The Relationship between the Seirei Questionnaire of Swallowing and 30 ml Water Swallowing Test

Abstract

[Purpose] To investigate the relationship between the questionnaire for screening dysphagia and 30 ml water swallowing test.

[Subjects] In total, 310 outpatients of the rehabilitation department, consisting of 197 males and 113 females with age ranging from 25-93 (mean age of 66), were studied. Major disorders included cerebral vascular accidents, head injury, and neurogenic and muscular disorders.

[Method] The questionnaire contained 15 items reflecting factors such as history of pneumonia, nutritional state, oral, pharyngeal and esophageal functions and airway protective function, with three levels of severity as possible answers to be chosen. All subjects were assessed with the questionnaire as well as the water swallowing test (drinking 30 ml of water from a cup; Kubota, 1982). After univariate analysis on the relationship between the response of each item on the questionnaire and the profile of the water swallowing test with the chi square test, logistic regression analysis (stepwise: forward selection method) was performed. In the analyses, “responding A to any item” was considered abnormal on the questionnaire, and on the water swallowing test profiles 1 and 2 were considered normal and 3-5 were considered abnormal.

[Results] The chi square test revealed a significant relationship between the items reflecting pharyngeal function and airway protective function on the questionnaire and the water swallowing test. No relationship was indicated on the items reflecting oral and esophageal functions. Logistic regression analysis revealed that the following three items, “Do you cough when you drink tea?,” “Have you lost weight?,” “Does your throat sound gurgly during or after meals?,” were significant factors, and that the odds ratio of each was 11.96, 10.75, 3.80, respectively.

[Discussion] The questionnaire contains an item that is highly correlated to the results of the water swallowing test, which checks if “patient coughs when drinking liquid.” Thus, the questionnaire items are considered to be valid to some extent. If the questionnaire is used effectively, it is possible to screen dysphagia as well as the 30 ml water swallowing test with a low risk of aspiration.