Consciencia de disfagia en la enfermedad de Parkinson / Awareness of dysphagia in Parkinson's disease

Introducción y objetivo. Con el fin de evaluar el nivel de consciencia de los trastornos de la deglución en la enfermedad de Parkinson (EP), se ha diseñado y validado un cuestionario específico, el Dysphapark. Pacientes y métodos. Un total de 470 afectados de EP han respondido a la pregunta de si creen que tienen o no problemas de deglución, y seguidamente han cumplimentado un cuestionario autoadministrado que valora la eficacia y seguridad de la deglución. Se validó el Dysphapark a través del análisis de Rasch y métodos psicométricos clásicos. Resultados. Las dimensiones de seguridad y eficacia del Dysphapark muestran un buen ajuste al modelo de Rasch. La dimensión eficacia mostró diferencias significativas por género, duración de la enfermedad, consciencia de disfagia y duración de las comidas; la dimensión seguridad, por duración y gravedad de la enfermedad, consciencia de disfagia, logoterapia y conocimiento de espesante. A pesar de que un 90% de los pacientes tenía problemas de eficacia y seguridad en la deglución, un 79,45% no era consciente de padecer disfagia. Conclusiones. El cuestionario Dysphapark es una medida adecuada de la disfagia en EP, según el análisis de Rasch. Una alta proporción de pacientes con EP tiene disfagia, observándose una baja consciencia de la condición, de las consecuencias que puede tener y de la posibilidad de usar espesante. Dado que algunos de los trastornos de la deglución en la EP son asintomáticos y que existe una baja consciencia del trastorno, es recomendable incluir cuestionarios específicos, así como valoración clínica e instrumental de la disfagia en la práctica clínica

Introduction and aim. In order to be able to assess the level of awareness of swallowing disorders in Parkinson’s disease (PD), a specific questionnaire was designed and validated: the Dysphapark questionnaire. Patients and methods. A total of 470 persons with PD were asked whether they believe they have problems swallowing or not, and then they filled in a self-administered questionnaire that evaluates the effectiveness and safety of swallowing. The Dysphapark questionnaire was validated by means of Rasch analysis and classical psychometric methods. Results. The safety and effectiveness dimensions of the Dysphapark fit the Rasch model well. The efficacy dimensionshowed significant differences for gender, length of the illness, awareness of dysphagia and length of meals. Significant differences were also found in the safety dimension for length and severity of illness, awareness of dysphagia, speech therapy and knowledge of thickening agents. Despite the fact that 90% of patients had problems concerning effectiveness and safety in swallowing, 79.45% were not aware that they suffered from dysphagia. Conclusions. The Dysphapark questionnaire is a suitable measure of dysphagia in PD, according to the Rasch analysis. A high proportion of patients with PD have dysphagia, although it has been observed that they have a low level of awareness of the condition, of the consequences it may have and of the possibility of using thickening agents. Given that some of the swallowing disorders in PD are asymptomatic and that the level of awareness of the disorder is low, we recommend including specific questionnaires as well as clinical and instrumental evaluation of dysphagia in clinical practice

[Awareness of dysphagia in Parkinson's disease]. / Consciencia de disfagia en la enfermedad de Parkinson.

INTRODUCTION AND AIM: In order to be able to assess the level of awareness of swallowing disorders in Parkinson's disease (PD), a specific questionnaire was designed and validated: the Dysphapark questionnaire. PATIENTS AND METHODS: A total of 470 persons with PD were asked whether they believe they have problems swallowing or not, and then they filled in a self-administered questionnaire that evaluates the effectiveness and safety of swallowing. The Dysphapark questionnaire was validated by means of Rasch analysis and classical psychometric methods. RESULTS: The safety and effectiveness dimensions of the Dysphapark fit the Rasch model well. The efficacy dimension showed significant differences for gender, length of the illness, awareness of dysphagia and length of meals. Significant differences were also found in the safety dimension for length and severity of illness, awareness of dysphagia, speech therapy and knowledge of thickening agents. Despite the fact that 90% of patients had problems concerning effectiveness and safety in swallowing, 79.45% were not aware that they suffered from dysphagia. CONCLUSIONS: The Dysphapark questionnaire is a suitable measure of dysphagia in PD, according to the Rasch analysis. A high proportion of patients with PD have dysphagia, although it has been observed that they have a low level of awareness of the condition, of the consequences it may have and of the possibility of using thickening agents. Given that some of the swallowing disorders in PD are asymptomatic and that the level of awareness of the disorder is low, we recommend including specific questionnaires as well as clinical and instrumental evaluation of dysphagia in clinical practice.