Translation and Cross-Cultural Adaptation of Sydney Swallow Questionnaire in Urdu and Its Psychometric Properties Among Post-Stroke Dysphagia PatientsOA

Objectives:Self-rating questionnaires provide a detailed overview of the symptomatic severity of post-stroke dysphagia in the geriatric population;such assessment tools or the subjective evaluation of post-stroke dysphagia are unavailable for Urdu-speaking patients.Sydney Swallow Questionnaire(SSQ)is a reliable assessment tool used to evaluate the symptoms of dysphagia,especially among geriatric patients with oropharyngeal dysphagia.The purpose of this study was translation and cross-cultural adaptation of the SSQ in Urdu and to assess its psychometric properties among post-stroke dysphagia patients.Methods:The SSQ was translated following the WHO Guidelines for Translation and Adaptation.Cognitive interviews and focused group discussions were conducted to evaluate the comprehension level of the questionnaire among Urdu-speaking clinicians.After getting ethical approval from the Shifa Review Board,the final version was administered to 61 patients with post-stroke dysphagia to assess the severity of the problem they faced during swallowing.Psychometric properties,including Cronbach''''s alpha reliability,test-retest reliability,intra-rater reliability,and scale validity index,were assessed to confirm the standardization of the questionnaire.Results:The Urdu version of SSQ had a Cronbach''s alpha reliability of 0.941 with ap value of 0.000,which was very close to the original questionnaire.Test-retest and inter-rater reliability of SSQ-Urdu(SSQ-U)shows Cronbach''s alpha reliability of 0.990 and 0.993,respectively.The final version fulfilled the criteria of psychometric properties,showing a Content Validity Index of 0.862 and a Scale Content Validity Index of 0.8.Conclusions:Results of cognitive interviews depicted that the Urdu-translated final version of SSQ was close to the original version,and was easy to comprehend,and well accepted by both clinicians and post-stroke dysphagia patients.The SSQ-U proves to be a valid and reliable tool for assessing dysphagia among post-stroke patients of Pakistan and can be used for academic,clinical,and research purposes.Summary Post-stroke dysphagia is more prevalent among the geriatric population.To evaluate dysphagia,patient-reported outcomes(PRO)are considered a crucial component to examine how patients feel and function after getting the treatment.The Sydney Swallow Questionnaire(SSQ)has also been translated into many languages for the subjective assessment of post-stroke dysphagia.