Physiology and Execution of Swallowing Maneuvers in 3D Videos: Integrating the Technology into Patient Care.

Abstract

Educational technologies have proven to be an effective way to guide and educate patients, allowing them to increase awareness of their dysphagia condition and how treatment will help them. In this sense, this study aimed to develop and validate the content and appearance of 3D iconographic videos, which addressed the physiological demonstration and execution of protective and facilitating swallowing maneuvers, as well as verifying the feasibility of its use in teleconsultation, having adults and elderly people with oropharyngeal dysphagia as the main target audience. The development of the 3D videos was elaborated based on a guiding scientific script, constructed from an integrative literature review. After the development of the 3D videos by the digital designer, a committee of 12 expert judges evaluated the material produced to validate the content and appearance where a minimum agreement index of 0.8 among the judges was considered satisfactory. Subsequently with the validated material, the proof of concept was conducted together with the target population of 10 dysphagic patients through individual teleconsultation via Google Meet platform. After the teleconsultation, patients responded to a Google Forms questionnaire, analyzing the videos presented. From the integrative literature review, 29 studies that contained relevant information about the physiological effects caused by swallowing maneuvers were selected. Based on this information, the scientific script was created, allowing a detailed description of the physiological events that occurred during swallowing while executing the maneuvers. With the finished script, 3D videos of swallowing maneuvers were produced. After developing the material, the committee of expert judges validated the content and appearance. The twelve items that had an agreement index below 0.8 were adjusted. Once the adjustments were completed, the videos were analyzed again, obtaining approval from the judges, and ensuring the validation of content and appearance of the material developed. A proof of concept was conducted on ten dysphagic patients. The maneuver applied was chosen according to the patient's physiological changes, causing only 4 of the 9 maneuvers to be tested, as the patients did not demonstrate changes in swallowing that would justify the use of the other maneuvers. After this, patients answered a form in which all items covered received positive evaluations, related to both ease of understanding and learning. This study allowed the development of the 3D videos with a didactic demonstration of the physiology and execution of protective and facilitating swallowing maneuvers, in addition to having its content and appearance validity assured through analysis by the committee of expert judges.