Patient responses to swallowing safety cues: A comparison of traditional face-to-face and tele-dysphagia instructional methods

Abstract

This investigation compared the outcomes of traditional face-to-face dysphagia intervention to online tele-dysphagia intervention by measuring the correct and incorrect responses to visual and auditory cues presented by a speech-language pathologist. Thirty participants with a confirmed medical condition of dysphagia were randomly assigned into two groups of fifteen, with one group receiving tele-dysphagia intervention and the other traditional face-to-face intervention. Data analysis conducted via t-test indicated that there was no significant difference in the mean scores from tele-dysphagia method (M=9.67, SD=3.74) as compared to faceto-face method (M=9.00, SD=2.70), t (28) =-0.56, p=0.580. Additionally, inter-rater reliability scores were obtained by determining a Cohen's kappa coefficient, and revealed a kappa statistic of k=1 for all items, given a 100% agreement for all trials. Effectiveness measures revealed that 87% of the tele-dysphagia participants achieved their clinical goal in comparison to 80% of their face-to-face study counterparts, with tele-dysphagia demonstrating slightly increased effectiveness (7%). Given that there was no significant statistical difference between the two delivery methods and with inter-rater reliability scores demonstrating perfect agreement, we can suggest that the online tele-dysphagia method can potentially yield effective clinical outcomes similar to a traditional face-to-face method.

Telehealth versus face-to-face delivery of speech language pathology services: a systematic review and meta-analysis

“…Four other trials compared telehealth to face-to-face delivery of speech language pathology services: one trial for school children with speech sound impairments, (25) one trial for elderly persons with dysphonia,(26) one trial for patients with post-stroke dysphagia, (24) and one trial for patients with post-stroke aphasia. (27)…”

“…One trial (24) compared the delivery of instructional methods for dysphagia via video to face-to-face, to patients with post-stroke dysphagia. The trial found no significant difference between the telehealth and the face-to-face groups in swallowing ability, with 87% of participants in the telehealth group and 80% of the participants in the face-to-face groups achieving a goal of over 80% accuracy of 15 trials (difference not significant).…”

“…Nevertheless, from a healthcare provider perspective, telehealth models may in some cases increase attendance and adherence rates, and also enable speech pathology clients greater flexibility and more equitable access to services,(21) with comparable satisfaction rates to face-to-face services. (24)…”

Telehealth and oropharyngeal dysphagia: An integrative review

“…2017 24 To compare the results of traditional dysphagia intervention with teledysphagia intervention, measuring correct and incorrect responses to visual and auditory cues presented by a speech-language pathologist.…”

“…The studies identified as components of telemonitoring were prevalent in relation to other telehealth modalities 24,27,29,30,34,37,40,41,43,44 . Among these, four studies 24,30,37,44 compared remote care with in-person care to list the weaknesses and potential of each modality, as well as the implementation of monitoring methods and applications.…”