Pettigrew Catharine M, O'Toole Ciara
Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland.
Dysphagia. 2007 Jul;22(3):235-44. doi: 10.1007/s00455-007-9079-2. Epub 2007 Apr 25.
The purpose of this study was to investigate clinical assessment practices and instrumental examination decision-making by speech and language therapists (SLTs) in Ireland. A 21-question survey (including patient scenarios) was sent to 480 SLTs in Ireland. A total of 261 completed surveys were returned (54%), providing demographic information on SLTs currently working in Ireland and their services. Of these 261 surveys, 70 provided the data for the study, focusing on SLTs currently working in dysphagia, with adults/seniors at least some of the time. The results also showed clinician variability regarding which components are included in a bedside clinical examination of swallowing, with a high degree of consistency for only 11 of the 20 components. Clinicians agreed in their instrumental vs. noninstrumental evaluation recommendations for two of the six patient scenarios, with wide variability in clinical decision-making. Possible influences on clinical decision-making are discussed in relation to the findings of similar previous studies, as well as the current status and future needs of dysphagia training and services in Ireland.
本研究的目的是调查爱尔兰言语和语言治疗师（SLT）的临床评估实践以及仪器检查决策情况。一份包含21个问题（包括患者场景）的调查问卷被发送给了爱尔兰的480名言语和语言治疗师。共收回261份完整的调查问卷（回复率为54%），提供了关于目前在爱尔兰工作的言语和语言治疗师及其服务的人口统计学信息。在这261份调查问卷中，70份提供了本研究的数据，重点关注目前至少部分时间从事吞咽困难治疗工作、服务对象为成人/老年人的言语和语言治疗师。结果还显示，在吞咽床边临床检查应包含哪些组成部分方面，临床医生存在差异，20个组成部分中只有11个具有高度一致性。在六个患者场景中的两个场景中，临床医生在仪器评估与非仪器评估建议上达成了一致，但临床决策差异很大。结合以往类似研究的结果，以及爱尔兰吞咽困难培训和服务的现状与未来需求，讨论了对临床决策可能产生影响的因素。
