Skip to main content
Top
Published in: Dysphagia 2/2022

01-04-2022 | Dysphagia | Original Article

Emotional and Psychological Effects of Dysphagia: Validation of the Jugendwerk Dysphagia Emotion and Family Assessment (JDEFA)

Authors: Stefan Bushuven, Isabell Niebel, Johanna Huber, Paul Diesener

Published in: Dysphagia | Issue 2/2022

Login to get access

ABSTRACT

Introduction

Patients suffering from swallowing disorders are experiencing emotional effects like anger, anxiety, and sadness. This may be affecting patient–therapist relation and family functioning. To assess emotional reaction and their influence on family systems, we developed a 55-item questionnaire based on the Atlas of Emotion and the Calgary Family Intervention Model.

Methods

We recruited more than 160 participants to validate an online survey, namely the Jugendwerk Dysphagia Emotion and Family Assessment Score (JDEFA). Forty-Nine health care workers, patients, and family members completed the survey and provided additional comments regarding interactions of emotions and dysphagia. Analysis was accomplished by non-parametric tests and principal component analyses with Varimax rotation. Additionally, we accomplished a qualitative content analysis taking a phenomenological single-coder approach.

Results

Analysis revealed a Cronbach’s Alpha of 0.93. Using primary component analyses, justified by a Kaiser–Meyer–Olkin value of 0.81, we identified two main factors (emotion and family). Patients experienced sadness and anger more often than health care providers, whereas family members felt anxiety even more often. Our qualitative analysis revealed 20 themes (7 for anger, 2 enjoyment, 4 sadness, 3 anxiety, 2 disgust, 1 shame, and 1 punishment). Predominantly, the fear of choking was mentioned by patients, whereas professionals reported about the fear of making mistakes.

Conclusion

The JDEFA is a valid and reliable testing tool for the assessment of swallowing disorders concerning emotional aspects and family functioning. Both factors have a significant role in dysphagia and evaluations should go along with functional assessments and psychological scores for a holistic understanding of swallowing disorders.
Literature
1.
go back to reference Béjot Y, et al. Epidemiology of stroke in Europe and trends for the 21st century. Presse Med. 2016;45(12 Pt 2):e391–8.PubMedCrossRef Béjot Y, et al. Epidemiology of stroke in Europe and trends for the 21st century. Presse Med. 2016;45(12 Pt 2):e391–8.PubMedCrossRef
2.
go back to reference Martino R, et al. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005;36(12):2756–63.PubMedCrossRef Martino R, et al. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005;36(12):2756–63.PubMedCrossRef
3.
go back to reference Roy N, et al. Dysphagia in the elderly: preliminary evidence of prevalence, risk factors, and socioemotional effects. Ann Otol Rhinol Laryngol. 2007;116(11):858–65.PubMedCrossRef Roy N, et al. Dysphagia in the elderly: preliminary evidence of prevalence, risk factors, and socioemotional effects. Ann Otol Rhinol Laryngol. 2007;116(11):858–65.PubMedCrossRef
5.
go back to reference Greco E, et al. Dysphagia treatment for patients with head and neck cancer undergoing radiation therapy: a meta-analysis review. Int J Radiat Oncol Biol Phys. 2018;101(2):421–44.PubMedCrossRef Greco E, et al. Dysphagia treatment for patients with head and neck cancer undergoing radiation therapy: a meta-analysis review. Int J Radiat Oncol Biol Phys. 2018;101(2):421–44.PubMedCrossRef
6.
go back to reference Vansant MB, Kunduk M, McWhorter AJ. A review of postsurgical dysphagia in nonmalignant disease. Curr Opin Otolaryngol Head Neck Surg. 2016;24(6):477–82.PubMedCrossRef Vansant MB, Kunduk M, McWhorter AJ. A review of postsurgical dysphagia in nonmalignant disease. Curr Opin Otolaryngol Head Neck Surg. 2016;24(6):477–82.PubMedCrossRef
8.
9.
go back to reference Patel DA, et al. Economic and survival burden of dysphagia among inpatients in the United States. Dis Esophagus. 2018;31(1):1–7.PubMedCrossRef Patel DA, et al. Economic and survival burden of dysphagia among inpatients in the United States. Dis Esophagus. 2018;31(1):1–7.PubMedCrossRef
10.
go back to reference Ekberg O, et al. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia. 2002;17(2):139–46.PubMedCrossRef Ekberg O, et al. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia. 2002;17(2):139–46.PubMedCrossRef
11.
go back to reference Nguyen NP, et al. Impact of dysphagia on quality of life after treatment of head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2005;61(3):772–8.PubMedCrossRef Nguyen NP, et al. Impact of dysphagia on quality of life after treatment of head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2005;61(3):772–8.PubMedCrossRef
12.
go back to reference Nund RL, et al. Survivors’ experiences of dysphagia-related services following head and neck cancer: implications for clinical practice. Int J Lang Commun Disord. 2014;49(3):354–63.PubMedCrossRef Nund RL, et al. Survivors’ experiences of dysphagia-related services following head and neck cancer: implications for clinical practice. Int J Lang Commun Disord. 2014;49(3):354–63.PubMedCrossRef
13.
go back to reference Eltringham SA, et al. Experiences of dysphagia after stroke: an interview study of stroke survivors and their informal caregivers. Geriatrics (Basel). 2019;4(4):67.CrossRef Eltringham SA, et al. Experiences of dysphagia after stroke: an interview study of stroke survivors and their informal caregivers. Geriatrics (Basel). 2019;4(4):67.CrossRef
14.
go back to reference Lisiecka D, Kelly H, Jackson J. How do people with motor neurone disease experience dysphagia? A qualitative investigation of personal experiences. Disabil Rehabil. 2019;43(4):479–88.PubMedCrossRef Lisiecka D, Kelly H, Jackson J. How do people with motor neurone disease experience dysphagia? A qualitative investigation of personal experiences. Disabil Rehabil. 2019;43(4):479–88.PubMedCrossRef
15.
go back to reference Namasivayam-MacDonald AM, Shune SE. The burden of dysphagia on family caregivers of the elderly: a systematic review. Geriatrics (Basel). 2018;3(2):30.CrossRef Namasivayam-MacDonald AM, Shune SE. The burden of dysphagia on family caregivers of the elderly: a systematic review. Geriatrics (Basel). 2018;3(2):30.CrossRef
16.
go back to reference Shune SE, Namasivayam-MacDonald AM. Swallowing impairments increase emotional burden in spousal caregivers of older adults. J Appl Gerontol. 2020;39(2):172–80.PubMedCrossRef Shune SE, Namasivayam-MacDonald AM. Swallowing impairments increase emotional burden in spousal caregivers of older adults. J Appl Gerontol. 2020;39(2):172–80.PubMedCrossRef
17.
go back to reference Chen SC, et al. Swallowing ability and its impact on dysphagia-specific health-related QOL in oral cavity cancer patients post-treatment. Eur J Oncol Nurs. 2018;36:89–94.PubMedCrossRef Chen SC, et al. Swallowing ability and its impact on dysphagia-specific health-related QOL in oral cavity cancer patients post-treatment. Eur J Oncol Nurs. 2018;36:89–94.PubMedCrossRef
18.
go back to reference Yi YG, et al. Dysphagia-related quality of life in adults with cerebral palsy on full oral diet without enteral nutrition. Dysphagia. 2019;34(2):201–9.PubMedCrossRef Yi YG, et al. Dysphagia-related quality of life in adults with cerebral palsy on full oral diet without enteral nutrition. Dysphagia. 2019;34(2):201–9.PubMedCrossRef
19.
go back to reference Belafsky PC, et al. Validity and reliability of the eating assessment tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919–24.PubMedCrossRef Belafsky PC, et al. Validity and reliability of the eating assessment tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919–24.PubMedCrossRef
20.
go back to reference Ekman, P.E., Eve, The Atlas of Emotions Project Website 2014. Ekman, P.E., Eve, The Atlas of Emotions Project Website 2014.
21.
go back to reference de Vere AJ, Kuczaj SA 2nd. Where are we in the study of animal emotions? Wiley Interdiscip Rev Cogn Sci. 2016;7(5):354–62.PubMedCrossRef de Vere AJ, Kuczaj SA 2nd. Where are we in the study of animal emotions? Wiley Interdiscip Rev Cogn Sci. 2016;7(5):354–62.PubMedCrossRef
22.
go back to reference Tybur JM, Lieberman D, Griskevicius V. Microbes, mating, and morality: individual differences in three functional domains of disgust. J Pers Soc Psychol. 2009;97(1):103–22.PubMedCrossRef Tybur JM, Lieberman D, Griskevicius V. Microbes, mating, and morality: individual differences in three functional domains of disgust. J Pers Soc Psychol. 2009;97(1):103–22.PubMedCrossRef
25.
go back to reference Ickes WT. The observational method: studying the interaction of minds and bodies. Handbook Personal Relationships. 1988;1:79–96. Ickes WT. The observational method: studying the interaction of minds and bodies. Handbook Personal Relationships. 1988;1:79–96.
26.
go back to reference William I. Measuring mind reading everydays. Mind Reading. 2003;1:51–75. William I. Measuring mind reading everydays. Mind Reading. 2003;1:51–75.
27.
go back to reference Larson EB, Yao X. Clinical empathy as emotional labor in the patient-physician relationship. JAMA. 2005;293(9):1100–6.PubMedCrossRef Larson EB, Yao X. Clinical empathy as emotional labor in the patient-physician relationship. JAMA. 2005;293(9):1100–6.PubMedCrossRef
28.
go back to reference Kim SS, Kaplowitz S, Johnston MV. The effects of physician empathy on patient satisfaction and compliance. Eval Health Prof. 2004;27(3):237–51.PubMedCrossRef Kim SS, Kaplowitz S, Johnston MV. The effects of physician empathy on patient satisfaction and compliance. Eval Health Prof. 2004;27(3):237–51.PubMedCrossRef
30.
go back to reference Leahey M, Wright LM. Application of the calgary family assessment and intervention models: reflections on the reciprocity between the personal and the professional. J Fam Nurs. 2016;22(4):450–9.PubMedCrossRef Leahey M, Wright LM. Application of the calgary family assessment and intervention models: reflections on the reciprocity between the personal and the professional. J Fam Nurs. 2016;22(4):450–9.PubMedCrossRef
31.
go back to reference Bradley EH, Curry LA, Devers KJ. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res. 2007;42(4):1758–72.PubMedPubMedCentralCrossRef Bradley EH, Curry LA, Devers KJ. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res. 2007;42(4):1758–72.PubMedPubMedCentralCrossRef
32.
go back to reference Bujang MA, Omar ED, Baharum NA. A review on sample size determination for Cronbach’s alpha test: a simple guide for researchers. Malays J Med Sci. 2018;25(6):85–99.PubMedPubMedCentral Bujang MA, Omar ED, Baharum NA. A review on sample size determination for Cronbach’s alpha test: a simple guide for researchers. Malays J Med Sci. 2018;25(6):85–99.PubMedPubMedCentral
33.
34.
go back to reference Delva MY, Delva II, Lytvynenko NV. Post-stroke fatigue and its dimensions over the second half year after stroke. Wiad Lek. 2018;71(2):314–7.PubMed Delva MY, Delva II, Lytvynenko NV. Post-stroke fatigue and its dimensions over the second half year after stroke. Wiad Lek. 2018;71(2):314–7.PubMed
35.
go back to reference Okon-Singer H, et al. The neurobiology of emotion-cognition interactions: fundamental questions and strategies for future research. Front Hum Neurosci. 2015;9:58.PubMedPubMedCentralCrossRef Okon-Singer H, et al. The neurobiology of emotion-cognition interactions: fundamental questions and strategies for future research. Front Hum Neurosci. 2015;9:58.PubMedPubMedCentralCrossRef
36.
go back to reference Sened H, et al. Empathic accuracy and relationship satisfaction: a meta-analytic review. J Fam Psychol. 2017;31(6):742–52.PubMedCrossRef Sened H, et al. Empathic accuracy and relationship satisfaction: a meta-analytic review. J Fam Psychol. 2017;31(6):742–52.PubMedCrossRef
37.
go back to reference Sekhon JK, et al. Counselling training for speech-language therapists working with people affected by post-stroke aphasia: a systematic review. Int J Lang Commun Disord. 2019;54(3):321–46.PubMedCrossRef Sekhon JK, et al. Counselling training for speech-language therapists working with people affected by post-stroke aphasia: a systematic review. Int J Lang Commun Disord. 2019;54(3):321–46.PubMedCrossRef
38.
go back to reference Northcott S, et al. How do speech-and-language therapists address the psychosocial well-being of people with aphasia? Results of a UK online survey. Int J Lang Commun Disord. 2017;52(3):356–73.PubMedCrossRef Northcott S, et al. How do speech-and-language therapists address the psychosocial well-being of people with aphasia? Results of a UK online survey. Int J Lang Commun Disord. 2017;52(3):356–73.PubMedCrossRef
40.
go back to reference Baijens LW, Koetsenruijter K, Pilz W. Diagnosis and treatment of phagophobia: a review. Dysphagia. 2013;28(2):260–70.PubMedCrossRef Baijens LW, Koetsenruijter K, Pilz W. Diagnosis and treatment of phagophobia: a review. Dysphagia. 2013;28(2):260–70.PubMedCrossRef
41.
42.
go back to reference Colodny N. Interjudge and intrajudge reliabilities in fiberoptic endoscopic evaluation of swallowing (fees) using the penetration-aspiration scale: a replication study. Dysphagia. 2002;17(4):308–15.PubMedCrossRef Colodny N. Interjudge and intrajudge reliabilities in fiberoptic endoscopic evaluation of swallowing (fees) using the penetration-aspiration scale: a replication study. Dysphagia. 2002;17(4):308–15.PubMedCrossRef
43.
go back to reference Bartolome G, Prosiegel M, Yassouridis A. Long-term functional outcome in patients with neurogenic dysphagia. NeuroRehabilitation. 1997;9(3):195–204.PubMedCrossRef Bartolome G, Prosiegel M, Yassouridis A. Long-term functional outcome in patients with neurogenic dysphagia. NeuroRehabilitation. 1997;9(3):195–204.PubMedCrossRef
44.
go back to reference Maher EJ, et al. The use of the Hospital Anxiety and Depression Scale (HADS) and the EORTC QLQ-C30 questionnaires to screen for treatable unmet needs in patients attending routinely for radiotherapy. Cancer Treat Rev. 1996;22 Suppl A:123–9.PubMedCrossRef Maher EJ, et al. The use of the Hospital Anxiety and Depression Scale (HADS) and the EORTC QLQ-C30 questionnaires to screen for treatable unmet needs in patients attending routinely for radiotherapy. Cancer Treat Rev. 1996;22 Suppl A:123–9.PubMedCrossRef
45.
go back to reference Donaldson C, et al. QALYS and long-term care for elderly people in the UK: scales for assessment of quality of life. Age Ageing. 1988;17(6):379–87.PubMedCrossRef Donaldson C, et al. QALYS and long-term care for elderly people in the UK: scales for assessment of quality of life. Age Ageing. 1988;17(6):379–87.PubMedCrossRef
46.
go back to reference Regehr C, LeBlanc VR. PTSD, acute stress, performance and decision-making in emergency service workers. J Am Acad Psychiatry Law. 2017;45(2):184–92.PubMed Regehr C, LeBlanc VR. PTSD, acute stress, performance and decision-making in emergency service workers. J Am Acad Psychiatry Law. 2017;45(2):184–92.PubMed
47.
go back to reference Burlison JD, et al. The second victim experience and support tool: validation of an organizational resource for assessing second victim effects and the quality of support resources. J Patient Saf. 2017;13(2):93–102.PubMedPubMedCentralCrossRef Burlison JD, et al. The second victim experience and support tool: validation of an organizational resource for assessing second victim effects and the quality of support resources. J Patient Saf. 2017;13(2):93–102.PubMedPubMedCentralCrossRef
Metadata
Title
Emotional and Psychological Effects of Dysphagia: Validation of the Jugendwerk Dysphagia Emotion and Family Assessment (JDEFA)
Authors
Stefan Bushuven
Isabell Niebel
Johanna Huber
Paul Diesener
Publication date
01-04-2022
Publisher
Springer US
Published in
Dysphagia / Issue 2/2022
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-021-10289-1

Other articles of this Issue 2/2022

Dysphagia 2/2022 Go to the issue