DysphagiaPub Date : 2025-02-01Epub Date: 2024-06-05DOI: 10.1007/s00455-024-10719-w
Emma Charters, Anna Lawless, Jonathan R Clark, Natalie McCabe, Chris Milross, Rafe Britton, Gillian Heller, Raymond Wu
{"title":"Association between Swallowing Outcomes and Dose to Critical Swallow Structures in Patients Undergoing Transoral Robotic Surgery and Post-Operative Radiation Therapy.","authors":"Emma Charters, Anna Lawless, Jonathan R Clark, Natalie McCabe, Chris Milross, Rafe Britton, Gillian Heller, Raymond Wu","doi":"10.1007/s00455-024-10719-w","DOIUrl":"10.1007/s00455-024-10719-w","url":null,"abstract":"<p><strong>Background: </strong>The radiation dose to dysphagia and aspiration-related structures (DARS) for patients undergoing transoral robotic surgery (TORS) and post-operative radiation therapy (PORT) for primary oropharyngeal carcinoma is unknown.</p><p><strong>Methods: </strong>This prospective study measured swallowing using the MD Anderson Dysphagia Inventory at baseline and then 12-months after PORT. Dosimetric parameters were collected.</p><p><strong>Results: </strong>19 patients were recruited between 2017 and 2019. Worse swallow function at 12-months after PORT was associated with dose-parameters to the oesophageal inlet muscle, superior pharyngeal constrictor muscle and cervical oesophagus. Mean dose, V50Gy, and V60Gy to the base of tongue and pharyngeal constrictors was significantly lower in those receiving PORT to the neck alone.</p><p><strong>Conclusion: </strong>Dose to DARS was lower in patients who received PORT to the neck alone. In patients treated with TORS and PORT, poorer swallowing outcomes at 12 months post-treatment were associated with increased dose to oesophageal inlet muscle, superior constrictor muscle, and cervical oesophagus.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"200-207"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-02-01Epub Date: 2024-05-27DOI: 10.1007/s00455-024-10718-x
Kelsey L Thompson, Cuyler Romeo, Hayley H Estrem, Jaclyn Pederson, Matthew Peterson, Amy L Delaney, Paula Rabaey, William G Sharp
{"title":"Preparedness of Speech Language Pathologists and Occupational Therapists to Treat Pediatric Feeding Disorder: A Cross-Sectional Survey.","authors":"Kelsey L Thompson, Cuyler Romeo, Hayley H Estrem, Jaclyn Pederson, Matthew Peterson, Amy L Delaney, Paula Rabaey, William G Sharp","doi":"10.1007/s00455-024-10718-x","DOIUrl":"10.1007/s00455-024-10718-x","url":null,"abstract":"<p><strong>Background: </strong>Pediatric feeding disorder (PFD) is increasingly common and is often treated by speech language pathologists (SLPs) and occupational therapists (OTs) in the community setting. However, the preparedness of these disciplines to effectively address PFD is relatively unknown.</p><p><strong>Methods: </strong>A national (US), online survey was disseminated to providers who assess and treat PFD. For the present analysis, the responses of SLPs (N = 418) and OTs (N = 195) related to their clinical background, educational background, post-graduate training, and self-rated clinical effectiveness were statistically analyzed and compared across the two disciplines.</p><p><strong>Results: </strong>Both SLPs and OTs report feeling underprepared to work with PFD clients immediately following their academic training, but time spent in post-graduate training and years of clinical practice both significantly (p < 0.0001) increased feelings of effectiveness in assessing and treating PFD. Most SLPs and OTs pursued self-directed learning activities to increase competence, with the most common activities being article review, podcasts, and peer case review, although SLPs were significantly more likely to use podcasts (p < 0.0001) and peer review (p = 0.0004) than OTs. The most common barriers for providers were financial, time, travel, and institutional support barriers.</p><p><strong>Conclusions: </strong>While PFD is a key practice area of both SLPs and OTs, both provider groups feel unprepared and under-supported in providing competent care to these patients upon graduation. Future research and policy should support advancements in training for current SLPs and OTs related to PFD and address current barriers to a specialized educational pathway.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"187-199"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-02-01Epub Date: 2024-07-15DOI: 10.1007/s00455-024-10729-8
Dongmiao Han, Jinling Cheng, Yanfeng Chen, Hui Du, Zhanxiang Lin, Renlong Zhong, Zicai Liu
{"title":"Evidence for Intermittent Theta Burst Transcranial Magnetic Stimulation for Dysphagia after Stroke: A Systematic Review and Meta-analysis.","authors":"Dongmiao Han, Jinling Cheng, Yanfeng Chen, Hui Du, Zhanxiang Lin, Renlong Zhong, Zicai Liu","doi":"10.1007/s00455-024-10729-8","DOIUrl":"10.1007/s00455-024-10729-8","url":null,"abstract":"<p><p>Dysphagia is the most common serious complication after stroke, with an incidence of about 37-78%, which seriously affects the independence of patients in daily life and clinical recovery. Repetitive transcranial magnetic stimulation (rTMS), as a non-invasive neuromodulation technique, is an emerging option for post-stroke dysphagia. Theta burst stimulation (TBS) is a new mode of transcranial magnetic stimulation that simulates the frequency of pulses released in the hippocampus.Intermittent theta burst stimulation (iTBS) has been shown to increase cortical excitability and improve swallowing function in patients. Our study sought to summarize existing clinical randomized controlled trials to provide evidence-based medical evidence for the clinical use of iTBS. A computer search was conducted on 4 Chinese (Chinese Biomedical Literature Database, VIP Information Resource System, CNKI, and Wanfang Medical Science) and 4 English (including Cochrane Library, Embase, PubMed, Web of Science) databases to retrieve all randomized controlled trials in Chinese and English that explored the effects of Intermittent Theta Burst Stimulation for post-stroke dysphagia. The retrieval years are from database construction to 23 November 2023. The primary outcome measure was a change in Penetration/Aspiration Scale (PAS), Standardized Swallowing Assessment (SSA) and Functional Oral Intake Scale (FOIS), Secondary outcomes included Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), water-swallowing test (WST) etc. A meta-analysis by Standardized Mean Difference (SMD) and 95% confidence interval (CI) was performed with RevMan 5.3. we appraise risk of bias(RoB) of each study with the Cochrane RoB tool. Detailed instructions for using the Cochrane RoB tool are provided in the Cochrane Handbook for Systematic Reviews of Interventions (The Cochrane Handbook). Nine studies were obtained from eight databases after screening by inclusion and exclusion criteria, 567 patients from 9 studies were included in the meta-analysis, and one study was included in the qualitative analysis due to different control groups. Two of the nine studies had an unclear risk of bias, and four studies were at low risk. The results showed that iTBS significantly improved SSA, PAS, FOIS, and PAS scores in stroke patients compared to the control group(P < 0.05), and promoted swallowing function recovery. Our systematic review provides the first evidence of the efficacy of iTBS in improving dysphagia in stroke patients. However, the number of available studies limits the persuasiveness of the evidence and further validation by additional randomized controlled trials is needed.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"54-65"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-02-01Epub Date: 2024-06-29DOI: 10.1007/s00455-024-10713-2
Ellie Orr, Rishni Perera, Alesha Sayner, Acushla Thompson, Michael Pang, Damoon Entesari-Tatafi, Gerard Dalgleish, Lisa Nguyen, Lucy Cliffe, Isobel McDonald, Kylie Than, Megan Keage, Renee P Clapham
{"title":"Impacts of a Dysphagia Screening Questionnaire on Speech Pathology Input Using a Transdisciplinary Approach for Patients with Chronic Obstructive Pulmonary Disease in a Pulmonary Rehabilitation Program.","authors":"Ellie Orr, Rishni Perera, Alesha Sayner, Acushla Thompson, Michael Pang, Damoon Entesari-Tatafi, Gerard Dalgleish, Lisa Nguyen, Lucy Cliffe, Isobel McDonald, Kylie Than, Megan Keage, Renee P Clapham","doi":"10.1007/s00455-024-10713-2","DOIUrl":"10.1007/s00455-024-10713-2","url":null,"abstract":"<p><p>Patients with chronic obstructive pulmonary disease (COPD) in pulmonary rehabilitation programs (PRPs) are not routinely screened for dysphagia. An Australian regional health service audit revealed that patients with COPD are frequently referred to speech pathology during acute admissions, rather than proactively to mitigate the risk of dysphagia-related consequences. Referral patterns to speech pathology using a novel transdisciplinary approach for identifying at risk for dysphagia patients in a PRP were explored. The aim of this study was to investigate the impact of a transdisciplinary dysphagia screening questionnaire on speech pathology referrals within a cohort of patients with COPD enrolled in a PRP. This quasi-experimental study introduced a dysphagia screening questionnaire in a PRP using a transdisciplinary approach. A retrospective audit of PRP patients (n = 563) between 01/01/2014 and 31/12/2018 was conducted to identify the frequency of referrals to speech pathology for dysphagia. Data was compared to a cohort of patients (n = 50) enrolled in the PRP (from 01/02/21 to 30/11/21) after introduction of the questionnaire using Fisher's exact test. Less than 1% (n = 4/563) of PRP patients were referred to speech pathology prior to implementation of the questionnaire. Following the implementation, referrals to speech pathology significantly increased to 16% (8/50) (X<sup>2</sup> = 7.72, P < 0.05; odds ratio = 7.89 95% CI [1.94, 32.1]). Introducing a dysphagia screening questionnaire increased referrals to speech pathology from a PRP. This study demonstrated the potential for a transdisciplinary approach in early screening for patients at risk of dysphagia for patients with COPD. Further research is encouraged to explore patient motivation towards speech pathology input with COPD-related dysphagia and clinicians' perceived self-efficacy in using the questionnaire.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"152-161"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-02-01Epub Date: 2024-06-27DOI: 10.1007/s00455-024-10721-2
Katherine A Hutcheson, Ella F Aldridge, Carla L Warneke, Sheila N Buoy, Xiaohui Tang, Cameron Macdonald, Clare P Alvarez, Denise A Barringer, Carly E A Barbon, Barbara M Ebersole, Holly McMillan, Jane R Montealegre
{"title":"Clinical Implementation of DIGEST as an Evidence-Based Practice Tool for Videofluoroscopy in Oncology: A Six-Year Single Institution Implementation Evaluation.","authors":"Katherine A Hutcheson, Ella F Aldridge, Carla L Warneke, Sheila N Buoy, Xiaohui Tang, Cameron Macdonald, Clare P Alvarez, Denise A Barringer, Carly E A Barbon, Barbara M Ebersole, Holly McMillan, Jane R Montealegre","doi":"10.1007/s00455-024-10721-2","DOIUrl":"10.1007/s00455-024-10721-2","url":null,"abstract":"<p><p>Clinical implementation of evidence-based practice (EBP) tools is a healthcare priority. The Dynamic Grade of Swallowing Toxicity (DIGEST) is an EBP tool developed in 2016 for videofluoroscopy in head and neck (H&N) oncology with clinical implementation as a goal. We sought to examine: (1) feasibility of clinical implementation of DIGEST in a national comprehensive cancer center, and (2) fidelity of DIGEST adoption in real-world practice. A retrospective implementation evaluation was conducted in accordance with the STARI framework. Electronic health record (EHR) databases were queried for all consecutive modified barium swallow (MBS) studies conducted at MD Anderson Cancer Center from 2016 to 2021. Implementation outcomes included: feasibility as measured by DIGEST reporting in EHR (as a marker of clinical use) and fidelity as measured by accuracy of DIGEST reporting relative to the decision-tree logic (penetration-aspiration scale [PAS], residue, and Safety [S] and Efficiency [E] grades). Contextual factors examined included year, setting, cancer type, MBS indication, and provider. 13,055 MBS were conducted by 29 providers in 7,842 unique patients across the lifespan in diverse oncology populations (69% M; age 1-96 years; 58% H&N cancer; 10% inpatient, 90% outpatient). DIGEST was reported in 12,137/13,088 exams over the 6-year implementation period representing 93% (95% CI: 93-94%) adoption in all exams and 99% (95% CI: 98-99%) of exams excluding the total laryngectomy population (n = 730). DIGEST reporting varied modestly by year, cancer type, and setting/provider (> 91% in all subgroups, p < 0.001). Accuracy of DIGEST reporting was high for overall DIGEST (incorrect SE profile 1.6%, 200/12,137), DIGEST-safety (incorrect PAS 0.4% 51/12,137) and DIGEST-efficiency (incorrect residue 1.2%, 148/12,137). Clinical implementation of DIGEST was feasible with high fidelity in a busy oncology practice across a large number of providers. Adoption of the tool across the lifespan in diverse cancer diagnoses may motivate validation beyond H&N oncology.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"220-230"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-02-01Epub Date: 2024-05-16DOI: 10.1007/s00455-024-10717-y
Jenny Selg, Thorbjörn Holmlund, Eva Levring Jäghagen, Jenny McGreevy, Sara Svanberg, Per Wester, Patricia Hägglund
{"title":"Validity and Reliability of the Swedish Version of the Gugging Swallowing Screen for use in Acute Stroke Care.","authors":"Jenny Selg, Thorbjörn Holmlund, Eva Levring Jäghagen, Jenny McGreevy, Sara Svanberg, Per Wester, Patricia Hägglund","doi":"10.1007/s00455-024-10717-y","DOIUrl":"10.1007/s00455-024-10717-y","url":null,"abstract":"<p><p>The purpose of this study was to cross-culturally validate the Swedish version of the Gugging Swallowing Screen (GUSS-S) for use in the acute phase of stroke. Further, to evaluate the inter-rater reliability between different healthcare professionals. GUSS was translated into Swedish using a forward-backward method followed by expert rating to obtain content validity. For criterion validity, the GUSS-S score was compared with Flexible Endoscopic Evaluation of Swallowing (FEES) assessed with the Penetration-Aspiration Scale (PAS) in acute stroke patients (≤ 96 h after stroke onset). Convergent validity was calculated by comparison with the Functional Oral Intake Scale (FOIS) as per the comprehensive FEES assessment, the Standardized Swallowing Assessment (SSA), and the National Institutes of Health Stroke Scale (NIHSS). To evaluate inter-rater reliability, a nurse and a speech-language pathologist (SLP) independently assessed 30 patients. In total, 80 patients (32 women, median age 77 years (range 29-93) were included, mean 1.7 ± 0.9 days after admission. With a cut-off value of 14 points, the GUSS-S identified aspiration with a sensitivity of 100% and a specificity of 73% (area under the curve: 0.87, 95% CI 0.78-0.95). Spearman rank correlation showed very strong correlation between the GUSS-S and PAS (r<sub>s</sub>=-0.718, P = < 0.001) and FOIS (r<sub>s</sub>=0.720, P = 0.001) and strong correlation between the GUSS-S and SSA (r<sub>s</sub>=0.545, P = < 0.001) and NIHSS (r<sub>s</sub>=-0.447, P = 0.001). The inter-rater agreement for GUSS-S was substantial (<sub>Kw</sub>=0.67, P = < 0.001). The results indicate that the GUSS-S is a valid and reliable tool for the assessment of dysphagia in acute stroke patients by different healthcare professionals.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":"176-186"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-01-30DOI: 10.1007/s00455-025-10803-9
Anne Mette Schmidt, Helene Nørgaard Kristensen, Dorte Melgaard, Asger Roer Pedersen, Lene Mark, Charlotte Weiling Appel, Sofie Langergaard, Charlotte Overgaard
{"title":"Development of a Screening Intervention for Dysphagia in Hospitalised Geriatric Patients.","authors":"Anne Mette Schmidt, Helene Nørgaard Kristensen, Dorte Melgaard, Asger Roer Pedersen, Lene Mark, Charlotte Weiling Appel, Sofie Langergaard, Charlotte Overgaard","doi":"10.1007/s00455-025-10803-9","DOIUrl":"https://doi.org/10.1007/s00455-025-10803-9","url":null,"abstract":"<p><p>Prevalence of dysphagia is high in hospitalised geriatric patients, posing risks of complications including malnutrition, dehydration, aspiration, and pneumonia. These complications may lead to reduced daily functioning, frailty, prolonged hospital stays, readmissions, and mortality. Diagnosing dysphagia in geriatric patients is often challenging due to the complex health conditions of this patient group, and overall these patients are at risk of lack of continuity in patient pathways and unnecessary hospitalisations. Recognising the critical importance of prompt diagnosis and treatment of dysphagia, we developed a dysphagia screening intervention aligned with clinical guidelines and the political focus to improve patient pathways and reduce preventable hospitalisations. This article outlines the development process of a dysphagia screening intervention to geriatric patients (≥ 65 years) admitted to medical inpatient wards. We applied a theory-, evidence- and implementation-based approach combined with stakeholder involvement in adherence to the IdentifyiNg and assessing different approaches to DEveloping compleX intervention (INDEX) guidance, encompassing eleven actions. We developed a dysphagia screening intervention comprising a screening procedure (the 4 Questionnaire Test (4QT), the 30 ml water swallowing test, and an action algorithm) targeting the patient level. Moreover, we developed an implementation strategy (activities necessary for adequate delivery of the dysphagia screening procedure and activities supporting the delivery of the screening procedure) targeting health professionals and the organisational level. The dysphagia screening intervention is now ready for feasibility testing, promising improved health and healthcare services for hospitalised geriatric patients.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-01-23DOI: 10.1007/s00455-024-10794-z
Xiaobin Guo, Tengfei Ke, Yifan Liu, Chengde Liao, Manzhu Li
{"title":"Compressed Sensing-Based Cine-MRI for Location of Dysphagia and Swallowing Function assessment in Patients with Head and Neck Cancer: A Comparative Study.","authors":"Xiaobin Guo, Tengfei Ke, Yifan Liu, Chengde Liao, Manzhu Li","doi":"10.1007/s00455-024-10794-z","DOIUrl":"https://doi.org/10.1007/s00455-024-10794-z","url":null,"abstract":"<p><p>Cine magnetic resonance imaging (Cine-MRI) may evaluate the swallowing function and locations of patients with dysphagia, which requires very fast imaging speed. Compressed sensing is a technique that allows for faster MRI imaging by sampling fewer data points and reconstructing the image via optimization techniques, crucial for capturing the rapid movements involved in swallowing. This study aimed to analyze swallowing function and locations in patients with head and neck cancer and healthy individuals using Cine-MRI based on compressed sensing. This comparative study enrolled 36 patients with dysphagia and 10 healthy controls at the Department of Radiology, Yunnan Cancer Hospital between June 2020 and January 2021. Significant correlations were found between primary tumor location and Cine-MRI parameters, and between swallowing function and Cine-MRI parameters. The areas under the receiver operating characteristic curve for the combined Cine-MRI-related parameters in predicting mild and severe dysphagia were 0.806 (95% CI: 0.662-0.949). Cine-MRI with compressed sensing may identify swallowing function and abnormal stages of the physiologic swallowing process in patients with dysphagia after treatment.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-01-21DOI: 10.1007/s00455-024-10785-0
Sarah E Wilson, Bena Brown, Clare L Burns
{"title":"Clinical Swallow Examination Following Laryngectomy: An International e-Delphi Consensus Process.","authors":"Sarah E Wilson, Bena Brown, Clare L Burns","doi":"10.1007/s00455-024-10785-0","DOIUrl":"https://doi.org/10.1007/s00455-024-10785-0","url":null,"abstract":"<p><p>Clinical swallow examination (CSE) following laryngectomy (± pharyngeal resection) remains a critical step in dysphagia evaluation. Whilst the core components of a standard CSE service a broad spectrum of patient populations, no evidence exists examining the essential assessment items specific to CSE in the laryngectomy population. The aim of this study was to identify the tasks, measures and observations considered necessary to include in a CSE post laryngectomy. Using an e-Delphi approach, a 4-round online survey series was undertaken with 34 speech pathologists experienced in laryngectomy swallowing management from 6 countries. In the first round (item generation) participants were provided with the questions from the swallowing outcomes after laryngectomy (SOAL) as stimulus, to generate a list of tasks, measures and observations as well as clarifying questions they would ask the patient during a CSE. In the subsequent e-Delphi rounds the participants rated the importance of the compiled assessment items. A total of 34 items were rated of critical importance for inclusion in a laryngectomy CSE by ≥ 75% of participants. Two thirds of the consensus items (23 items) were patient history and interview questions incorporating medical and swallowing history (4 items) and patient interview (19 items). The remaining 11 items related to swallow tasks and observations (9 items) and onward referral (2 items). These 34 consensus items can be considered as a draft framework for laryngectomy CSE to guide clinical practice and research.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
DysphagiaPub Date : 2025-01-18DOI: 10.1007/s00455-024-10800-4
Rabia Yeşilkuş, Selen Serel Arslan
{"title":"A New Instrument to Define Parental Fear Regarding Feeding Their Children: A Reliability and Validity Study.","authors":"Rabia Yeşilkuş, Selen Serel Arslan","doi":"10.1007/s00455-024-10800-4","DOIUrl":"https://doi.org/10.1007/s00455-024-10800-4","url":null,"abstract":"<p><p>This study aimed to develop the 'Fear of Feeding My Child- A Parental Report (FF-PR)', which measures the parental fear of feeding their children, and to determine its reliability and validity. The study consists of the developmental phase and reported the content validity, internal consistency, test-retest reliability, construct, criterion, and discriminant validity. The study included two groups; 'Group I (N = 90)' who had a neurological disorder and their parents, and 'Group II (N = 60)' who were typically developing children without any feeding and swallowing problems and their parents. Limited literature review, clinical experience, and parental interviews have been used in creating the item pool. A panel of 7 experts assessed the content validity in two Delphi rounds. Cronbach's α measured the internal consistency of each item. The test-retest reliability was determined using the FF-PR scores given by the parents in Group I one week apart. Confirmatory factor analysis was used to measure the construct validity. The Nordic Orofacial Screening Test (NOT-S), Dysphagia Disorder Survey (DDS), and the Turkish version of the Feeding-Swallowing Impact Survey (T-FS-IS) were used for the criterion validity of the FF-PR. The discriminant validity of the FF-PR was determined by comparing the FF-PR scores of the groups and using the receiver-operating characteristic (ROC) curve. The content validity index was 0.92. The Cronbach's α was found to be high (test: 0.966, retest: 0.969). The FF-PR had an excellent chi-square fit (χ<sup>2</sup>/df = 123.075/127 p = 0.582) and according to the fit indices; the FF-PR was found to have a good fit. There was a low-moderate correlation between FF-PR and NOT-S (r = 0.335 - 0.462, p < 0.001) and DDS (r = 0.461 - 0.535, p < 0.001) and a moderate-high correlation between FF-PR and T-FS-IS (r = 0.501 - 0.807, p < 0.001). The FF-PR total and subscale scores were higher in Group I than in Group II. In conclusion, the FF-PR scale is a valid and reliable tool for measuring parental fear about feeding their child.</p>","PeriodicalId":11508,"journal":{"name":"Dysphagia","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}