Cross-cultural adaptation and validation of the Swallowing Disturbance Questionnaire and the Sialorrhea Clinical Scale in Portuguese patients with Parkinson’s disease

To date, no valid outcome measure has been developed in European Portuguese (EP) to evaluate the Parkinsons’ Disease (PD) patients' (PwP) reports regarding their swallowing disturbances.
The aim of this study was to translate and cross-culturally adapt the Swallowing Disturbance Questionnaire (SDQ) and the Sialorrhea Clinical Scale for PD (SCS-PD) into EP and to determine its clinimetric properties in PwP.
The original English SDQ and SCS-PD versions were cross-culturally adapted following recommendations established in international guidelines. The validation process involved 75 PwP and 65 healthy sex- and age-matched participants.
The EP versions of the SDQ and SCS-PD are equivalent to the original versions (content, depth, and scoring). Statistical analyses for the SDQ tool revealed good feasibility (missing data <5%), acceptability (no floor or ceiling effects), excellent internal consistency (Cronbach´s α = 0.95), good construct validity (78.5% revealed large to moderate loadings), moderate convergent validity (r = 0.60), good divergent validity (r = 0.40), good known-groups validity (p-value < .05) and a fair sensitivity and specificity (AUC = 0.700). Statistical analyses for the SCS-PD tool shows good feasibility, reasonable acceptability (floor effect), good internal consistency (Cronbach´s α = 0.85), good construct validity (85.7% showed between large to moderate loadings), good convergent validity (r = 0.78), good divergent validity (r = 0.39), good known groups validity (p-value < .05) and a fair sensitivity and specificity (AUC = 0.704).
The EP versions of the SDQ and SCS-PD maintained the characteristics of the original versions and therefore consistent tools to be used in PwP.

截至目前，针对欧洲葡萄牙语（European Portuguese, EP）环境，尚未开发出可用于评估帕金森病（Parkinson's Disease, PD）患者（People with Parkinson's Disease, PwP）吞咽障碍自述情况的有效结局测评指标。
本研究旨在将吞咽障碍问卷（Swallowing Disturbance Questionnaire, SDQ）与帕金森病流涎临床量表（Sialorrhea Clinical Scale for PD, SCS-PD）翻译并进行跨文化调适，形成欧洲葡萄牙语版本，并检验其在PD患者中的临床测量学特性。
本研究遵循国际指南中的相关建议，对原版英文SDQ与SCS-PD量表进行跨文化调适。验证过程共纳入75名PD患者与65名性别、年龄相匹配的健康对照参与者。
欧洲葡萄牙语版SDQ与原版量表在内容、维度与计分规则上均保持一致。针对SDQ的统计学分析结果显示，其具备良好的可行性（缺失数据占比<5%）、可接受性（无地板效应或天花板效应）、极佳的内部一致性（克朗巴赫α系数=0.95）、良好的结构效度（78.5%的条目呈现中等至较大载荷）、中等的会聚效度（相关系数r=0.60）、良好的区分效度（相关系数r=0.40）、良好的已知群组效度（p值<0.05），以及尚可的灵敏度与特异度（受试者工作特征曲线下面积AUC=0.700）。针对SCS-PD的统计学分析结果则显示，其具备良好的可行性、合理的可接受性（存在地板效应）、良好的内部一致性（克朗巴赫α系数=0.85）、良好的结构效度（85.7%的条目呈现中等至较大载荷）、良好的会聚效度（相关系数r=0.78）、良好的区分效度（相关系数r=0.39）、良好的已知群组效度（p值<0.05），以及尚可的灵敏度与特异度（AUC=0.704）。
欧洲葡萄牙语版SDQ与SCS-PD量表保留了原版量表的各项特征，因此可作为适用于PD患者的可靠评估工具。