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一项针对多学科新冠长期症状服务中存在言语和语言治疗需求患者的回顾性研究:一项服务评估,描述并比较两个国民保健服务信托基金中的两个队列。

A retrospective study of patients presenting with speech and language therapy needs within multidisciplinary Long COVID services: A service evaluation describing and comparing two cohorts across two NHS Trusts.

作者信息

Chalmers Sophie, Harrall Kate, Wong Sze Yin, Kablan Widad, Clunie Gemma

机构信息

Long COVID Service, Long Term Conditions, Integrated Community Services Division, Bolton NHS Foundation Trust, Bolton, UK.

Allied Health Research Unit, School of Sport and Health Sciences, University of Central Lancashire, Preston, UK.

出版信息

Int J Lang Commun Disord. 2023 Sep-Oct;58(5):1424-1439. doi: 10.1111/1460-6984.12868. Epub 2023 Mar 14.

Abstract

BACKGROUND

Post-COVID Syndrome (also known as Long COVID) refers to the multi-system condition affecting individuals following COVID-19 infection. This can include speech and language therapy (SLT) needs, including voice, swallowing, communication and upper airway difficulties. There is limited published literature in this clinical area of practice, particularly for those receiving input from community SLT services.

AIMS

To describe and compare demand, typical SLT presentation and service delivery across two National Health Service (NHS) Long COVID multidisciplinary services. Independent retrospective service evaluation was completed for each service. Descriptive statistics were produced and compared across services. This service evaluation followed The Strengthening the Reporting of Observation Studies in Epidemiology guidelines for cohort studies.

OUTCOMES & RESULTS: The findings indicated similarities across the two services in SLT service need and demand, clinical presentations and intervention approaches provided within Long COVID services. There were specific differences in the service provision and delivery of intervention in cognitive communication and upper airways subspecialities.

CONCLUSIONS & IMPLICATIONS: This study highlights the clinical complexities of SLT needs in individuals with Long COVID and the importance for an appropriately skilled and supported workforce within effective multidisciplinary teams. We call for consensus on SLT practices and a consistent and standardized approach to evaluation for SLT needs in Long COVID.

WHAT THIS PAPER ADDS

What is already known on this subject SLT needs, including voice, swallowing, communication and upper airway difficulties, are present in individuals presenting with Long COVID, both in those who were or were not hospitalized. SLTs are seeing such individuals in a variety of settings, including community services and Long COVID multidisciplinary teams. There is minimal evidence of the clinical presentations and interventions provided to individuals with SLT needs compared across Long COVID services. What this study adds to existing knowledge This study compares two NHS Long COVID services providing a SLT service pathway. It highlights the similarities and differences in service demand and capacity, patient presentation, and SLT intervention to make suggestions for future practice consideration and priority evaluation. Expert consensus among SLT clinicians is a priority to ensure clinicians are delivering consistent and equitable care for patients, while new evidence and data emerge. A consistent and standardized approach to data collection and outcome measures is essential to ensure future research captures the impact and value of SLT input with individuals with Long COVID. What are the clinical implications of this work? The complexities and multifactorial SLT needs of individual with Long COVID call for appropriate SLT staffing provision, skill and training to fulfil the needs of this population. Speech and language therapists should be integrated with multidisciplinary Long COVID services to provide holistic care for patients and to support the professionals working with individuals with post-COVID voice, swallowing, communication and upper airway symptoms.

摘要

背景

新冠后综合征(也称为长期新冠)指的是新冠病毒感染后影响个体的多系统病症。这可能包括言语和语言治疗(SLT)需求,如嗓音、吞咽、沟通及上呼吸道方面的困难。该临床实践领域的已发表文献有限,尤其是针对那些接受社区言语和语言治疗服务的患者。

目的

描述并比较两家国民医疗服务体系(NHS)的长期新冠多学科服务中对言语和语言治疗的需求、典型表现及服务提供情况。对每项服务进行了独立的回顾性服务评估。生成描述性统计数据并在各项服务之间进行比较。本服务评估遵循了《加强流行病学观察性研究报告规范》中关于队列研究的指南。

结果

研究结果表明,在长期新冠服务中,两家服务机构在言语和语言治疗服务需求、临床表现及所提供的干预方法方面存在相似之处。在认知沟通和上呼吸道亚专业的干预服务提供和实施方面存在特定差异。

结论与启示

本研究突出了长期新冠患者言语和语言治疗需求的临床复杂性,以及在有效的多学科团队中拥有具备适当技能且获得支持的工作人员的重要性。我们呼吁就言语和语言治疗实践达成共识,并采用一致且标准化的方法来评估长期新冠患者的言语和语言治疗需求。

本文的新增内容

关于该主题的已知信息 长期新冠患者存在言语和语言治疗需求,包括嗓音、吞咽、沟通及上呼吸道方面的困难,无论患者是否住院。言语和语言治疗师在包括社区服务和长期新冠多学科团队在内的各种环境中为这类患者提供服务。相比不同的长期新冠服务,针对有言语和语言治疗需求患者的临床表现及所提供干预措施的证据极少。本研究对现有知识的补充 本研究比较了两家提供言语和语言治疗服务途径的国民医疗服务体系长期新冠服务机构。它突出了服务需求与能力、患者表现以及言语和语言治疗干预方面的异同,为未来的实践考量和优先评估提供建议。言语和语言治疗临床医生之间的专家共识是当务之急,以确保临床医生为患者提供一致且公平的护理,同时新的证据和数据不断涌现。采用一致且标准化的数据收集方法和结果测量方法对于确保未来研究能够捕捉言语和语言治疗对长期新冠患者的影响及价值至关重要。这项工作的临床意义是什么?长期新冠患者复杂且多因素的言语和语言治疗需求要求提供适当的言语和语言治疗人员配置、技能及培训,以满足这一人群的需求。言语和语言治疗师应融入长期新冠多学科服务中,为患者提供全面护理,并支持与有新冠后嗓音、吞咽、沟通及上呼吸道症状患者打交道的专业人员。

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