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Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice

The international approach to the assessment and management of dysphagia in the acute phase post stroke is little studied. A questionnaire was sent to clinicians in stroke services that explored the current practice in dysphagia screening, assessment, and management within the acute phase post strok...

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Detalles Bibliográficos
Autores principales: Fairfield, Carol A., G. Smithard, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151229/
https://www.ncbi.nlm.nih.gov/pubmed/31972979
http://dx.doi.org/10.3390/geriatrics5010004
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author Fairfield, Carol A.
G. Smithard, David
author_facet Fairfield, Carol A.
G. Smithard, David
author_sort Fairfield, Carol A.
collection PubMed
description The international approach to the assessment and management of dysphagia in the acute phase post stroke is little studied. A questionnaire was sent to clinicians in stroke services that explored the current practice in dysphagia screening, assessment, and management within the acute phase post stroke. The findings from four (the UK, the US, Canada, and Australia) of the 22 countries returning data are analysed. Consistent approaches to dysphagia screening and the modification of food and liquid were identified across all four countries. The timing of videofluoroscopy (VFS) assessment was significantly different, with the US utilising this assessment earlier post stroke. Compensatory and Postural techniques were employed significantly more by Canada and the US than the UK and Australia. Only food and fluid modification, tongue exercises, effortful swallow and chin down/tuck were employed by more than fifty percent of all respondents. The techniques used for assessment and management tended to be similar within, but not between, countries. Relationships were found between the use of instrumental assessment and the compensatory management techniques that were employed. The variation in practice that was found, may reflect the lack of an available robust evidence base to develop care pathways and identify the best practice. Further investigation and identification of the impact on dysphagia outcome is needed.
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spelling pubmed-71512292020-04-20 Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice Fairfield, Carol A. G. Smithard, David Geriatrics (Basel) Article The international approach to the assessment and management of dysphagia in the acute phase post stroke is little studied. A questionnaire was sent to clinicians in stroke services that explored the current practice in dysphagia screening, assessment, and management within the acute phase post stroke. The findings from four (the UK, the US, Canada, and Australia) of the 22 countries returning data are analysed. Consistent approaches to dysphagia screening and the modification of food and liquid were identified across all four countries. The timing of videofluoroscopy (VFS) assessment was significantly different, with the US utilising this assessment earlier post stroke. Compensatory and Postural techniques were employed significantly more by Canada and the US than the UK and Australia. Only food and fluid modification, tongue exercises, effortful swallow and chin down/tuck were employed by more than fifty percent of all respondents. The techniques used for assessment and management tended to be similar within, but not between, countries. Relationships were found between the use of instrumental assessment and the compensatory management techniques that were employed. The variation in practice that was found, may reflect the lack of an available robust evidence base to develop care pathways and identify the best practice. Further investigation and identification of the impact on dysphagia outcome is needed. MDPI 2020-01-21 /pmc/articles/PMC7151229/ /pubmed/31972979 http://dx.doi.org/10.3390/geriatrics5010004 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fairfield, Carol A.
G. Smithard, David
Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice
title Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice
title_full Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice
title_fullStr Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice
title_full_unstemmed Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice
title_short Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice
title_sort assessment and management of dysphagia in acute stroke: an initial service review of international practice
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151229/
https://www.ncbi.nlm.nih.gov/pubmed/31972979
http://dx.doi.org/10.3390/geriatrics5010004
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