Ward Matthew G, Bowman Angela S
SA Swallowing Services, Nashville, TN, United States.
Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, TN, United States.
Front Rehabil Sci. 2025 May 9;6:1520240. doi: 10.3389/fresc.2025.1520240. eCollection 2025.
The modification of diet textures and liquid viscosity represents the primary form of management of oropharyngeal dysphagia (OD) by speech-language pathologists (SLPs). Despite the ubiquitous use of modified texture diets (MTDs) to prevent aspiration in an attempt to prevent pneumonia, there is no convincing evidence that consumption of MTDs protects individuals with dysphagia from developing pneumonia. Furthermore, informed consent is required for the prescription of MTDs. To date, no study has investigated if practicing SLPs know the risks associated with MTDs, consider the risks when making clinical decisions, and disclose those risks to their patients.
Thirteen negative health outcomes associated with MTDs were identified in the research literature. A web-based survey was created and distributed. Participants were asked to identify known risks associated with MTDs, how often they considered the risks associated with MTDs before recommending them, and how often they informed patients with OD of the known risks associated with MTDs.
Only 6.3% of the SLPs surveyed identified all thirteen listed health risks associated with MTDs, and greater than one in five respondents ( = 55; 21.7%) were unable to select even one known risk. Seventy percent ( = 140) of participants indicated that they "almost always" weigh the risks associated with drinking thickened liquids, and fifty-four percent of respondents ( = 108) specified that they "almost always" weigh the risks associated with consuming modified texture solids. Less than half of the participants ( = 99; 49.7%) stated that they "almost always" inform the patient of the risks associated with thickened liquids and 39.9% ( = 79) indicated that they "almost always" inform patients of the risks associated with altered texture solids.
Participants demonstrated poor overall knowledge of the hazards associated with MTDs, limited consideration of known risks of MTDs, and suboptimal levels of disclosure of the risks associated with MTDs to patients with OD.
调整饮食质地和液体黏稠度是言语治疗师管理口咽吞咽困难（OD）的主要方式。尽管为预防误吸进而预防肺炎而广泛使用改良质地饮食（MTD），但尚无令人信服的证据表明食用MTD能保护吞咽困难患者不患肺炎。此外，开具MTD需要获得知情同意。迄今为止，尚无研究调查执业言语治疗师是否了解与MTD相关的风险、在做出临床决策时是否考虑这些风险以及是否向患者披露这些风险。
在研究文献中确定了与MTD相关的13种负面健康结果。创建并分发了一项基于网络的调查。参与者被要求识别与MTD相关的已知风险、在推荐MTD之前他们多久会考虑与之相关的风险，以及他们多久会告知OD患者与MTD相关的已知风险。
在接受调查的言语治疗师中，只有6.3%的人识别出了与MTD相关的所有13种列出的健康风险，超过五分之一的受访者（n = 55；21.7%）甚至无法选出一种已知风险。70%（n = 140）的参与者表示他们“几乎总是”权衡饮用增稠液体相关的风险，54%的受访者（n = 108）明确表示他们“几乎总是 ”权衡食用改良质地固体食物相关的风险。不到一半的参与者（n = 99；49.7%）表示他们“几乎总是”告知患者增稠液体相关的风险，39.9%（n = 79）表示他们“几乎总是”告知患者质地改变的固体食物相关的风险。
参与者对与MTD相关的危害总体了解不足，对MTD已知风险的考虑有限，向OD患者披露与MTD相关风险的水平也不尽人意。
