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https://revistacefac.org.br/article/doi/10.1590/1982-0216/20262835525
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Cross-cultural adaptation and psychometric validation of the EAT-10pe in Peruvian adults

Adaptación transcultural y validación psicométrica del EAT-10pe en adultos peruanos

Belkis David Parra-Reyes; Ivan Ramos Gutarra

http://dx.doi.org/10.1590/1982-0216/20262835525 Revista CEFAC, vol.28, n3, e5525, 2026
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Abstract

Purpose: to validate the Peruvian version of the Eating Assessment Tool-10 (EAT-10pe) for assessing self-perceived dysphagia in Peruvian adults. This included translation, cultural adaptation, and evaluation of its psychometric properties in Peruvian adults with suspected or diagnosed oropharyngeal dysphagia.

Methods: the cultural adaptation included forward and back-translation, synthesis of the translation, review by a multidisciplinary expert committee, and a pilot test with 30 Peruvian adults. Internal consistency, construct validity, concurrent validity, and test-retest reproducibility were calculated for the psychometric evaluation in a sample of 120 participants (mean age: 64.7 years; 71.67% females).

Results: the EAT-10pe showed excellent internal consistency (Cronbach's alpha = 0.89) and a unidimensional structure that explained 58.4% of the total variance. Reproducibility was excellent, with an intraclass correlation coefficient of 0.92. It was significantly correlated with the volume-viscosity test (r = 0.67, p < 0.001) and clinical signs of aspiration (r = 0.53, p < 0.01).

Conclusion: the translation, cultural adaptation, and psychometric evaluation of the EAT-10pe in Peruvian adults with suspected or diagnosed oropharyngeal dysphagia proved it to be a brief, reliable, and valid instrument for assessing self-perceived dysphagia in adults.

Keywords

Dysphagia; Instrument Validation; Questionnaires; Reproducibility of Results; Patient Perception

Resumen

Objetivo: validar la versión peruana del cuestionario Eating Assessment Tool-10 (EAT-10pe) para evaluar la autopercepción de disfagia en la población adulta de Perú. Incluyendo la traducción, adaptación cultural y evaluación de sus propiedades psicométricas en adultos peruanos con sospecha o diagnóstico de disfagia orofaríngea.

Métodos: el proceso de adaptación cultural se incluyeron traducción directa e inversa, síntesis de la traducción, revisión por un comité de expertos multidisciplinario y una prueba piloto con 30 adultos peruanos. Para la evaluación psicométrica en una muestra de 120 participantes (edad media 64,7 años, 71,67% mujeres), se calculó la consistencia interna, la validez de constructo, la validez concurrente, y la reproducibilidad test-retest.

Resultados: el EAT-10pe mostró una excelente consistencia interna (Alfa de Cronbach = 0,89) y una estructura unidimensional que explicó el 58,4% de la varianza total. La reproducibilidad fue excelente con un coeficiente de correlación intraclase de 0,92. Se encontraron correlaciones significativas con el test volumen-viscosidad (r = 0,67, p < 0,001) y signos clínicos de aspiración (r = 0,53, p < 0,01).

Conclusión: la traducción, adaptación cultural y la valoración de sus propiedades psicométricas del Eating Assessment Tool-10 (EAT-10pe) en adultos peruanos con sospecha o diagnóstico de disfagia orofaríngea, resultó ser un instrumento breve, confiable y válido para evaluar la autopercepción de disfagia en adultos.

Palabras clave

Disfagia; Validación de Instrumentos; Cuestionarios; Estudios de Reproducibilidad; Percepción del Paciente

References

1. Nogueira DS, Reis E. Swallowing disorders in nursing home residents: How can the problem be explained? Clin Interv Aging. 2013;8:221-7. https://doi.org/10.2147/CIA.S39452 PMID: 23449951.

2. Rivelsrud MC, Hartelius L, Bergström L, Løvstad M, Speyer R. Prevalence of oropharyngeal dysphagia in adults in different healthcare settings: A systematic review and meta-analyses. Dysphagia. 2023;38(1):76-121. https://doi.org/10.1007/s00455-022-10465-x PMID: 35639156.

3. Tian L, Hu Z, Yang L, Xiang Y. The prevalence of dysphagia at risk among older adults in nursing homes: A meta-analysis. Psychogeriatrics. 2024;24(1):127-37. https://doi.org/10.1111/psyg.13034 PMID: 37919048.

4. Lee DS, Kim HE, Choi JS. Oral health-related factors associated with dysphagia risk among older, healthy, community-dwelling Korean adults: A pilot study. Healthcare (Basel). 2024;12(2):267. https://doi.org/10.3390/healthcare12020267 PMID: 38275546.

5. Ortega O, Guidotti L, Yoshimatsu Y, Sitges C, Martos J, Miró J et al. Swallowing and aspiration: How to evaluate and treat swallowing disorders associated with aspiration pneumonia in older persons. Semin Respir Crit Care Med. 2024;45(6):678-93. https://doi.org/10.1055/a-2445-8952 PMID: 39433063.

6. Takahashi N, Kikutani T, Ebihara K, Genkai S, Takahashi I, Kodama M et al. Factors associated with the maintenance in food texture for dependent older people with dysphagia living in nursing home: A retrospective cohort study. Spec Care Dentist. 2024;44(3):886-92. https://doi.org/10.1111/scd.12937 PMID: 37919247.

7. Verma H, Kumar S, Sharma A, Mishra R, Nagamani B. Swallowing dysfunction between the community-living older adults with and without comorbid conditions using patient-reported outcome measures (PROM). Geriatr Nurs. 2024;56:64-73. https://doi.org/10.1016/j.gerinurse.2023.12.020 PMID: 38301436.

8. Chung KC, Muthutantri A, Goldsmith GG, Watts MR, Brown AE, Patrick DL. Symptom impact and health-related quality of life (HRQoL) assessment by cancer stage: A narrative literature review. BMC Cancer. 2024;24(1):884. https://doi.org/10.1186/s12885-024-12612-z PMID: 39039461.

9. Bartlett RS, Walters AS, Wayment HA. Psychosocial experiences associated with dysphagia and relevant clinical implications among adults with Parkinson disease. Dysphagia. 2025;40(1):231-47. https://doi.org/10.1007/s00455-024-10722-1 PMID: 38839625.

10. Wu Y, Guo K, Chu Y, Wang Z, Yang H, Zhang J. Advancements and challenges in non-invasive sensor technologies for swallowing assessment: A review. Bioengineering (Basel). 2024;11(5):430. https://doi.org/10.3390/bioengineering11050430 PMID: 38790297.

11. Schindler A, Mozzanica F, Monzani A, Ceriani E, Atac M, Jukic-Peladic N et al. Reliability and validity of the Italian Eating Assessment Tool. Ann Otol Rhinol Laryngol. 2013;122(11):717-24. https://doi.org/10.1177/000348941312201109 PMID: 24358633.

12. 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. 2000;15(3):115-21. https://doi.org/10.1007/s004550010012 PMID: 10839823.

13. Carlsson S, Ryden A, Rudberg I, Bove M, Bergquist H, Finizia C. Validation of the Swedish M. D. Anderson Dysphagia Inventory (MDADI) in patients with head and neck cancer and neurologic swallowing disturbances. Dysphagia. 2012;27(3):361-9. https://doi.org/10.1007/s00455-011-9375-8 PMID: 22105944.

14. Manor Y, Giladi N, Cohen A, Fliss DM, Cohen JT. Validation of a swallowing disturbance questionnaire for detecting dysphagia in patients with Parkinson's disease. Mov Disord. 2007;22(13):1917-21. https://doi.org/10.1002/mds.21625 PMID: 17588237.

15. Dwivedi RC, St Rose S, Roe JW, Khan AS, Pepper C, Nutting CM et al. Validation of the Sydney Swallow Questionnaire (SSQ) in a cohort of head and neck cancer patients. Oral Oncol. 2010;46(4):e10-4. https://doi.org/10.1016/j.oraloncology.2010.02.004 PMID: 20219415.

16. Rofes L, Arreola V, Mukherjee R, Clavé P. Sensitivity and specificity of the Eating Assessment Tool and the Volume-Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;26(9):1256-65. https://doi.org/10.1111/nmo.12382 PMID: 24909661.

17. Rofes L, Arreola V, Clavé P. The volume-viscosity swallow test for clinical screening of dysphagia and aspiration. Nestle Nutr Inst Workshop Ser. 2012;72:33-42. https://doi.org/10.1159/000339979 PMID: 23051998.

18. DePippo KL, Holas MA, Reding MJ. Validation of the 3-oz Water Swallow Test for aspiration following stroke. Arch Neurol. 1992;49(12):1259-61. https://doi.org/10.1001/archneur.1992.00530360057018 PMID: 1449405.

19. Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J et al. Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919-24. https://doi.org/10.1177/000348940811701 PMID: 19140539.

20. Burgos R, Sarto B, Segurola H, Romagosa A, Puiggros C, Vazquez C et al. Translation and validation of the Spanish version of the EAT-10 (Eating Assessment Tool-10) for the screening of dysphagia. Nutr Hosp. 2012;27(6):2048-54. https://doi.org/10.3305/nh.2012.27.6.6100 PMID: 23588456.

21. Demir N, Serel Arslan S, Inal Ö, Karaduman AA. Reliability and validity of the Turkish Eating Assessment Tool (T-EAT-10). Dysphagia. 2016;31(5):644-9. https://doi.org/10.1007/s00455-016-9723-9 PMID: 27405421.

22. Schindler A, Mozzanica F, Monzani A, Ceriani E, Atac M, Jukic-Peladic N et al. Reliability and validity of the Italian Eating Assessment Tool. Ann Otol Rhinol Laryngol. 2013;122(11):717-24. https://doi.org/10.1177/000348941312201109 PMID: 24358633.

23. Gonçalves MIR, Remaili CB, Behlau M. Cross-cultural adaptation of the Brazilian version of the Eating Assessment Tool-EAT-10. CoDAS. 2013;25(6):601-4. https://doi.org/10.1590/S2317-17822013.05000012 PMID: 24626972.

24. Nogueira DS, Ferreira PL, Reis EA, Lopes IS. Measuring outcomes for dysphagia: Validity and reliability of the European Portuguese Eating Assessment Tool (P-EAT-10). Dysphagia. 2015;30(5):511-20. https://doi.org/10.1007/s00455-015-9630-5 PMID: 26078095.

25. Giraldo-Cadavid LF, Gutiérrez-Achury AM, Ruales-Suárez K, Rengifo-Varona ML, Barros C, Posada A et al. Validation of the Spanish version of the Eating Assessment Tool-10 (EAT-10spa) in Colombia. A blinded prospective cohort study. Dysphagia. 2016;31(3):398-406. https://doi.org/10.1007/s00455-016-9690-1 PMID: 26803775.

26. Królikowska A, Reichert P, Senorski EH, Karlsson J, Becker R, Prill R. Scores and sores: Exploring patient-reported outcomes for knee evaluation in orthopaedics, sports medicine and rehabilitation. Knee Surg Sports Traumatol Arthrosc. 2025;33(1):21-8. https://doi.org/10.1002/ksa.12334 PMID: 39072858.

27. Manduchi B, Che Z, Ringash JG, Fitch MI, Howell D, Martino R. Patient-reported outcome measures for dysphagia in head and neck cancer: A systematic review and appraisal of content validity and internal structure. Head Neck. 2024;46(4):951-72. https://doi.org/10.1002/hed.27693 PMID: 38356437.

28. Abou-Elsaad T, Alvarez CP, Bader CA, Baert F, Bohlender JE, Denk-Linnert DM et al. Rehabilitation and prognosis of dysphagia. In: Phoniatrics III: Acquired motor speech and language disorders-dysphagia-phoniatrics and COVID-19. Cham: Springer Nature Switzerland; 2025. p.465-532. https://doi.org/10.1007/978-3-031-48091-1_15

29. de Castro MAF, Dedivitis RA, de Matos LL, Baraúna JC, Kowalski LP, de Carvalho Moura K et al. Endoscopic and videofluoroscopic evaluations of swallowing for dysphagia: A systematic review. Braz J Otorhinolaryngol. 2025;91Suppl1(Suppl1):101598. https://doi.org/10.1016/j.bjorl.2025.101598 PMID: 40209342.

30. Ministerio de Salud del Perú. Consideraciones Éticas para la Investigación en Salud con Seres Humanos. Resolución Ministerial N.° 233-2020-MINSA. Available at: https://cdn.www.gob.pe/uploads/document/file/662949/RM_233-2020-MINSA_Y_ANEXOS.PDF?v=1588082657

31. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine. 2000;25(24):3186-91. Available at: https://journals.lww.com/spinejournal/citation/2000/12150/guidelines_for_the_process_of_cross_cultural.14.aspx

32. Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A et al. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: Report of the ISPOR task force for translation and cultural adaptation. Value Health. 2005;8(2):94-104. https://doi.org/10.1111/j.1524-4733.2005.04054.x PMID: 15804318.

33. Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines. J Clin Epidemiol. 1993;46(12):1417-32. https://doi.org/10.1016/0895-4356(93)90142-N PMID: 8263569.

34. Hosmer DW Jr, Lemeshow S, Sturdivant RX. Applied logistic regression. 3rd ed. Hoboken: John Wiley & Sons; 2013.

35. Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155-63. https://doi.org/10.1016/j.jcm.2016.02.012 PMID: 27330520.

36. Nunnally JC, Bernstein IH. Psychometric theory. 3rd ed. New York: McGraw-Hill; 1994.

37. Zhang PP, Yuan Y, Lu DZ, Li TT, Zhang H, Wang HY et al. Diagnostic accuracy of the Eating Assessment Tool-10 (EAT-10) in screening dysphagia: A systematic review and meta-analysis. Dysphagia. 2023;38(1):145-58. https://doi.org/10.1007/s00455-022-10486-6 PMID: 35849209.
 

Submitted date:
06/26/2025

Accepted date:
02/25/2026

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