Chewing and swallowing dysfunction are the common problems in head and neck cancer patients. They may interfere patients’ eating and lead to malnutrition. An easily used tool to assess the problems is needed. The purposes of the study were to (1) develop the Chewing Swallowing Inventory (CSI) and (2) examine the psychometric properties of CSI.
This is an instrument development and testing study. We recruited adult patients with head and neck cancers in the head and neck cancer outpatient clinics in the medical center in northern Taiwan. The items of CSI was developed based our previous research results, clinical observation, literature review and preliminarily validated by experts panel. Psychometric testing includes content validity, internal consistency reliability, construct validity by examining of its factor structures (exploratory factor analysis), theoretical supported correlation and discriminated constructs by groups.
The CIS was a 21-item 0 to 4 Likert’s typed scale with 0 representing “no problem/difficulty at all” and 4 representing “having extremely severe difficulty”. We recruited 175 patients. The results showed that (1) CSI has good internal consistency reliability with Cronbach’s α value as 0.93. (2) The factor analysis suggest that CSI contains four clear factors which are chewing, swallowing, tongue moving/stirring and taste and saliva changes which explained 70.32% of variances. (3) CSI has good construct supported correlation with nutrition. (4) CSI had good discriminate validity to differentiate patients with different diagnosis, surgical modalities, treatments, and disease stages.
CSI is a simple, easily used, reliable and validated tool to assess patients’ eating difficulties. It will better support health care professionals to detect HNC patients’ eating related chewing and swallowing problems and provide personalized intervention to prevent malnutrition.
Clinical trial identification
Legal entity responsible for the study
National Taiwan University Hospital
All authors have declared no conflicts of interest.