Department of Communication Sciences and Disorders, Faculty of Health and Rehabilitation Sciences, University of Cape Town, Cape Town.
S Afr J Commun Disord. 2023 Oct 10;70(1):e1-e15. doi: 10.4102/sajcd.v70i1.957.
There is a lack of prospective research in South Africa's speech therapy private sector, specifically, in the acute stroke population. There is a need to understand the quality of speech therapy services and outcomes post-stroke in the private sector.
This prospective cohort study investigated associations between speech, language, and swallowing conditions (i.e. dysarthria, apraxia of speech, aphasia, dysphagia), and outcomes post-stroke (i.e. length of hospital stay [LOS], degree of physical disability according to the Modified Rankin Scale [mRS], functional level of oral intake according to the Functional Oral Intake Scale [FOIS], dehydration, weight loss, aspiration pneumonia, mortality).
A prospective design was used to determine the incidence of speech, language, and swallowing conditions post-stroke. Convenience sampling was used to select participants (N = 68). Various statistical tests were used and the alpha level was set at Bonferroni correction p 0.01.
Co-occurring speech, language, and swallowing conditions frequently occurred post-stroke (88%). Participants who were referred to speech therapy later than 24 h post-admission (52.94%) stayed in hospital for a median of 3 days longer than those who were referred within 24 h (p = 0.042). Dysphagia was significantly associated with moderate to severe physical disability (p 0.01). Dysphagia with aspiration was significantly associated with poor functional level of oral intake, at admission and at discharge (p 0.01). At discharge, aspiration pneumonia was significantly associated with severe physical disability (p 0.01, r = 0.70).
In South Africa's private sector, co-occurring speech, language, and swallowing conditions commonly occurred post-stroke, and dysphagia was strongly associated with physical disability and poor functional level of oral intake. Length of hospital stay was increased by delayed speech therapy referrals.Contribution: This article contributes data on speech therapy services, communication and swallowing disorders post-stroke, and outcomes in South Africa's private sector.
南非的言语治疗私营部门缺乏前瞻性研究，特别是在急性中风患者中。需要了解私营部门中风后言语治疗服务的质量和结果。
本前瞻性队列研究调查了中风后言语、语言和吞咽状况（即构音障碍、言语失用症、失语症、吞咽困难）与中风后结果（即住院时间[LOS]、根据改良 Rankin 量表[mRS]评估的身体残疾程度、根据功能性口腔摄入量表[FOIS]评估的口腔摄入功能水平、脱水、体重减轻、吸入性肺炎、死亡率）之间的关联。
采用前瞻性设计确定中风后发生言语、语言和吞咽状况的发生率。采用方便抽样选择参与者（N=68）。使用了各种统计检验，alpha 水平设置为 Bonferroni 校正 p 0.01。
中风后常同时出现多种言语、语言和吞咽状况（88%）。与 24 小时内转诊的患者相比，入院后 24 小时以上转诊的患者住院时间中位数延长了 3 天（p=0.042）。吞咽困难与中度至重度身体残疾显著相关（p 0.01）。吞咽困难伴吸入与入院和出院时的口腔摄入功能水平差显著相关（p 0.01）。出院时，吸入性肺炎与严重身体残疾显著相关（p 0.01，r=0.70）。
在南非的私营部门，中风后常同时出现多种言语、语言和吞咽状况，吞咽困难与身体残疾和口腔摄入功能水平差密切相关。延迟言语治疗转诊会延长住院时间。贡献：本文提供了南非私营部门中风后言语治疗服务、沟通和吞咽障碍以及结果的数据。
