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      Validation of the Persian version of the dysphagia in multiple sclerosis questionnaire for the assessment of dysphagia in multiple sclerosis

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          Abstract

          Background

          This study is to evaluate swallowing problems (dysphasia) in multiple sclerosis (MS) patients; the importance of using tools that are durable and appropriate is well understood. One of the most trusted tools is the dysphagia in multiple sclerosis (DYMUS) test. The aim of this study was to prepare a Persian version and to evaluate the validity and reliability of the test.

          Materials and Methods

          This methodological study was conducted on 236 MS patients in Southeast of Iran from August 2015 to February 2016. After translation and cultural adaptation of the test in Persian, the validity of this test was determined using expert opinions accordance with the International Quality of Life Assessment Project. In addition, exploratory factor analysis (EFA) was performed with varimax rotation. The confirmatory factor analysis (CFA) was conducted and the goodness of fit indices was calculated. Moreover, to test the reliability, Cronbach's alpha coefficient and intraclass correlation coefficient (ICC) were used.

          Results:

          In total, 236 MS patients were included in the study (81 males and 155 females). All the questions in the test's Persian version obtained an acceptable face and content validity (content validity ratio = 1, Scale content validity index/Ave = 1). EFA revealed that the scale has two factors (solid–liquid) with 67.5% cumulative variance. CFA indicated a good fit to the intended two-factor structure, and the ratio of Chi-square to the degree of freedom was 1.79, and the root mean square error of approximation was 0.058. The internal consistency of total test indicated the appropriate level (Cronbach's alpha coefficient = 0.775), and test–retest reliability total questionnaire was found to be ICC = 0.985, indicating its high reliability.

          Conclusion:

          The results of this study indicated that the Persian version of the DYMUS questionnaire had good reliability and validity for patients with MS.

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          Most cited references29

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          The worldwide prevalence of multiple sclerosis.

          Maura Pugliatti, Stefano Sotgiu, Giulio Rosati (2002)
          Article 0 comments Cited 68 times – based on 0 reviews     Review now
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            Epidemiology of Multiple Sclerosis in Iran: A Systematic Review

            Masoud Etemadifar, M. Fereidan-esfahani, Sepideh Sajjadi … (2013)
            Background: There is a wide variation in the prevalence of multiple sclerosis (MS) in different geographical regions and the epidemiology of MS in Iran has been a major topic of concern during the last decade. Several population-based studies have shown a sharp increase in the prevalence and incidence of MS in this region. In this study, for the first time, the aim was to provide a comprehensive review regarding the incidence and prevalence of MS across Iran. Methods: A comprehensive literature search was performed using PubMed, Embase, and Web of Science. We also did a manual search of reference lists from primary articles and relevant reviews. Databases of ongoing research and unpublished literature were also searched. Results: A total of 22 relevant studies were reviewed and 11 studies met the inclusion criteria. Incidence data were found in 5 studies and ranged from 0.68 to 9.1/100,000 per year in the Iranian population. Prevalence was reported in all studies and ranged from 5.3 to 74.28/100,000 with the higher prevalence among females (female/male ratio ranged from 1.8 to 3.6). The most prevalent subtype of MS was the relapsing-remitting form (65.8-87.8%). The sensory disturbance was the most initial presentation. Conclusion: The incidence and prevalence of MS in Iran has been increasing rapidly, especially in females. Future research should focus on determining the epidemiological features of MS in the neglected provinces with different ethnicities. Such an effort along with further research towards improvement of data on previously studied areas can enable a field to be opened up to identify the patterns of MS in varied genetic backgrounds and environments of Iran.
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              Multiple sclerosis in Isfahan, Iran.

              Mohammad Saadatnia, Amir Maghzi, Masoud Etemadifar (2006)
              This survey was planned to study the prevalence and incidence of multiple sclerosis (MS) in Isfahan, Iran and to describe the clinical features of MS in general and in specific subgroups of patients (early-onset, late-onset, familial, and conjugal cases) and to compare our results with other reports. A cross-sectional study was conducted from April 5, 2003 to July 31, 2006. All patients known to have definite MS according to McDonald's criteria, alive, resident within Isfahan (a large province of Iran) and members of Isfahan MS Society (IMSS) were included in the study. Demographic and case-related information were recorded. A total number of 1718 definite MS patients (388 men and 1330 women) were identified from IMSS database. The overall period prevalence of MS was 43.8/100,000. Among men the prevalence was 19.2 (95% CI: 17.4-21.2)/100,000 and among women 69.6 (95% CI: 66-73.4)/100,000. A female preponderance of 3.4 existed among these patients. In the year 2005, 143 new cases were diagnosed, resulting in an incidence rate of 3.64/100,000. The mean age of onset was 25.36 +/- 8.6 years (range 5-63 year), and mean duration of disease was 7.1 (+/-5.2) years for men and 6.7 (+/-5) years for women. Sensory and visual disturbances were the most common initial presentations with a prevalence of 51.7% and 47.5%, respectively. Cases identified include: early-onset MS (less than 15 years old at onset) with 87 cases (5%), late-onset MS (over 50 years old at onset) with 20 cases (1.1%), familial MS with 209 cases (12.2%), and conjugal MS with 6 cases (0.5%). Isfahan is a medium- to high-risk area for MS, with prevalence higher than what has previously been reported, possibly because of an increase in the incidence rate. Clinical and demographic characteristics were similar to other reports; however, some differences existed.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Res Med Sci
                Journal ID (iso-abbrev): J Res Med Sci
                Journal ID (publisher-id): JRMS
                Title: Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences
                Publisher: Wolters Kluwer - Medknow (India )
                ISSN (Print): 1735-1995
                ISSN (Electronic): 1735-7136
                Publication date Collection: 2019
                Publication date (Electronic): 25 June 2019
                Volume: 24
                Electronic Location Identifier: 52
                Affiliations
                [1]Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
                [1 ]Behavioral Sciences Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
                Author notes
                Address for correspondence: Dr. Azar Mehri, Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Pich-e-Shemiran, Enghelab Avenue, Tehran 1148965141, Iran. E-mail: mehri@ 123456tums.ac.ir
                Article
                Publisher ID: JRMS-24-52
                DOI: 10.4103/jrms.JRMS_248_18
                PMC ID: 6611185
                SO-VID: ea1a7f1a-0452-48f9-a4ef-76715d07e118
                Copyright © Copyright: © 2019 Journal of Research in Medical Sciences
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Date received : 18 April 2018
                Date revision received : 10 September 2018
                Date accepted : 10 March 2019
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Medicine
                Keywords: dysphagia,multiple sclerosis,questionnaire,reliability,validity
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: dysphagia, multiple sclerosis, questionnaire, reliability, validity

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