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https://www.revistacefac.org.br/article/doi/10.1590/1982-0216/202628411525
Revista CEFAC
Original Articles

Validity and reliability of the Protocol for Functional Evaluation of Swallowing by Nasal Endoscopy

Validez y confiabilidad del protocolo de evaluación funcional de la deglución por nasofibroscopía

Belkis David Parra-Reyes; Helen Angulo-Luna

http://dx.doi.org/10.1590/1982-0216/202628411525 Revista CEFAC, vol.28, n4, e11525, 2026
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Abstract

Purpose: to evaluate the validity and reliability of the Protocol for Functional Evaluation of Swallowing by Nasal Endoscopy as a multidisciplinary assessment tool for dysphagia.

Methods: a protocol including six items related to structural and functional aspects of the pharyngeal phase with an instrumental study conducted in two phases. In the first phase, content validity was assessed using the Content Validity Index (CVI), based on the judgment of seven dysphagia experts. In the second phase, the instrument's reliability was analyzed through a pilot test applied to 120 patients diagnosed with oropharyngeal dysphagia, calculating Cronbach's alpha coefficient and item-total correlations.

Results: the protocol demonstrated adequate content validity, with item CVI values greater than 0.78 and an overall CVI of 0.94. Internal consistency was good (α = 0.86), with item-total correlations greater than 0.65 (p < 0.001). The sample consisted primarily of patients with neurological dysphagia (64.2%), predominantly due to stroke sequelae, and with moderate severity (73.3%). Pharyngeal residue (71.7%) was the most frequent finding in the functional assessment.

Conclusion: the Protocol for Functional Evaluation of Swallowing by Nasal Endoscopy demonstrated adequate content validity and reliability. It allows for a structured clinical evaluation, contributing to the detection of functional alterations and to therapeutic decision-making.

Keywords

Swallowing; Dysphagia; Nasofibroscopy; Reliability; Validation Study

Resumen

Objetivo: evaluar la validez y confiabilidad del Protocolo de evaluación funcional de la deglución por nasofibroscopía, como un instrumento de evaluación multidisciplinar para la disfagia.

Metodos: el protocolo incluye 6 ítems relacionados con aspectos estructurales y funcionales de la fase faríngea. Se realizó un estudio instrumental en dos fases. En la primera, se evaluó la validez de contenido mediante el Índice de Validez de Contenido (IVC), a partir del juicio de 7 expertos en disfagia. En la segunda, se analizó la confiabilidad del instrumento mediante una prueba piloto aplicada a 120 pacientes con diagnóstico de disfagia orofaríngea, calculando el coeficiente alfa de Cronbach y las correlaciones ítem-total.

Resultados: el protocolo mostró una adecuada validez de contenido, con valores de IVC por ítem superiores a 0,78 y un IVC global de 0,94. La consistencia interna fue buena (α = 0,86), con correlaciones ítem-total superiores a 0,65 (p < 0,001). La muestra estuvo conformada principalmente por pacientes con disfagia de origen neurológico (64,2%), predominando las secuelas de accidente cerebrovascular, y con severidad moderada (73,3%). En la evaluación funcional, el hallazgo más frecuente fue la presencia de residuos faríngeos (71,7%).

Conclusión: el protocolo de evaluación funcional de la deglución por nasofibroscopía, ha mostrado una adecuada validez de contenido y confiabilidad; y permite una valoración clínica estructurada, contribuyendo a la detección de alteraciones funcionales y a la toma de decisiones terapéuticas.

Palabras clave

Deglución; Disfagia; Nasofibroscopía; Confiabilidad; Estudios de Validación

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Submitted date:
10/07/2025

Accepted date:
04/15/2026

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