Massey Documents by Type

Permanent URI for this communityhttps://mro.massey.ac.nz/handle/10179/294

Browse

Filters

2020 - 20225

Settings

Subject: search.filters.subject.Deglutition Disorders

Search Results

Now showing 1 - 5 of 5
  • Thumbnail Image
    Item
    An International Commentary on Dysphagia and Dysphonia During the COVID-19 Pandemic
    (Springer Nature, 2022-12) Miles A; McRae J; Clunie G; Gillivan-Murphy P; Inamoto Y; Kalf H; Pillay M; Pownall S; Ratcliffe P; Richard T; Robinson U; Wallace S; Brodsky MB
    COVID-19 has had an impact globally with millions infected, high mortality, significant economic ramifications, travel restrictions, national lockdowns, overloaded healthcare systems, effects on healthcare workers’ health and well-being, and large amounts of funding diverted into rapid vaccine development and implementation. Patients with COVID-19, especially those who become severely ill, have frequently developed dysphagia and dysphonia. Health professionals working in the field have needed to learn about this new disease while managing these patients with enhanced personal protective equipment. Emerging research suggests differences in the clinical symptoms and journey to recovery for patients with COVID-19 in comparison to other intensive care populations. New insights from outpatient clinics also suggest distinct presentations of dysphagia and dysphonia in people after COVID-19 who were not hospitalized or severely ill. This international expert panel provides commentary on the impact of the pandemic on speech pathologists and our current understanding of dysphagia and dysphonia in patients with COVID-19, from acute illness to long-term recovery. This narrative review provides a unique, comprehensive critical appraisal of published peer-reviewed primary data as well as emerging previously unpublished, original primary data from across the globe, including clinical symptoms, trajectory, and prognosis. We conclude with our international expert opinion on what we have learnt and where we need to go next as this pandemic continues across the globe.
  • Thumbnail Image
    Item
    Contextualising clinical reasoning within the clinical swallow evaluation: A scoping review and expert consultation
    (AOSIS, 2021-07-29) Pillay T; Pillay M
    Background: This study explored the available literature on the phenomenon of clinical reasoning and described its influence on the clinical swallow evaluation. By exploring the relationship between clinical reasoning and the clinical swallow evaluation, it is possible to modernise the approach to dysphagia assessment. Objectives: This study aimed to contextualise the available literature on clinical reasoning and the CSE to low-middle income contexts through the use of a scoping review and expert consultation. Method: A scoping review was performed based on the PRISMA-ScR framework. The data was analysed using thematic analysis. Articles were considered if they discussed the clinical swallow evaluation and clinical reasoning, and were published in the last 49 years. Results: Through rigorous electronic and manual searching, 12 articles were identified. This review made an argument for the value of clinical reasoning within the clinical swallow evaluation. The results of the study revealed three core themes related to the acquisition, variability and positive impact of clinical reasoning in the clinical swallow evaluation. Conclusion: The results of this review showed that the clinical swallow evaluation is a complex process with significant levels of variability usually linked to the impact of context. This demonstrates that in order to deliver effective and relevant services, despite challenging conditions, healthcare practitioners must depend on clinical reasoning to make appropriate modifications to the assessment process that considers these salient factors.
  • Thumbnail Image
    Item
    It’s crunch time: Exploring the sensibility of food textural acoustics for individuals with dysphagia
    (AOSIS, 2021-06-30) Karani TF; Pillay M
    Background: Various fields of study have alluded to food textural, and its associated acoustic, properties (i.e. food textural acoustics). However, because of the challenging nature of the inclusion of acoustic properties in diet textural modifications in dysphagia (swallowing disorders), this construct has not been sufficiently considered in the field. Objective: To investigate the sensibility of food textural acoustics as a construct to understand eating for individuals with dysphagia. Method: The study design was based on qualitative evidence synthesis methodologies. This involved revised scoping review methods (peer-reviewed published articles from 1980 to 2020 over seven databases), with an adapted consultation phase through online focus group discussions with six world experts. The data was analysed using frequency and thematic analysis, and ideology critique. Results: A total of 11 articles were included in the revised scoping review analysis (seven research studies and four review articles). The analysis of these articles revealed a lack of diversity in geography, discipline and perspective exploring the construct of food textural acoustics. A total of three themes with three associated core arguments emerged from the revised scoping review and the consultation phase. These arguments highlighted (1) the need to study food textural acoustics because of its salience and pleasure responses, (2) possible methodological dilemmas in studying food textural acoustics due to the complexity of eating, and (3) considerations with regard to the approach and positioning adopted when studying the construct. Conclusion: Food textural acoustics may be a sensible construct to understand eating for individuals with dysphagia. As eating is a complex process, there is a need to challenge the methods we use when studying this construct of food textural acoustics. We hope that this article inspires researchers and practitioners to think differently by using textural, and its associated acoustic, properties as a way to reimagine dysphagia practice, especially for those from low- to middle-income contexts such as South Africa and Brazil.
  • Thumbnail Image
    Item
    Post-stroke dysphagia: An exploration of initial identification and management performed by nurses and doctors
    (AOSIS, 2020-05-28) Pierpoint M; Pillay M
    Background: South African speech-language therapists are the only health professionals charged with dysphagia rehabilitation. However, registered nurses and doctors are often initial healthcare contact points for post-stroke dysphagia. Notwithstanding service concerns, they do indeed identify and manage post-stroke dysphagia. However, little is known about specifically what they do during these initial clinical encounters. Objective: To explore how doctors and registered nurses, on initial clinical contact, identify and manage post-stroke dysphagia. Method: A quantitative descriptive survey design, with non-probability, purposive sampling, was used. Twenty-one registered nurses and four doctors at a private South African hospital self-administered a questionnaire. Univariate analyses were completed by calculating frequency distributions of nurses’ and doctors’ identification and management practices. Results: Most (86%) did not use a formal screening tool. Indicators screened informally included: presence of drooling (84%) or gag reflex (76%), level of alertness (80%) and spontaneous saliva swallow (80%). Participants neglected important indicators like voluntary cough and vocal quality. Management provided included head of bed elevation (96%), speech-language therapist referrals (92%), nasogastric tube insertions (88%), intravenous fluids (84%) and positional adjustments (76%). Alternative management included total parenteral nutrition (52%), syringe feeding (48%), swallow muscle strengthening exercises (56%) and swallow manoeuvres (52%). Conclusion: Results indicated that doctors and registered nurses under-utilised important dysphagia indicators and used potentially harmful management practices like syringe feeding. Management practices further included out-of-scope methods like dysphagia rehabilitation exercises or manoeuvres. Recommendations include peer dysphagia screening training using formal tools and basic dysphagia management methods to better equip doctors and registered nurses when they clinically engage post-stroke patients.
  • Thumbnail Image
    Item
    Pathogenic oral bacteria in hospitalised patients with dysphagia: The silent epidem
    (AOSIS, 2021-07-30) Weimers MJ; Pillay M
    Background: Aspiration pneumonia is a serious and fatal complication of dysphagia, secondary to the ingestion of bacteria-laden secretions. However, no studies have documented the oral hygiene features present in patients who present with dysphagia. Objectives: The purpose of this study was to describe the oral hygiene problems of adults admitted to a sub-acute rehabilitation hospital and who presented with dysphagia. Methods: A descriptive, cross-sectional survey was conducted, during which 40 participants – 57.5% (n = 23) male and 42.5% (n = 17) female – underwent a clinical swallow evaluation using the Mann Assessment of Swallowing Ability (MASA) augmented with cervical auscultation (CA) and pulse oximetry (PO), an oral hygiene assessment using an adapted version of the Oral Health Assessment Tool (OHAT), followed by microbiology laboratory analysis of buccal swab samples to detect bacteria not considered part of the normal oral flora. Results: Results indicated that poor oral hygiene status was a common feature amongst all participants who presented with dysphagia. The most prevalent oral hygiene issues were related to abnormalities concerning saliva (60%), oral cleanliness (82.5%), the tongue (80%) and the use of dentures (71.4%). A high prevalence, 62.5% (n = 25), of opportunistic bacteria was found. The most commonly occurring bacteria groups were: (1) Candida albicans (47.5%) and (2) respiratory pathogens (37.5%) such as Klebsiella pneumoniae and Staphylococcus aureus. Conclusion: Persons with dysphagia have poor oral hygiene which creates favourable environments for bacteria to flourish and increases the prevalence of pathogenic oral bacteria associated with the development of aspiration pneumonia. The management of oral health issues for persons with dysphagia should receive greater attention during hospitalisation.