Perspectives on Airway Protection: A Mixed Methods Investigation in People With Parkinson's Disease.

IF 2.3 3区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Jordanna S Sevitz, Nicole Rogus-Pulia, Michelle S Troche
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引用次数: 0

Abstract

Purpose: Disordered airway protection, including both disordered swallowing (dysphagia) and disordered cough (dystussia), is highly prevalent among persons with Parkinson's disease (pwPD). A comprehensive understanding of the perspectives of pwPD as it relates to airway protection is currently lacking and is necessary to provide relevant, person-centered care. Therefore, this study used a parallel-convergent mixed methods design to quantitatively and qualitatively investigate pwPD's perspectives on airway protection.

Method: Thirteen pwPD were consecutively recruited from a cough training trial. Quantitative data (obtained from the Swallowing Quality of Life questionnaire [SWAL-QOL] and the modified Canadian Occupational Performance Measure [mCOPM]) and qualitative data (obtained from semistructured interviews) were integrated to define participant knowledge, perceived importance, perceived performance, and psychosocial implications of airway protective deficits.

Results: All participants reported basic knowledge about airway protection, which centered around four themes-physiology, the interconnectedness between bulbar functions, danger, and impaired airway protection as a consequence of PD. All participants believed that airway protection was important (median mCOPM score = 10), with three primary themes related to importance-survival, anticipated future decline, and maintaining oral intake. We identified a split between participants who perceived themselves to have "a swallowing problem" and those who did not, with three themes relating to perceived impairment-use of eating strategies, unpredictable and inconsistent symptom experience, and vigilance required to mitigate symptoms. Psychosocial ramifications centered on three key themes that aligned with three SWAL-QOL domains-overall burden, fear of future decline, and social embarrassment.

Conclusion: The integration of quantitative and qualitative data in this study highlights the importance of considering unique patient perspectives to develop personalized and relevant management plans for each unique pwPD that integrate objective and clinical findings with patient priorities and needs.

Supplemental material: https://doi.org/10.23641/asha.28489280.

对帕金森病患者气道保护的展望:一项混合方法的调查。
目的:气道保护障碍,包括吞咽障碍(吞咽困难)和咳嗽障碍(吞咽困难),在帕金森病(pwPD)患者中非常普遍。目前缺乏对pwPD与气道保护相关的观点的全面理解,这对于提供相关的、以人为本的护理是必要的。因此,本研究采用平行收敛混合方法设计,定量和定性地探讨pwPD对气道保护的观点。方法:从咳嗽训练试验中连续招募13名pwPD。定量数据(来自吞咽生活质量问卷[sval - qol]和修改后的加拿大职业绩效量表[mCOPM])和定性数据(来自半结构化访谈)被整合以定义参与者知识、感知重要性、感知表现和气道保护缺陷的社会心理影响。结果:所有参与者都报告了气道保护的基本知识,主要围绕四个主题:生理学、球功能之间的相互联系、危险和PD导致的气道保护受损。所有参与者都认为气道保护是重要的(中位mCOPM评分= 10),与重要性相关的三个主要主题是生存、预期未来衰退和维持口服摄入。我们确定了认为自己有“吞咽问题”和没有“吞咽问题”的参与者之间的分裂,有三个主题与感知到的损伤有关-饮食策略的使用,不可预测和不一致的症状经历,以及减轻症状所需的警惕。社会心理影响主要集中在与三个swa - qol领域相一致的三个关键主题上——总体负担、对未来衰退的恐惧和社交尴尬。结论:本研究中定量和定性数据的整合突出了考虑独特患者观点的重要性,为每个独特的pwPD制定个性化和相关的管理计划,将客观和临床发现与患者的优先事项和需求结合起来。补充资料:https://doi.org/10.23641/asha.28489280。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American Journal of Speech-Language Pathology
American Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION
CiteScore
4.30
自引率
11.50%
发文量
353
审稿时长
>12 weeks
期刊介绍: Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.
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