Despite the remarkable burden of dysphagia, appropriate multidisciplinary management is lacking in Iran and patients are often deprived of effective treatments. Obtaining a full understanding of knowledge, attitude and practice (KAP) of healthcare providers is necessary to determine the gaps in improvement of the quality of care for dysphagic patients. A questionnaire was designed covering demographic information and the parameters of KAP. Face and content validity were determined. Test-retest reliability confirmed that the questionnaire scores are stable over time (r = 0.77, p value < 0.01). Participants were healthcare providers employed in university-affiliated hospitals in three major cities of Iran; Tehran, Shiraz and Mashhad. In total, 312 healthcare professionals completed our survey. The majority (96.8%) were familiar with the term "dysphagia or swallowing disorders". Most of the participants believed their profession (88.5%), as well as other disciplines (92.3%) can play an important role in the management of dysphagia; and this problem should be recognized in a multidisciplinary manner (96.2%). Also, 60.9% had encountered a patient with dysphagia. 52.2% had used at least one assessment method, while 49.9% had applied at least one treatment method. However, very few participants were familiar with a standard test for screening and assessment of dysphagia (11.9%). 74.7% were willing to participate in a workshop on dysphagia. As the main pitfalls of care lie in diagnosis and treatment expertise, the policy of hospitals should prioritize educating and updating the skills of healthcare professionals, encourage multidisciplinary teamwork, establishing clear guidelines and facilitate access to advanced tools.
Social media is a powerful tool in providing information and support for minority groups such as patients with chronic diseases. We aimed to assess the link between using online social media and depression in a sample population of Iranian Multiple Sclerosis (MS) patients. In this cross-sectional study, a number of MS patients between 18-55 years were recruited. The Persian-language version of the Beck Depression Inventory-II (BDI-II-Persian) was used to screen MS patients for depression. We selected a cutoff point of 16 to identify depressed MS patients, who answered the self-administered questionnaire designed by the authors (the validity and reliability was confirmed before). Patients, whose interaction with social networks and communication tools was limited to < 1 h/day for < 5 times/month, were allocated as controls. A two-sided p < 0.05 was considered statistically significant. We compared the depression score between patients who used internet and social media (16.38 ± 8.35) with those who did not (25 ± 13.98). We found out there was a significant difference (p = 0.046). However, there were no significant differences between the type (r = 0.098, p = 0.513) and duration (r = − 0.102, p = 0.564) of social media with depression score. Also, based on a cutoff of 3 number of social media there was no significant difference in the status of depression among patients (p = 0.921). Based on the experience of patients, it is helpful to implement a source using online social media to facilitate patients' access to rehabilitation support and establish support groups with standard supervised information delivery.
Post-stroke dysphagia is a prevalent, life threatening condition. Scientists recommended implementing behavioral therapies with new technologies such as transcranial direct current of stimulation (TDCS). Studies showed promising TDCS effects, and scientists suggested the investigation of the effectiveness of different montages. Supramarginal gyrus (SMG) is important in swallowing function. Our study aimed to investigate the effectiveness of stimulating SMG in improving post-stroke dysphagia. Forty-four patients finished the study (a randomized, double-blind one). All of them received behavioral therapy. The real group received anodal (2 mA, 20 min) stimulation on the intact SMG, and the sham group received the same for 30 s (5 sessions). Patients were assessed with Functional Oral Intake Scale (FOIS) and Mann Assessment of Swallowing Ability (MASA) after treatment and at one-month follow-up. The results showed that the difference between groups at baseline was not significant. According to MASA both groups improved significantly during the time ( p -value < 0.001). The improvement in the real group was significantly higher than in the sham group after treatment ( p -value = 0.002) and after one-month follow-up ( p -value < 0.001). According to FOIS, most of the patients in the real group (72.70%) reached level 6 or 7 after one-month follow-up which was significantly higher than the sham group (31.80%, p -value = 0.007). In conclusion, TDCS applied to the scalp's surface associated with SMG localization may improve swallowing function in the stroke patients with dysphagia.
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