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Published on: March 1, 2015
Speech-language pathologists' perspectives of dysphagia following reperfusion therapies: An Australian mixed-methods
Ellie Minchell1,2,3, Anna Rumbach1, Emma Finch1,3,4
1School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
Purpose:
To investigate speech-language pathologists' (SLPs) perceptions and clinical experiences of dysphagia management following reperfusion therapies.
Method:
A multi-staged mixed approach involving a two-phase cross-sectional design was used. Data generated during phase 1 (a purpose-built, online survey) guided the development of phase 2 (semi-structured interviews). Sixty-two SLPs participated in phase 1 and six SLPs participated in phase 2.
Result:
SLPs in both phases reported perceived changes in dysphagia presentation according to the success of reperfusion therapy administered and had concerns regarding worsened dysphagia following unsuccessful procedures. Fluctuations in dysphagia were more frequently reported in the acute stage post-stroke. SLPs reported increased workload demands due to increased interhospital transfers between ECR/thrombolysis centres and referring facilities. The optimal timing for swallowing screening and assessment was not identified, with initial SLP involvement ranging from during the administration of thrombolysis to up to 24 hours post-reperfusion therapy.
Conclusion:
Preliminary evidence suggests that SLPs perceive that the presentation of post-stroke dysphagia is changing, with increasing fluctuations and complexities in the acute stage of post-stroke care, within the context of increasing use of reperfusion therapies. There is a critical need for research investigating the trajectory of dysphagia in the acute stage to inform dysphagia management within this patient population.
