Van Sickle Angela J, Bice Ed M
Department of Speech, Language, Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
IOPI Medical, LLC, Woodinville, Washington, USA.
Int J Geriatr Psychiatry. 2025 Feb;40(2):e70048. doi: 10.1002/gps.70048.
The main objective of this survey was to determine the effects of a dementia diagnosis on dysphagia management by speech-language pathologists (SLP).
A survey of SLPs interested and/or working with individuals with dysphagia was conducted via a website. The SLPs viewed two written cases of patients with dysphagia, one with dementia and one without dementia. Both cases included a video capture of the patients' swallows. SLPs answered specific questions related to each case and video.
Frequency counts, McNemar's Test, and descriptive analysis of responses showed that participants were less likely to initiate dysphagia therapy (p < 0.001) or use rehabilitative swallowing strategies (p = 0.008) for individuals with dysphagia and a dementia diagnosis than for an individual with dysphagia without a dementia diagnosis. In addition, SLPs overidentified impairments and chose treatment targets not present.
Based on the current survey, SLPs displayed a bias when the diagnosis of dementia was present. The bias appears to exist regardless of experience or education. Not initiating treatment or not providing rehabilitative strategies may have detrimental effects on the health and quality-of-life of individuals with dementia.
本次调查的主要目的是确定痴呆症诊断对言语病理学家（SLP）吞咽困难管理的影响。
通过网站对有兴趣和/或从事吞咽困难患者工作的言语病理学家进行了一项调查。言语病理学家查看了两个吞咽困难患者的书面病例，一个患有痴呆症，一个没有痴呆症。两个病例都包括患者吞咽的视频记录。言语病理学家回答了与每个病例和视频相关的特定问题。
频率计数、麦克尼马尔检验以及对回答的描述性分析表明，与没有痴呆症诊断的吞咽困难患者相比，参与者对患有痴呆症诊断的吞咽困难患者启动吞咽困难治疗（p < 0.001）或使用吞咽康复策略（p = 0.008）的可能性较小。此外，言语病理学家过度识别了损伤并选择了不存在的治疗目标。
根据目前的调查，当存在痴呆症诊断时，言语病理学家表现出偏见。无论经验或教育程度如何，这种偏见似乎都存在。不启动治疗或不提供康复策略可能会对痴呆症患者的健康和生活质量产生不利影响。
