Dr. Pallavi Patel College of Health Care Sciences, Nova Southeastern University, Fort Lauderdale, FL, USA.
Department of Otolaryngology-Head and Neck Surgery, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
Ann Otol Rhinol Laryngol. 2021 Nov;130(11):1254-1262. doi: 10.1177/00034894211001065. Epub 2021 Mar 18.
Clinical practices of speech-language pathologists (SLP) treating head and neck cancer (HNC) patients range widely despite literature trending toward best practices. This survey study was designed to identify current patterns and assess for gaps in clinical implementation of research evidence.
A web-based survey was distributed to SLPs via listserv and social media outlets. Descriptive statistics and group calculations were completed to identify trends and associations in responses.
Of 152 received surveys, the majority of respondents were hospital-based (86%) and had greater than 5 years of experience (65%). There was group consensus for the use of prophylactic exercise programs (95%), recommendations for SLP intervention during HNC treatment (75%), and use of maintenance programs post-treatment (97%). Conversely, no group consensus was observed for use of pre-treatment swallow evaluations, frequency of service provision, and content of therapy sessions. Variation in clinical decision making was noted in use of prophylactic feeding tubes and number of patients taking nothing by mouth during treatment. No associations were found between years of experience and decision-making practices, nor were any associations found between practice setting and clinical decision making.
Despite the growing body of literature outlining evidence-based treatment practices for HNC patients, clinical practice patterns among SLPs continue to vary widely resulting in inconsistent patient care across practice settings. As compared to prior similar data, increased alignment with best practices was observed relative to early referrals, implementation of prophylactic intervention programs, and intervention with the SLP during the period of HNC treatment.
尽管文献倾向于最佳实践，但治疗头颈部癌症（HNC）患者的言语语言病理学家（SLP）的临床实践差异很大。本调查研究旨在确定当前的模式，并评估研究证据在临床实施中的差距。
通过列表服务和社交媒体向 SLP 分发了基于网络的调查。完成描述性统计和组计算，以确定响应中的趋势和关联。
在收到的 152 份调查中，大多数受访者来自医院（86%），且拥有超过 5 年的经验（65%）。对于预防性运动计划的使用（95%）、HNC 治疗期间 SLP 干预的建议（75%）以及治疗后维持方案的使用（97%），存在小组共识。相反，对于治疗前吞咽评估、服务提供的频率以及治疗期间的治疗内容，未观察到小组共识。在预防性喂养管的使用和治疗期间不进食的患者数量方面，临床决策存在差异。经验年限与决策实践之间未发现关联，实践环境与临床决策之间也未发现关联。
尽管有越来越多的文献概述了针对 HNC 患者的循证治疗实践，但 SLP 的临床实践模式仍然差异很大，导致在不同的实践环境中患者的护理不一致。与之前类似的数据相比，在早期转介、实施预防性干预计划以及在 HNC 治疗期间进行 SLP 干预方面，与最佳实践的一致性有所提高。
