Decision making and the bedside assessment: The Speech Language Therapists’ thinking when making a diagnosis at the bed

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dc.citation.issue1
dc.citation.volume68
dc.contributor.authorCoutts K
dc.contributor.authorPillay M
dc.coverage.spatialSouth Africa
dc.date.accessioned2023-09-06T03:21:01Z
dc.date.accessioned2023-09-21T22:15:01Z
dc.date.available2021-06-30
dc.date.available2023-09-06T03:21:01Z
dc.date.available2023-09-21T22:15:01Z
dc.date.issued2021-06-30
dc.date.updated2023-09-06T02:08:47Z
dc.description© 2021. The Authors.en_US
dc.description.abstractBackground: The bedside assessment is often seen as a screener because of its high variability in sensitivity and specificity, whilst the instrumental measures are viewed as gold standards because of the ability of speech-language therapist (SLT) to visualise the swallow more objectively. Objectives: This research article explores how the value needs to be placed on the decision-making abilities of the SLT rather than on the assessment measure itself. Method: A mixed methodology concurrent triangulation design was employed to collect data in two phases: the first phase included observing seven SLTs conducting assessments using a standardised bedside measure together with pulse oximetry and cervical auscultation. The second phase was a focus group discussion based on the findings from the first phase. Data were analysed thematically using a bottom-up approach. Results: The following factors were found to influence the decision-making process at the bedside: bedside assessment data sets, patient, multidisciplinary team, context and then SLT. The availability of more data from the assessment from different data sets improved the confidence of the SLT at the bedside when needing to make clinical decisions. Clinical instincts are developed through experience and observation of those more experienced. These skills need to be developed from junior years. Conclusion: This research study showed that a bedside assessment can provide valuable information that will allow for diagnostic decisions to be made at the bedside. This study also highlighted the importance of critical thinking using clinical instincts, and that these are the factors that need to be valued and emphasised rather than the assessment measures themselves.
dc.format.extente1-e8
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/34212747
dc.identifier.citationCoutts K, Pillay M. (2021). Decision making and the bedside assessment: The Speech Language Therapists' thinking when making a diagnosis at the bed.. S Afr J Commun Disord. 68. 1. (pp. e1-e8).
dc.identifier.doi10.4102/sajcd.v68i1.790
dc.identifier.eissn2225-4765
dc.identifier.elements-typejournal-article
dc.identifier.harvestedMassey_Dark
dc.identifier.issn0379-8046
dc.identifier.urihttp://hdl.handle.net/10179/20112
dc.languageeng
dc.publisherAOSIS
dc.relation.isPartOfS Afr J Commun Disord
dc.rightsCC BY 4.0en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en_US
dc.subjectclinical decision making
dc.subjectclinical swallow evaluation
dc.subjectdysphagia
dc.subjectpulse oximetry and cervical auscultation
dc.subjectspeech-language therapy
dc.subjectDecision Making
dc.subjectHumans
dc.subjectLanguage Therapy
dc.subjectSpeech
dc.subjectSpeech Therapy
dc.titleDecision making and the bedside assessment: The Speech Language Therapists’ thinking when making a diagnosis at the bed
dc.typeJournal article
pubs.elements-id447452
pubs.organisational-groupOther
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