Rumbach Anna, Coombes Caitlin, Doeltgen Sebastian
Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, QLD, 4072, Australia.
Discipline of Speech Pathology & Audiology, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, SA, 5161, Australia.
Dysphagia. 2018 Apr;33(2):216-226. doi: 10.1007/s00455-017-9849-4. Epub 2017 Sep 20.
Dysphagia assessment and rehabilitation practice is complex, and significant variability in speech-language pathology approaches has been documented internationally. The aim of this study was to evaluate swallowing-related assessment and rehabilitation practices of SLPs currently working in Australia. One hundred and fifty-four SLPs completed an online questionnaire administered via QuickSurveys from May to July 2015. Results were analysed descriptively. The majority of clinicians had accessed post-graduate training in dysphagia management and assessment (66.23%). Referral and screening were typically on an ad hoc basis (74.03%). Clinical swallow examination (CSE) and Videofluoroscopic Swallowing Study were used by 93.51 and 88.31% of respondents, respectively. CSE was the assessment that predominantly informed clinical decision-making (52.63%). Clinicians typically treated clients with dysphagia for 30 min per session (46.10%), with recommendations of repetition of exercises inconsistent across settings. Outcome measures were utilised by many (67.53%), which however were typically informal. Results indicate variable practice patterns for dysphagia assessment and management across Australia. This variability may reflect the heterogeneous nature of dysphagia and the varying needs of patients accessing different services.
吞咽困难评估与康复实践十分复杂,国际上已有文献记载言语语言病理学方法存在显著差异。本研究旨在评估目前在澳大利亚工作的言语语言病理学家与吞咽相关的评估和康复实践。154名言语语言病理学家于2015年5月至7月通过QuickSurveys完成了一份在线调查问卷。对结果进行了描述性分析。大多数临床医生接受过吞咽困难管理和评估方面的研究生培训(66.23%)。转诊和筛查通常是临时进行的(74.03%)。分别有93.51%和88.31%的受访者使用临床吞咽检查(CSE)和电视荧光吞咽造影检查。CSE是主要为临床决策提供依据的评估方法(52.63%)。临床医生通常每次为吞咽困难患者治疗30分钟(46.10%),不同机构关于重复练习的建议不一致。许多人使用了结果测量方法(67.53%),然而这些方法通常是非正式的。结果表明澳大利亚各地吞咽困难评估和管理的实践模式存在差异。这种差异可能反映了吞咽困难的异质性以及接受不同服务的患者的不同需求。