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Quality of Life in Swallowing Disorders (SWAL-QOL)
Quality of Life in Swallowing Disorders (SWAL-QOL)
| Availability |
Please visit this website for more information about the instrument: Quality of Life in Swallowing Disorders
For further information please contact Dr. Colleen McHorney at: cam1325@comcast.net.
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| Classification |
NeuroRehab Supplemental - Highly Recommended:
Recommendations for use: Indicated for studies requiring a measure of dysphagia.
Supplemental: Amyotrophic Lateral Sclerosis (ALS) and Parkinson's Disease (PD)
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| Short Description of Instrument |
The Quality of Life in Swallowing Disorders (SWAL-QOL) (McHorney et al., 2000a, 2000b, 2002) was specifically designed to assess dysphagia-related impact on patients and its validity has been assessed in varied samples of patients, including patients with neurodegenerative diseases (Rinkel et al., 2009; Timmerman et al., 2014). The SWAL-QOL can be administered by an interviewer, self-administered, or be completed by a proxy (i.e., a close family member) (McHorney et al., 2000a).
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| Comments/Special Instructions |
The initial SWAL-QOL contained 93 items, which was considered to be impractical and was subsequently split into two scales (SWAL-QOL and SWAL-CARE), with the revised SWAL-QOL narrowed to the current 44 items. It has been translated into multiple languages.
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| Scoring |
The SWAL-QOL is a 44 item tool that assesses 10 quality-of-life concepts related to swallowing on a 5 point scale. The 10 quality-of-life concepts include: Food selection, Burden, Mental health, Social functioning, Fear, Eating duration, Eating desire, Communication, Sleep and Fatigue (McHorney et al., 2002).
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| Scoring and Psychometric Properties |
Scoring: The SWAL-QOL is a 44-item tool that assesses 10 quality-of-life concepts related to swallowing on a 5-point scale. The 10 quality-of-life concepts include: Food selection, Burden, Mental health, Social functioning, Fear, Eating duration, Eating desire, Communication, Sleep and Fatigue (McHorney et al., 2002). It can be self-administered, proxy-administered, or interviewer-administered.
Psychometric Properties: For internal consistency reliability, The Cronbach's a coefficient for the 11 domains ranges from 0.79 to 0.94. For test-retest reliability, the Intraclass Correlation Coefficient for the 11 domains ranges from 0.59 to 0.91. Additional validation measures are detailed in McHorney, et al., 2002.
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| Rationale/Justification |
NeuroRehab-Specific:
Strengths: Well-validated across a wide range of diseases and dysphagia severity; N=386 in validation study.
Weaknesses: 44 items, large patient burden with the number of questions and the time required to complete; requires SAS program to officially score.
Parkinson's Disease-Specific:
Strengths: The SWAL-QOL is thorough and well-validated. It is straight-forward to administer.
Weaknesses: The SWAL-QOL is lengthy and is estimated to take 14 minutes to complete. It has not been validated specifically for Parkinson's disease.
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| References |
Key References:
McHorney CA, Bricker DE, Kramer AE, Rosenbek JC, Robbins J, Chignell KA, Logemann JA, Clarke C. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: I. Conceptual foundation and item development. Dysphagia. Summer 2000a;15(3):115-21.
McHorney CA, Bricker DE, Robbins J, Kramer AE, Rosenbek JC, Chignell KA. The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: II. Item reduction and preliminary scaling. Dysphagia. Summer 2000b;15(3):122-133.
McHorney CA, Robbins J, Lomax K, Rosenbek JC, Chignell K, Kramer AE, Bricker DE. The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia. 2002 Spring;17(2):97-114.
Additional References:
Carneiro D, das Gracas Wanderley de Sales Coriolano M, Belo LR, de Marcos Rabelo AR, Asano AG, Lins OG. Quality of life related to swallowing in Parkinson's disease. Dysphagia. 2014 Oct ;29(5):578-82.
Keage M, Delatycki M, Corben L, Vogel A. A systematic review of self-reported swallowing assessments in progressive neurological disorders. Dysphagia. 2015 Feb;30(1):27-46.
McHorney CA, Martin-Harris B, Robbins J, Rosenbek J. Clinical validity of the SWAL-QOL and SWAL-CARE outcome tools with respect to bolus flow measures. Dysphagia. 2006 Jul;21(3):141-8. Erratum in: Dysphagia. 2008 Dec;23(4):461.
Plowman-Prine EK, Sapienza CM, Okun MS, Pollock SL, Jacobson C, Wu SS, Rosenbek JC. The relationship between quality of life and swallowing in Parkinson's disease. Mov Disord. 2009 Jul 15;24(9):1352-8.
Rinkel RN, Verdonck-de Leeuw IM, Langendijk JA, van Reij EJ, Aaronson NK, Leemans CR. The psychometric and clinical validity of the SWAL-QOL questionnaire in evaluating swallowing problems experienced by patients with oral and oropharyngeal cancer. Oral Oncol. 2009 Aug;45(8):e67-71.
Timmerman AA, Speyer R, Heijnen BJ, Klijn-Zwijnenberg IR. Psychometric characteristics of health-related quality-of-life questionnaires in oropharyngeal dysphagia. Dysphagia. 2014 Apr;29(2):183-98.
Document last updated August 2022
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