Dosages of Swallowing Exercises Prescribed in Stroke Rehabilitation: A Medical Record Audit

Choy, Jacinda; Pourkazemi, Fereshteh; Anderson, Caitlin; Bogaardt, Hans

doi:10.1007/s00455-022-10500-x

Cited by 8 publications

(5 citation statements)

References 101 publications

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“…Further, more than half of the recommended interventions did not match the patient's symptoms (Carnaby & Harenberg, 2013). Similar variability in dysphagia practice is seen in other surveys, medical record audits and reviews of the literature (Choy et al., 2022a, 2022b; Rumbach et al., 2018). Overall, variability and limited use of evidence‐based practice are issues reducing the quality of dysphagia rehabilitation.…”

Section: Introductionsupporting

confidence: 73%

Factors influencing speech pathology practice in dysphagia after stroke: A qualitative focus group study

Choy,

Pourkazemi,

Bogaardt

et al. 2024

Intl J Lang & Comm Disor

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BackgroundDysphagia affects over half of adults after stroke. Dysphagia rehabilitation aims to improve swallowing and reduce negative outcomes for these adults. However, significant variability exists in dysphagia rehabilitation. Research is needed to explore the underlying clinician‐specific and workplace factors that contribute to variability in dysphagia rehabilitation after stroke.AimTo explore factors influencing speech pathology practice in dysphagia rehabilitation after stroke.Methods & ProceduresWe used a phenomenological approach with an interpretivist perspective. Twenty speech pathologists working in dysphagia rehabilitation participated from different workplace settings around Australia. Five semi‐structured focus groups were conducted online. Data were inductively analysed using thematic analysis with a coding reliability method.Outcomes & ResultsFour themes were discussed within focus groups: (1) relationship between experienced and less experienced clinicians: ‘Following what other people have done’, (2) need for collaborative learning: ‘A safe space to share and train’, (3) variation between settings impacts on continuity of care: ‘There's a difference between community and acute’, and (4) working effectively with multidisciplinary teams (MDT): ‘An MDT which can listen to the voice of speech pathology’.Conclusions & ImplicationsRelationships between senior and junior speech pathologists, within speech pathology and MDT, and across inpatient and community settings influenced speech pathology practice. Flattened hierarchies in speech pathology, collaborative learning in workplaces, mutual respect within teams and connection across inpatient and community settings could improve the quality and consistency of dysphagia rehabilitation after stroke.What this paper addsWhat is already known on this subject Dysphagia rehabilitation can improve swallowing after a stroke. However, dysphagia rehabilitation is characterised by variability in clinical practice. Clinician‐specific and workplace factors influence clinical practice and may contribute to variability in dysphagia rehabilitation.What this study adds Professional relationships influence speech pathologists’ clinical practice, including relationships between senior and junior clinicians, between inpatient and community settings and with peers and multidisciplinary teams. Workplace norms and hierarchies, poor continuity of care between settings and competing priorities from other disciplines can hinder dysphagia rehabilitation. However, collaborative learning, positive workplace cultures and respectful transdisciplinary care can improve the quality and consistency of clinical practice.What are the clinical implications of this work? Flattening hierarchies in the workplace can foster a safe learning space. Further, questioning workplace norms and seeking out peer learning within and across settings can build clinical skills and confidence. Developing positive workplace cultures that support continuous development may be key for empowering speech pathologists to provide high‐quality and consistent dysphagia rehabilitation.

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Section: Introductionsupporting

confidence: 73%

Factors influencing speech pathology practice in dysphagia after stroke: A qualitative focus group study

Choy,

Pourkazemi,

Bogaardt

et al. 2024

Intl J Lang & Comm Disor

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“…Rehabilitation exercise can promote long-term improvement of swallowing function through neuroplasticity. These exercises encompass various categories, including oral exercises, indirect swallowing exercises for reinforcing suprahyoid muscles (e.g., chin tuck against resistance and shaker exercise), as well as direct pharyngeal exercises like the effortful swallow and Mendelsohn maneuver ( Choy et al, 2023a , b ). Besides, neurostimulation techniques including PES, NMES, rTMS, and transcranial direct current stimulation (tDCS) are also exerting significant impacts on the rehabilitation of PSD.…”

Section: Discussionmentioning

confidence: 99%

Research hotspots and trends in post-stroke dysphagia: a bibliometric analysis

Xu,

Bai,

Dai

et al. 2023

Front. Neurosci.

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BackgroundDysphagia represents one of the common complications following a stroke, and post-stroke dysphagia (PSD) can lead to aspiration, pneumonia, and malnutrition, thus prolonging hospital stay, escalating medical expenditures, and imposing a substantial economic strain on both patients and society. The utilization of bibliometric analysis offers a quantitative approach for investigating the existing literature and recognizes the current status of the research. However, bibliometric analysis on the subject of PSD remains absent. Consequently, we carried out this study to provide researchers with insights, facilitating their further exploration of PSD.MethodsConducting a bibliometric analysis of articles pertaining to PSD retrieved over the past two decades enables us to acquire the research hotspots and trends in this area. The publications concerning PSD were searched from the Core Collection of Web of Science, spanning the period ranging from 2003 to 2023. Articles or reviews published in English were included in this study. Subsequently, we employed CiteSpace and VOSviewer software to visualize the retrieved articles, thereby identifying the cooperative relationships of authors, institutions, and countries, as well as relevant information about journals and references.ResultsThis study comprised 866 papers in total, and the number of articles published each year shows an overall growth trend. As for the analysis of the authors, Dziewas R. was the most prolific author with 21 articles. The most frequently published institutions, countries, and journals were the University of Manchester, China, and Dysphagia, with 28, 254, and 75 publications, respectively. And the co-cited authors and journals with the highest counts were Martino R and Stroke. According to the analysis of keywords and references, dysphagia screening and assessment, prevention of pneumonia, rehabilitation approaches, and nutritional management of PSD are considered research hotpots. Additionally, future research may focus on the topics of systematic review and meta-analysis, noninvasive brain stimulation, and lesion location.ConclusionThrough the bibliometrics analysis of PSD, we can capture the research hotspots and frontiers of PSD, thereby providing inspiration and reference for subsequent studies in this field.

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“…If cluster nursing can effectively prevent their occurrence, it can undoubtedly greatly promote the prognosis of stroke patients, reduce medical costs, and alleviate the burden on the healthcare system. [ 23 , 24 ] Therefore, this study aims to explore the positive application effects of cluster nursing in preventing bacterial pneumonia in neurological department stroke patients, providing more favorable preventive nursing measures for clinical practice. In this study, 120 neurological department stroke patients will be randomly divided into 2 groups: the RG group and the CG group.…”

Section: Discussionmentioning

confidence: 99%

The application of cluster nursing to prevent bacterial pneumonia in stroke patients in neurology department

Hu,

Zhang

2023

Medicine

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The research aims to explore the intervention effect of cluster nursing methods on bacterial pneumonia in stroke patients in neurology. A retrospective analysis is conducted on 120 patients diagnosed with stroke in the hospital from 2020 to 2022, who are diagnosed as stroke patients in the neurology department by doctors. 120 patients are randomly separated into a control group (CG) and a research group (RG) for the experiment, with 60 people in each group. The CG receive normal nursing; The RG adopt cluster nursing methods. Comparison have done in the general information, nursing satisfaction, physical improvement after intervention, and oral hygiene indicators of the 2 groups of patients, and the intervention effect of the 2 nursing methods on patients suffering from bacterial pneumonia is evaluated. When the time reached the 7th day, the nutritional risk screening scores of both groups were (9.53 ± 2.29) and (8.10 ± 2.12), respectively. The serum albumin levels were (36.46 ± 4.80) g/L and (34.16 ± 3.69) g/L, respectively. After simultaneous nursing intervention, there were P < .005 in respiratory rates in the 2nd and 4th months of intervention, as well as after the completion of nursing intervention. The respiratory rates of the RG patients improved toward a larger range of normal respiratory rates, with significant statistical significance (P < .005). As time passed, the number of people with shortness of breath in the CG increased sharply to 46, while those in the RG was only 27, indicating P < .05 between the 2 groups. At the beginning of the 3rd month, the satisfaction rates of the RG and the CG were (92.33 ± 1.17)% and (78.18 ± 1.07)%, respectively, and there was P < .0.05 between the 2 groups of data. The cluster nursing strategy has a significant relieving effect on bacterial pneumonia in stroke patients in the neurology department, which can effectively reduce the probability of pneumonia, improve their physical condition, and enhance their quality of life. It has certain clinical application value.

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Dosages of Swallowing Exercises Prescribed in Stroke Rehabilitation: A Medical Record Audit

Cited by 8 publications

References 101 publications

Factors influencing speech pathology practice in dysphagia after stroke: A qualitative focus group study

Factors influencing speech pathology practice in dysphagia after stroke: A qualitative focus group study

Research hotspots and trends in post-stroke dysphagia: a bibliometric analysis

The application of cluster nursing to prevent bacterial pneumonia in stroke patients in neurology department

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