Social and Psychological Burden of Dysphagia: Its Impact on Diagnosis and Treatment

Abstract

The social and psychological impact of dysphagia has not been routinely reported in large studies. We sought to determine the effects of dysphagia on broad measures of the quality of life of patients and to explore the relationship between the psychological handicaps of the condition and the frequency of diagnosis and treatment. A total of 360 patients selected on the basis of known subjective dysphagia complaints, regardless of origin, in nursing homes and clinics in Germany, France, Spain, and the United Kingdom were interviewed using an established questionnaire. Qualitative interviews with a total of 28 health professionals were conducted to improve understanding of the patient data in the context of each country. Over 50% of patients claimed that they were "eating less" with 44% reporting weight loss during the preceding 12 months. Thirty-six percent of patients acknowledged receiving a confirmed diagnosis of dysphagia; only 32% acknowledged receiving professional treatment for it. Most people with dysphagia believe their condition to be untreatable; only 39% of the sufferers believed that their swallowing difficulties could be treated. Eighty-four percent of patients felt that eating should be an enjoyable experience but only 45% actually found it so. Moreover, 41% of patients stated that they experienced anxiety or panic during mealtimes. Over one-third (36%) of patients reported that they avoided eating with others because of their dysphagia. In a largely elderly population that might accept dysphagia as an untreatable part of the aging process, clinicians need to be aware of the adverse effects of dysphagia on self-esteem, socialization, and enjoyment of life. Careful questioning should assess the impact of the condition on each patient's life, and patients should be educated on their choices for treatment in the context of any coexisting illness. Awareness of the condition, diagnostic procedures, and treatment options must be increased in society and among the medical profession.

Management of Dysphagia Following Traumatic Brain Injury

“…Dysphagia is causally linked with an increased risk of aspiration pneumonia; [13][14][15][16] the incidence of which can be as high as 12 % following severe TBI [14]. The social and psychological impacts of dysphagia can reduce patients' quality of life [17]. Post-discharge from rehabilitation, patients with TBI can be 79 times more likely to die from aspiration pneumonia compared to the general population [18].…”

Anxiety, depression and swallowing disorders in patients with Parkinson's disease

“…It is well recognized that swallowing problems are associated with distressing psychological responses, such as anxiety, shame, depression, embarrassment, fear, and reduced self-esteem [2]. Emotional factors are believed to cause disturbances of appetite and eating, swallowing and digestive functions [3].…”

The Prevalence of Dysphagia in Primary Care Patients: A HamesNet Research Network Study

“…1 Patients with dysphagia suffer significant social and psychological burdens associated with their symptoms of difficulty with swallowing, including anxiety with meals or avoidance of eating with others. 2 The diagnosis of dysphagia is important because of the associated morbidity and mortality. Untreated dysphagia can lead to dehydration, malnutrition, respiratory infections, and death.…”

“…Untreated dysphagia can lead to dehydration, malnutrition, respiratory infections, and death. 2 The elderly with symptoms of dysphagia are at increased risk of the complications of dysphagia, including aspiration pneumonia. 3 Several studies have identified the elderly as being at risk for the development of dysphagia.…”