Obtenção de evidências de validade com base no conteúdo e nos processos de resposta do DEGLUTO: Instrumento de Avaliação Clínica da Deglutição

Abstract

Oropharyngeal dysphagia is a prevalent condition in various clinical populations and can lead to complications such as malnutrition, dehydration, and aspiration pneumonia. Structured clinical assessment is essential for the proper management of dysphagia, requiring reliable and validated instruments. Given the need for a protocol adapted to the Brazilian reality, the DEGLUTO: Swallowing Assessment Instrument at the Bedside was developed, and its validation process is the focus of this dissertation. This is a methodological study divided into two phases. The first phase involved obtaining evidence of validity based on content, conducted through the Delphi method, with the participation of 13 dysphagia expert judges. The instrument's items were analyzed for relevance, clarity, and alignment with the evaluated construct. Seven items were removed, and twenty-one. was reformulated, resulting in a preliminary version with 21 items. The second phase consisted of obtaining evidence of validity based on response processes through the application of the instrument by eight speech-language pathologists in hospital and outpatient settings. The professionals assessed the clarity and applicability of the items, as well as patients' understanding during the evaluation. Statistical analysis included the Content Validity Index (CVI), the Content Validity Coefficient (CVC), and the Kappa coefficient to assess agreement among raters. The results demonstrated high agreement for most items, except for one, which was removed, leading to the preliminary final version of DEGLUTO with 20 items. The study provided evidence that the instrument has clarity, relevance, and clinical applicability, contributing to the qualification of oropharyngeal dysphagia assessment. The findings support the continuation of the validation process.