and-neck cancer (HNC) survivors that explored the impacts of swallowing difficulties. Forty seven participants with HNC treated were recruited for the validation of the psychometric properties of HNSAM. They completed HNSAM and M. D. Anderson Dysphagia Inventory independently. A speech therapist rated Functional Oral Intake Scale and conducted bedside swallowing examination to assess their swallowing impairment severity. HNSAM subscales were demonstrated to have strong internal consistency and test-retest reliability. Good content, criterion, construct and clinical validity was also established, revealing that HNSAM was able to measure the impacts of dysphagia on activities and participation, and QoL of HNC survivors.