Intensive care professionals' perspectives on dysphagia management: A focus group study.

Area of Science:

• Critical Care Medicine
• Swallowing Disorders
• Healthcare Professional Collaboration

Background:

• Intensive care unit (ICU)-acquired dysphagia significantly increases patient morbidity and mortality.
• Standardized protocols for swallowing function evaluation and specialized training are often limited.
• Dysphagia management relies on multiprofessional collaboration, but current practices are variable and nonstandardized.

Purpose of the Study:

• To explore and compare the perceptions of nurses, physicians, and occupational therapists regarding dysphagia management in the ICU.
• To identify differences and similarities in professional perspectives on managing ICU-acquired dysphagia.
• To understand the factors influencing interprofessional collaboration in dysphagia care within the ICU setting.

Main Methods:

• Six focus group interviews were conducted with 33 participants (23 nurses, 4 physicians, 6 occupational therapists).
• The framework method was employed for analysis, utilizing a matrix developed from initial interviews.
• Interview content was systematically plotted, condensed, and refined within the matrix.

Main Results:

• Clinical dysphagia management is contingent on recognizing at-risk patients and signs of swallowing difficulties.
• Assessment, therapeutic interventions, and patient care varied among professional groups based on their knowledge and roles.
• Effective interprofessional collaboration was influenced by resource availability, practical skills, knowledge, decision-making competence, mutual respect, and recognition of diverse professional perspectives.

Conclusions:

• Systematic interprofessional collaboration is essential for ICU dysphagia management, aiming to prevent aspiration and ensure safe swallowing rehabilitation.
• A common goal of preventing aspiration and rehabilitating swallowing function requires effective dysphagia assessment and therapeutic interventions.
• Improving interprofessional collaboration involves sharing knowledge and enhancing skills across different healthcare professional groups.