The Edinburgh Feeding Evaluation in Dementia scale (EdFED): Cross-cultural validation of the simplified Chinese version in mainland China

Aims and objectives. To translate the Edinburgh Feeding Evaluation in Dementia scale (EdFED) into simplified Chinese and to comprehensively evaluate its reliability and validity. Background. The EdFED, the only validated instrument at present for assessing feeding difficulty in older people with dementia, is available in the original English and traditional Chinese versions, but not available in simplified Chinese. The traditional Chinese version may not be applicable in Mainland China because of linguistic and cultural differences. Design. Survey. Methods. The scale was translated into simplified Chinese by the cross-culture translation method, and 102 participants with dementia were assessed. Data were collected by comprehensive methods and analysed by correlation, Mokken scaling and exploratory factor analysis. Results. Reliability and validity were demonstrated for the scale, and a strong and reliable Mokken scale was formed by six items. A three-factor structure was illustrated by exploratory factor analysis, and construct validity was further demonstrated by good convergent and discriminant validity. Conclusions. The simplified Chinese version shows good reliability and validity and can be applicable to measure feeding difficulty in people with dementia in Mainland China and other Chinese cultural groups. More work is required on Mokken scaling, and a confirmatory factor analysis is needed to confirm the three-factor structure. Relevance to clinical practice. The validation of Ch-EdFED has provided a validated instrument for measuring feeding difficulty in people with dementia in Chinese culture; thus, early recognition of feeding difficulty in older people with dementia can be achieved and proper interventions could be designed. Moreover, with the availability of the three different validated versions of the EdFED, research into cross-cultural comparisons could be conducted.