Completing the Picture of Managing Dysphagia Diets Across Healthcare Settings: The Qualitative Data
Type of Presentation
Poster Session
Location
Virtual
Abstract
Speech-language pathologists (SLPs) play a primary role in treating dysphagia and implementing compensatory treatments intended to reduce the impact on nutritional intake and quality of life. This often involves a diet with modified consistency of solids and viscosity of fluids to provide a safer consistency that helps compensate for swallowing dysfunction. For solids, if the restrictive diet compensates for impaired swallow function, it is safer. For liquids, a more restrictive consistency can pose greater risk if thicker viscosity does not compensate for dysfunction and bolus is aspirated. Honey thick liquids have been associated with higher incidence of pneumonia, dehydration, and additional adverse effects for people with dementia. SLPs are trained to determine whether thickening liquid is appropriate for patients on a case-by-case basis. Nurses are often the first line of defense in recognizing swallowing difficulties and referring to SLPs. Although an extensive literature search produced no documentation of formal recommendation to support this practice, nurses regularly cite permission to downgrade dysphagia diets without SLP consult. The quantitative branch of our research explored medical SLPs’ experiences with nurses’ diet modification practices patterns via a descriptive survey design. Most participants (86%) reported exposure to nursing staff claiming permission to modify dysphagia diets without consulting speech pathology. As a follow-up to our cross-sectional survey findings, we further explored medical SLPs’ experiences with TMDs and nurses’ TMD practices patterns via semi-structured interviews. The thematic analysis of medical SLPs interviews helps enhance the discussion on how to support SLPs through clinical guidelines.
Completing the Picture of Managing Dysphagia Diets Across Healthcare Settings: The Qualitative Data
Virtual
Speech-language pathologists (SLPs) play a primary role in treating dysphagia and implementing compensatory treatments intended to reduce the impact on nutritional intake and quality of life. This often involves a diet with modified consistency of solids and viscosity of fluids to provide a safer consistency that helps compensate for swallowing dysfunction. For solids, if the restrictive diet compensates for impaired swallow function, it is safer. For liquids, a more restrictive consistency can pose greater risk if thicker viscosity does not compensate for dysfunction and bolus is aspirated. Honey thick liquids have been associated with higher incidence of pneumonia, dehydration, and additional adverse effects for people with dementia. SLPs are trained to determine whether thickening liquid is appropriate for patients on a case-by-case basis. Nurses are often the first line of defense in recognizing swallowing difficulties and referring to SLPs. Although an extensive literature search produced no documentation of formal recommendation to support this practice, nurses regularly cite permission to downgrade dysphagia diets without SLP consult. The quantitative branch of our research explored medical SLPs’ experiences with nurses’ diet modification practices patterns via a descriptive survey design. Most participants (86%) reported exposure to nursing staff claiming permission to modify dysphagia diets without consulting speech pathology. As a follow-up to our cross-sectional survey findings, we further explored medical SLPs’ experiences with TMDs and nurses’ TMD practices patterns via semi-structured interviews. The thematic analysis of medical SLPs interviews helps enhance the discussion on how to support SLPs through clinical guidelines.