Clinical validation of the related factors and defining characteristics of impaired swallowing for patients with stroke.

This exploratory study was conducted to examine the reliability and validity of related factors and defining characteristics of impaired swallowing for stroke patients. Sample of the study included (1) 12 nursing experts, (2) 52 nurses who work in neurological wards, and (3) 107 stroke patients who were divided into a BDST (Burks Dysphagia Screening Test)-positive group (n = 51) and a BDST-negative group (n = 56). Data were collected and validated based on expert validity, diagnostic content validity (DCV), construct validity, and discriminate validity. Results showed that the DCV scores of 17 related factors and 12 defining characteristics were all greater than 0.5. The internal consistency of the 12 defining characteristics was demonstrated by a Cronbach alpha coefficient of 0.89. Two factors were extracted from the 12 defining characteristics after factor analysis; these were "high risk of aspiration with speech disorder" and "ineffectiveness of swallowing". Five major defining characteristics, i.e. pocketing of food, signs of acute aspiration, burning or tickling at the back of the throat, spitting food or food leaking from the mouth, and weak or hoarse cough, were determined by logistic regression. The findings of this study suggest that the 17 related factors and 12 defining characteristics are reliable and valid in diagnosing the problem of impaired swallowing for stroke patients.