Skip to main content
Erschienen in: Dysphagia 3/2007

01.07.2007

Dysphagia Evaluation Practices of Speech and Language Therapists in Ireland: Clinical Assessment and Instrumental Examination Decision-Making

verfasst von: Catharine M. Pettigrew, Ciara O’Toole

Erschienen in: Dysphagia | Ausgabe 3/2007

Einloggen, um Zugang zu erhalten

Abstract

The purpose of this study was to investigate clinical assessment practices and instrumental examination decision-making by speech and language therapists (SLTs) in Ireland. A 21-question survey (including patient scenarios) was sent to 480 SLTs in Ireland. A total of 261 completed surveys were returned (54%), providing demographic information on SLTs currently working in Ireland and their services. Of these 261 surveys, 70 provided the data for the study, focusing on SLTs currently working in dysphagia, with adults/seniors at least some of the time. The results also showed clinician variability regarding which components are included in a bedside clinical examination of swallowing, with a high degree of consistency for only 11 of the 20 components. Clinicians agreed in their instrumental vs. noninstrumental evaluation recommendations for two of the six patient scenarios, with wide variability in clinical decision-making. Possible influences on clinical decision-making are discussed in relation to the findings of similar previous studies, as well as the current status and future needs of dysphagia training and services in Ireland.
Literatur
1.
Zurück zum Zitat Royal College of Speech & Language Therapists (RCSLT): Communicating Quality 3. London: Royal College of Speech and Language Therapists, 2006 Royal College of Speech & Language Therapists (RCSLT): Communicating Quality 3. London: Royal College of Speech and Language Therapists, 2006
2.
Zurück zum Zitat Speech Pathology Australia (SPA): Dysphagia: General. Melbourne: Speech Pathology Australia, 2004 Speech Pathology Australia (SPA): Dysphagia: General. Melbourne: Speech Pathology Australia, 2004
3.
Zurück zum Zitat Nilsson H, Ekberg O, Olsson R, Hindfelt B: Dysphagia in stroke: a prospective study on quantitative aspects of swallowing in dysphagic patients. Dysphagia 13:32–38, 1998PubMedCrossRef Nilsson H, Ekberg O, Olsson R, Hindfelt B: Dysphagia in stroke: a prospective study on quantitative aspects of swallowing in dysphagic patients. Dysphagia 13:32–38, 1998PubMedCrossRef
4.
Zurück zum Zitat Leder SB, Espinosa JF: Aspiration risk after acute stroke: comparison of clinical examination and fiberoptic endoscopic evaluation of swallowing. Dysphagia 17:214–218, 2002PubMedCrossRef Leder SB, Espinosa JF: Aspiration risk after acute stroke: comparison of clinical examination and fiberoptic endoscopic evaluation of swallowing. Dysphagia 17:214–218, 2002PubMedCrossRef
5.
Zurück zum Zitat Broniatowski M, Sonies BC, Rubin JS, Bradshaw CR, Spiegel JR, Bastian RW, Kelly JH: Current evaluation and treatment of patients with swallowing disorders. Otolaryngol Head Neck Surg 120:464–473, 1999PubMedCrossRef Broniatowski M, Sonies BC, Rubin JS, Bradshaw CR, Spiegel JR, Bastian RW, Kelly JH: Current evaluation and treatment of patients with swallowing disorders. Otolaryngol Head Neck Surg 120:464–473, 1999PubMedCrossRef
6.
Zurück zum Zitat Royal College of Speech & Language Therapists (RCSLT): RCSLT Clinical Guidelines. Brackley, UK: Speechmark Publishing, 2005 Royal College of Speech & Language Therapists (RCSLT): RCSLT Clinical Guidelines. Brackley, UK: Speechmark Publishing, 2005
7.
Zurück zum Zitat American Speech-Language-Hearing Association (ASHA): Preferred practice patterns for the profession of speech-language pathology. Rockville, MD: ASHA, 1997 American Speech-Language-Hearing Association (ASHA): Preferred practice patterns for the profession of speech-language pathology. Rockville, MD: ASHA, 1997
8.
Zurück zum Zitat Logemann JA: Evaluation and Treatment of Swallowing Disorders, 2nd edn. Austin, TX: Pro-Ed, 1998 Logemann JA: Evaluation and Treatment of Swallowing Disorders, 2nd edn. Austin, TX: Pro-Ed, 1998
9.
Zurück zum Zitat Mathers-Schmidt BA, Kurlinski M: Dysphagia evaluation practices: Inconsistencies in clinical assessment and instrumental examination decision-making. Dysphagia 18:114–125, 2003PubMedCrossRef Mathers-Schmidt BA, Kurlinski M: Dysphagia evaluation practices: Inconsistencies in clinical assessment and instrumental examination decision-making. Dysphagia 18:114–125, 2003PubMedCrossRef
10.
Zurück zum Zitat American Speech-Language Hearing Association (ASHA): Knowledge and skills needed by speech-language pathologists providing services to dysphagic patients/clients. ASHA 32:7–12, 1990 American Speech-Language Hearing Association (ASHA): Knowledge and skills needed by speech-language pathologists providing services to dysphagic patients/clients. ASHA 32:7–12, 1990
11.
Zurück zum Zitat McCullough GH, Wertz RT, Rosenbek JC, et al. Clinicians’ preferences and practices in conducting clinical/bedside and videofluoroscopic swallowing examination in an adult, neurogenic population. Am J Speech Lang Pathol 8:149–163, 1999 McCullough GH, Wertz RT, Rosenbek JC, et al. Clinicians’ preferences and practices in conducting clinical/bedside and videofluoroscopic swallowing examination in an adult, neurogenic population. Am J Speech Lang Pathol 8:149–163, 1999
12.
Zurück zum Zitat Wilcox F, Liss JM, Siegel GM: Interjudge agreement in videofluoroscopic studies of swallowing. J Speech Hear Res 39:144–152, 1996PubMed Wilcox F, Liss JM, Siegel GM: Interjudge agreement in videofluoroscopic studies of swallowing. J Speech Hear Res 39:144–152, 1996PubMed
13.
Zurück zum Zitat Colodny N: Comparison of dysphagics and non-dysphagics on pulse oximetry during oral feeding. Dysphagia 15:68–73, 2000PubMed Colodny N: Comparison of dysphagics and non-dysphagics on pulse oximetry during oral feeding. Dysphagia 15:68–73, 2000PubMed
14.
Zurück zum Zitat Code C, Heron C: Services for aphasia, other acquired adult neurogenic communication and swallowing disorders in the United Kingdom, 2000. Disabil Rehabil 25:1231–1237, 2003PubMedCrossRef Code C, Heron C: Services for aphasia, other acquired adult neurogenic communication and swallowing disorders in the United Kingdom, 2000. Disabil Rehabil 25:1231–1237, 2003PubMedCrossRef
15.
Zurück zum Zitat Armstrong E: Communication culture in acute speech pathology settings: current issues. Adv Speech Lang Pathol 5:137–143, 2003CrossRef Armstrong E: Communication culture in acute speech pathology settings: current issues. Adv Speech Lang Pathol 5:137–143, 2003CrossRef
16.
Zurück zum Zitat Rossiter D, Marks L: Reflecting reality. RCSLT Bull April:13–14, 2004 Rossiter D, Marks L: Reflecting reality. RCSLT Bull April:13–14, 2004
17.
Zurück zum Zitat Cichero JA, Murdoch BE: The physiologic cause of swallowing sounds: answers from heart sounds and vocal tract acoustics. Dysphagia 13:39–52, 1998PubMedCrossRef Cichero JA, Murdoch BE: The physiologic cause of swallowing sounds: answers from heart sounds and vocal tract acoustics. Dysphagia 13:39–52, 1998PubMedCrossRef
18.
Zurück zum Zitat Sellars C, Dunnet C, Carter RL: A preliminary comparison of videofluoroscopy of swallow and pulse oximetry in the identification of aspiration in dysphagic patients. Dysphagia 13:82–86, 1998PubMedCrossRef Sellars C, Dunnet C, Carter RL: A preliminary comparison of videofluoroscopy of swallow and pulse oximetry in the identification of aspiration in dysphagic patients. Dysphagia 13:82–86, 1998PubMedCrossRef
19.
Zurück zum Zitat Smith HA, Lee SH, O’Neill PA, Connolly MJ: The combination of bedside swallowing assessment and oxygen saturation monitoring of swallowing in acute stroke: a safe and humane screening tool. Age Ageing 29:495–499, 2000PubMedCrossRef Smith HA, Lee SH, O’Neill PA, Connolly MJ: The combination of bedside swallowing assessment and oxygen saturation monitoring of swallowing in acute stroke: a safe and humane screening tool. Age Ageing 29:495–499, 2000PubMedCrossRef
20.
Zurück zum Zitat Zenner PM, Losinski DS, Mills RH: Using cervical auscultation in the clinical dysphagia examination in long-term care. Dysphagia 10:27–31, 1995PubMedCrossRef Zenner PM, Losinski DS, Mills RH: Using cervical auscultation in the clinical dysphagia examination in long-term care. Dysphagia 10:27–31, 1995PubMedCrossRef
21.
Zurück zum Zitat Hembree AC: Dysphagia evaluation and treatment. Operative Tech Otolaryngol Head Neck Surg 8:185–190, 1997CrossRef Hembree AC: Dysphagia evaluation and treatment. Operative Tech Otolaryngol Head Neck Surg 8:185–190, 1997CrossRef
22.
Zurück zum Zitat Ramsey DJ, Smithard DG, Kalra L: Early assessments of dysphagia and aspiration risk in acute stroke patients. Stroke 34:1252–1257, 2003PubMedCrossRef Ramsey DJ, Smithard DG, Kalra L: Early assessments of dysphagia and aspiration risk in acute stroke patients. Stroke 34:1252–1257, 2003PubMedCrossRef
23.
Zurück zum Zitat Rosenbek JC, McCullough GH, Wertz RT: Is the information about a test important? Applying the methods of evidence-based medicine to the clinical examination of swallowing. J Commun Disord 37:437–450, 2004PubMedCrossRef Rosenbek JC, McCullough GH, Wertz RT: Is the information about a test important? Applying the methods of evidence-based medicine to the clinical examination of swallowing. J Commun Disord 37:437–450, 2004PubMedCrossRef
24.
Zurück zum Zitat Langmore SE, Schatz K, Olson N: Endoscopic and videofluoroscopic evaluations of swallowing and aspiration. Ann Otol Rhinol Laryngol 100:678–681, 1991PubMed Langmore SE, Schatz K, Olson N: Endoscopic and videofluoroscopic evaluations of swallowing and aspiration. Ann Otol Rhinol Laryngol 100:678–681, 1991PubMed
25.
Zurück zum Zitat Lundy DS, Smith C, Colangelo L, Sullivan PA, Logemann JA, Lazarus CL, Newman LA, Murray T, Lombard L, Gaziano J: Aspiration: cause and implications. Otolaryngol Head Neck Surg 120:474–478, 1999PubMedCrossRef Lundy DS, Smith C, Colangelo L, Sullivan PA, Logemann JA, Lazarus CL, Newman LA, Murray T, Lombard L, Gaziano J: Aspiration: cause and implications. Otolaryngol Head Neck Surg 120:474–478, 1999PubMedCrossRef
Metadaten
Titel
Dysphagia Evaluation Practices of Speech and Language Therapists in Ireland: Clinical Assessment and Instrumental Examination Decision-Making
verfasst von
Catharine M. Pettigrew
Ciara O’Toole
Publikationsdatum
01.07.2007
Verlag
Springer-Verlag
Erschienen in
Dysphagia / Ausgabe 3/2007
Print ISSN: 0179-051X
Elektronische ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-007-9079-2

Weitere Artikel der Ausgabe 3/2007

Dysphagia 3/2007 Zur Ausgabe

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.