Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Turkish Adaptation of Modified Mann Swallowing Ability Test in Patients with Acute Stroke: A Validity and Reliability Study
Akut İnmeli Hastalarda Modifiye Mann Yutma Değerlendirme Testinin Türkçeye Uyarlanması: Geçerlik ve Güvenirlik Çalışması
Hilal BERBER ÇİFTCİa, Seyhun TOPBAŞa
aDepartment of Speech and Language Therapy, İstanbul Medipol University Faculty of Health Sciences, İstanbul, Türkiye
Turkiye Klinikleri J Health Sci. 2022;7(3):702-11
doi: 10.5336/healthsci.2021-86085
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of the dysphagia screening test is to identify as many cases as possible before aspiration occurs. In Türkiye, there is a need for a practical and non-invasive screening test that evaluates swallowing pre-skills apart from comprehensive clinical tests. For this purpose, the Turkish validity and reliability of the Modified Mann Assessment of Swallowing Ability (MMASA) test were examined. Material and Methods: The test was translated into Turkish, and its content validity index was calculated. Then, the test was re-translated to English, and its compliance with the original version was evaluated. The generated Turkish MMASA (TR-MMASA) test was applied to 90 patients with acute stroke. Similar scale validity was evaluated by checking its compliance with the Turkish Mann Assessment of Swallowing Ability (T-MASA) test. The test-retest and interrater reliability methods were used for reliability analysis. Internal consistency (IC) and item-total correlation were examined. Results: Reliability was calculated according to intraclass correlation (ICC) coefficients (ICC=0.92, ICC=0.97). IC and item-total correlation coefficients were examined (Cronbach's alpha=0.91). For convergent and discriminant validity, T-MASA test was applied, and the Spearman's rho correlation coefficient was examined (r=0.88). As a result of the receiver operating characteristic analysis, the sensitivity (87%), specificity (88%), positive predictive value (0.77), negative predictive value (0.93), positive likelihood ratio (7.14) and negative likelihood ratio (0.14) percentages of the test were found valid. Conclusion: TR-MMASA test was found to be a valid and reliable screening test for bedside clinical evaluation in patients with acute stroke.

Keywords: Dysphagia; stroke, bedside screening test; Modified Mann Assessment Swallowing Ability; TR-MMASA
ÖZET
 Amaç: Disfaji tarama testinde amaç, aspirasyon meydana gelmeden olabildiğince çok riskli vakayı belirlemektir. Türkiye'de kapsamlı klinik testlerin dışında yutma ön becerilerini değerlendiren pratik ve girişimsel olmayan bir tarama testine ihtiyaç duyulmaktadır. Bu amaçla çalışmada, Modifiye Mann Yutma Yeteneği [Modified Mann Assessment of Swallowing Ability (MMASA)] testi, Türkçeye uyarlanarak geçerlik ve güvenirliği incelenmiştir. Gereç ve Yöntemler: Test, ilk olarak Türkçeye çevrilerek sonrasında kapsam geçerlik indeksi hesaplanmıştır. İngilizceye geri çevirisi yapılarak orijinal hâliyle olan uyumuna bakılmıştır. Oluşturulan Türkçe MMASA (TRMMASA) testi, akut inmeli 90 hastaya uygulanmıştır. Benzer ölçüt geçerliliği için Türkçe Mann Yutma Yeteneği Değerlendirmesi [Turkish Mann Assessment of Swallowing Ability (T-MASA)] testi kullanılmıştır. Güvenirlik analizi için test-tekrar test ve klinisyenler arası güvenirlik yöntemleri uygulanmıştır. İç tutarlılık ve madde-toplam madde korelasyonu incelenmiştir. Bulgular: Güvenirlik, sınıf içi korelasyon katsayısına [intraclass correlation coefficients (ICC)] göre (ICC=0,92, ICC=0,97) hesaplanmıştır. İç tutarlılık ve madde-toplam madde korelasyon katsayıları incelenmiştir (Cronbach alfa=0,91). Yakınsak ve ayırt edici geçerlik için T-MASA testi uygulanarak Spearman rho korelasyon katsayısı bulunmuştur (r=0,88). Alıcı işletim karakteristiği analizi sonuçlarına göre duyarlılık (%87), özgüllük (%88), pozitif öngörü değeri (0,77), negatif öngörü değeri (0,93), pozitif olabilirlik oranı (7,14) ve negatif olabilirlik oranı (0,14) tespit edilmiştir. Sonuç: TR-MMASA testi, akut inmeli hastalarda yatak başı klinik değerlendirme için geçerli ve güvenilir bir tarama testi olarak bulunmuştur.

Anahtar Kelimeler: Disfaji; inme; yatak başı tarama testi; Modifiye Mann Yutma Değerlendirme Testi; TR-MMASA
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