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跨生命周期的吞咽障碍远程医疗:利用当代证据和专业知识指导 COVID-19 期间和之后的临床实践。

Telehealth for Dysphagia Across the Life Span: Using Contemporary Evidence and Expertise to Guide Clinical Practice During and After COVID-19.

机构信息

Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN.

Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN.

出版信息

Am J Speech Lang Pathol. 2021 Mar 26;30(2):532-550. doi: 10.1044/2020_AJSLP-20-00252. Epub 2021 Feb 8.

Abstract

Purpose Our aim was to critically review recent literature on the use of telehealth for dysphagia during the COVID-19 pandemic and enhance this information in order to provide evidence- and practice-based clinical guidance during and after the pandemic. Method We conducted a rapid systematized review to identify telehealth adaptations during COVID-19, according to peer-reviewed articles published from January to August 2020. Of the 40 articles identified, 11 met the inclusion criteria. Full-text reviews were completed by three raters, followed by qualitative synthesis of the results and description of practical recommendations for the use of telehealth for dysphagia. Results Seven articles were guidelines articles, three were editorials, and one was a narrative review. One article focused on telehealth and dysphagia during COVID-19. The remaining 10 mentioned telehealth in varying degrees while focusing on dysphagia management during the pandemic. No articles discussed pediatrics in depth. The most common procedure for which telehealth was recommended was the clinical swallowing assessment (8/11), followed by therapy (7/11). Six articles characterized telehealth as a second-tier service delivery option. Only one article included brief guidance on telehealth-specific factors, such as legal safeguards, safety, privacy, infrastructure, and facilitators. Conclusions Literature published during the pandemic on telehealth for dysphagia is extremely limited and guarded in endorsing telehealth as an equivalent service delivery model. We have presented prepandemic and emerging current evidence for the safety and reliability of dysphagia telemanagement, in combination with practical guidelines to facilitate the safe adoption of telehealth during and after the pandemic.

摘要

目的 本研究旨在批判性地回顾 COVID-19 大流行期间使用远程医疗治疗吞咽障碍的最新文献,并对这些信息进行增强,以便在大流行期间和之后提供基于证据和实践的临床指导。

方法 我们根据 2020 年 1 月至 8 月发表的同行评议文章,进行了一项快速系统综述,以确定 COVID-19 期间远程医疗的适应性。在确定的 40 篇文章中,有 11 篇符合纳入标准。由三位评估员完成全文审查,然后对结果进行定性综合,并描述在大流行期间和之后使用远程医疗治疗吞咽障碍的实用建议。

结果 有 7 篇文章是指南文章,3 篇是社论,1 篇是叙述性综述。有 1 篇文章专门讨论了 COVID-19 期间的远程医疗和吞咽障碍。其余 10 篇文章在不同程度上提到了远程医疗,同时重点介绍了大流行期间的吞咽障碍管理。没有文章深入讨论儿科。最常推荐使用远程医疗的程序是临床吞咽评估(8/11),其次是治疗(7/11)。有 6 篇文章将远程医疗描述为二线服务提供选择。只有 1 篇文章包括关于远程医疗特定因素的简要指导,例如法律保障、安全、隐私、基础设施和促进因素。

结论 在大流行期间发表的关于吞咽障碍远程医疗的文献非常有限,对将远程医疗作为等效的服务提供模式持谨慎态度。我们提出了大流行前和当前出现的吞咽障碍远程管理的安全性和可靠性证据,以及实用指南,以促进在大流行期间和之后安全采用远程医疗。

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