GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Impact of Dysphagia Assessment and Management on Risk of Stroke-Associated Pneumonia: A Systematic Review
    S. Karger AG ; 2018
    In:  Cerebrovascular Diseases Vol. 46, No. 3-4 ( 2018), p. 97-105
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 46, No. 3-4 ( 2018), p. 97-105
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Patients with dysphagia are at an increased risk of stroke-associated pneumonia. There is wide variation in the way patients are screened and assessed during the acute phase. The aim of this review was to identify the methods of assessment and management in acute stroke that influence the risk of stroke-associated pneumonia. Studies of stroke patients that reported dysphagia screening, assessment or management and occurrence of pneumonia during acute phase stroke were screened for inclusion after electronic searches of multiple databases from inception to November 2016. The primary outcome was association with stroke-associated pneumonia. 〈 b 〉 〈 i 〉 Summary: 〈 /i 〉 〈 /b 〉 Twelve studies of 87,824 patients were included. The type of dysphagia screening protocol varied widely across and within studies. There was limited information on what comprised a specialist swallow assessment and alternative feeding was the only management strategy, which was reported for association with stroke-associated pneumonia. Use of a formal screening protocol and early dysphagia screening (EDS) and assessment by a speech and language pathologist (SLP) were associated with a reduced risk of stroke-associated pneumonia. There was marked heterogeneity between the included studies, which precluded meta-analysis. 〈 b 〉 〈 i 〉 Key Messages: 〈 /i 〉 〈 /b 〉 There is variation in the assessment and management of dysphagia in acute stroke. There is increasing evidence that EDS and specialist swallow assessment by an SLP may reduce the odds of stroke-associated pneumonia. There is the potential for other factors to influence the incidence of stroke-associated pneumonia during the acute phase.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000492730
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1482069-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    European Stroke Organisation and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke dysphagia
    SAGE Publications ; 2021
    In:  European Stroke Journal Vol. 6, No. 3 ( 2021-09), p. LXXXIX-CXV
    Details
    In: European Stroke Journal, SAGE Publications, Vol. 6, No. 3 ( 2021-09), p. LXXXIX-CXV
    Abstract: Post-stroke dysphagia (PSD) is present in more than 50% of acute stroke patients, increases the risk of complications, in particular aspiration pneumonia, malnutrition and dehydration, and is linked to poor outcome and mortality. The aim of this guideline is to assist all members of the multidisciplinary team in their management of patients with PSD. These guidelines were developed based on the European Stroke Organisation (ESO) standard operating procedure and followed the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. An interdisciplinary working group identified 20 relevant questions, performed systematic reviews and meta-analyses of the literature, assessed the quality of the available evidence and wrote evidence-based recommendations. Expert opinion was provided if not enough evidence was available to provide recommendations based on the GRADE approach. We found moderate quality of evidence to recommend dysphagia screening in all stroke patients to prevent post-stroke pneumonia and to early mortality and low quality of evidence to suggest dysphagia assessment in stroke patients having been identified at being at risk of PSD. We found low to moderate quality of evidence for a variety of treatment options to improve swallowing physiology and swallowing safety. These options include dietary interventions, behavioural swallowing treatment including acupuncture, nutritional interventions, oral health care, different pharmacological agents and different types of neurostimulation treatment. Some of the studied interventions also had an impact on other clinical endpoints such as feedings status or pneumonia. Overall, further randomized trials are needed to improve the quality of evidence for the treatment of PSD.
    Type of Medium: Online Resource
    ISSN: 2396-9873 , 2396-9881
    URL: Article
    DOI: 10.1177/23969873211039721
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2851287-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    A rapid review and expert identification of the Allied Health Professions’ interventions as a contribution to public health outcomes
    Elsevier BV ; 2021
    In:  Public Health in Practice Vol. 2 ( 2021-11), p. 100067-
    Details
    In: Public Health in Practice, Elsevier BV, Vol. 2 ( 2021-11), p. 100067-
    Type of Medium: Online Resource
    ISSN: 2666-5352
    URL: Article
    DOI: 10.1016/j.puhip.2020.100067
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 3041067-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Evaluating a novel approach to enhancing dysphagia management: workplace‐based, blended e‐learning
    Wiley ; 2014
    In:  Journal of Clinical Nursing Vol. 23, No. 9-10 ( 2014-05), p. 1354-1364
    Details
    In: Journal of Clinical Nursing, Wiley, Vol. 23, No. 9-10 ( 2014-05), p. 1354-1364
    Abstract: To evaluate the learning effect and resource use cost of workplace‐based, blended e‐learning about dysphagia for stroke rehabilitation nurses. Background Dysphagia is a potentially life‐threatening problem that compromises quality of life. In many countries, nurses play a crucial role in supporting the management of patients with swallowing problems, yet the literature reports a need for training. Design A single‐group, pre‐ and post‐study with mixed methods. Methods Each blended e‐learning session comprised a needs analysis, e‐learning programmes, practical skills about modifying fluids and action planning to transfer learning into practice. Participants were the population of registered nurses ( n  = 22) and healthcare assistants ( n  = 10) on a stroke rehabilitation ward in a large, teaching hospital in E ngland between A ugust 2010– M arch 2011. Data collection comprised observation (34 hours), questionnaires administered at four time points to examine change in attitude, knowledge and practice, and estimating the resource use cost for the service. Nonparametric tests and content analysis were used to analyse the data. Results All participants achieved a nationally recognised level of competence. The learning effect was evident on the post‐ and follow‐up measures, with some items of dysphagia knowledge and attitude achieving significance at the p  ≤ 0·05 level. The most common self‐reported changes in practice related to medicines management, thickening fluids and oral hygiene. The resource use cost was estimated at £2688 for 108 hours training. Conclusions Workplace‐based, blended e‐learning was an acceptable, cost effective way of delivering essential clinical knowledge and skills about dysphagia. Relevance to clinical practice Dysphagia should be viewed as a patient safety issue because of the risks of malnutrition, dehydration and aspiration pneumonia. As such, it is pertinent to many members of the interdisciplinary team. Consideration should be given to including dysphagia management in initial education and continuing professional development programmes.
    Type of Medium: Online Resource
    ISSN: 0962-1067 , 1365-2702
    URL: Issue
    URL: Article
    DOI: 10.1111/jocn.2014.23.issue-9pt10
    DOI: 10.1111/jocn.12409
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2006661-2
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    Factors Associated with Risk of Stroke-Associated Pneumonia in Patients with Dysphagia: A Systematic Review
    Springer Science and Business Media LLC ; 2020
    In:  Dysphagia Vol. 35, No. 5 ( 2020-10), p. 735-744
    Details
    In: Dysphagia, Springer Science and Business Media LLC, Vol. 35, No. 5 ( 2020-10), p. 735-744
    Abstract: Dysphagia is associated with increased risk of stroke-associated pneumonia (SAP). However, it is unclear what other factors contribute to that risk or which measures may reduce it. This systematic review aimed to provide evidence on interventions and care processes associated with SAP in patients with dysphagia. Studies were screened for inclusion if they included dysphagia only patients, dysphagia and non-dysphagia patients or unselected patients that included dysphagic patients and evaluated factors associated with a recorded frequency of SAP. Electronic databases were searched from inception to February 2017. Eligible studies were critically appraised. Heterogeneity was evaluated using I 2 . The primary outcome was SAP. Eleven studies were included. Sample sizes ranged from 60 to 1088 patients. There was heterogeneity in study design. Measures of immunodepression are associated with SAP in dysphagic patients. There is insufficient evidence to justify screening for aerobic Gram-negative bacteria. Prophylactic antibiotics did not prevent SAP and proton pump inhibitors may increase risk. Treatment with metoclopramide may reduce SAP risk. Evidence that nasogastric tube (NGT) placement increases risk of SAP is equivocal. A multidisciplinary team approach and instrumental assessment of swallowing may reduce risk of pneumonia. Patients with impaired mobility were associated with increased risk. Findings should be interpreted with caution given the number of studies, heterogeneity and descriptive analyses. Several medical interventions and care processes, which may reduce risk of SAP in patients with dysphagia, have been identified. Further research is needed to evaluate the role of these interventions and care processes in clinical practice.
    Type of Medium: Online Resource
    ISSN: 0179-051X , 1432-0460
    URL: Article
    DOI: 10.1007/s00455-019-10061-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 1459017-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Neuromuscular Electrical Stimulation Plus Rehabilitative Exercise as a Treatment for Dysphagia in Stroke and Non-Stroke Patients in an NHS Setting: Feasibility and Outcomes
    MDPI AG ; 2019
    In:  Geriatrics Vol. 4, No. 4 ( 2019-09-24), p. 53-
    Details
    In: Geriatrics, MDPI AG, Vol. 4, No. 4 ( 2019-09-24), p. 53-
    Abstract: Dysphagia is a debilitating condition with significant consequences in terms of physical and mental health. This study demonstrates that it is feasible to provide an intensive therapy program combining neuromuscular electrical stimulation (NMES) with exercise against resistance in the treatment of dysphagia in a public healthcare setting. Thirty-one patients (17 stroke, 14 non-stroke) who experienced dysphagia with reduced laryngeal elevation completed the therapy program. After checking the data sets for comparability, it was deemed appropriate for the outcome data from these patients to be combined with that of 12 stroke patients previously reported to enable statistical analysis on a larger data set (n = 43). A repeated-measures ANOVA revealed a statistically significant increase in amount and variety of food a patient was able to take orally (FOIS) following completion of treatment (p 〈 0.001). There was no significant between-subject effect of stroke status (p = 0.43), or interaction between treatment and stroke status (p = 0.68). There was a significant improvement in secondary outcome measures of swallow safety with fluids (PAS) (p 〈 0.001) and swallow-related quality of life (Swal-Qol (p 〈 0.001). These findings indicate that the therapy program may be associated with reduced impairment in a subset of patients with dysphagia resulting from stroke and non-stroke atiologies, and the data will inform the design of future research to address unanswered questions.
    Type of Medium: Online Resource
    ISSN: 2308-3417
    URL: Article
    DOI: 10.3390/geriatrics4040053
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2934571-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    Variation in Dysphagia Assessment and Management in Acute Stroke: An Interview Study
    MDPI AG ; 2019
    In:  Geriatrics Vol. 4, No. 4 ( 2019-10-25), p. 60-
    Details
    In: Geriatrics, MDPI AG, Vol. 4, No. 4 ( 2019-10-25), p. 60-
    Abstract: (1) Background: Patients with dysphagia are at increased risk of stroke-associated pneumonia. There is wide variation in the way patients are screened and assessed. The aim of this study is to explore staff opinions about current practice of dysphagia screening, assessment and clinical management in acute phase stroke. (2) Methods: Fifteen interviews were conducted in five English National Health Service hospitals. Hospitals were selected based on size and performance against national targets for dysphagia screening and assessment, and prevalence of stroke-associated pneumonia. Participants were purposefully recruited to reflect a range of healthcare professions. Data were analysed using a six-stage thematic process. (3) Results: Three meta themes were identified: delays in care, lack of standardisation and variability in resources. Patient, staff, and service factors that contribute to delays in dysphagia screening, assessment by a speech and language therapist, and delays in nasogastric tube feeding were identified. These included admission route, perceived lack of ownership for screening patients, prioritisation of assessments and staff resources. There was a lack of standardisation of dysphagia screening protocols and oral care. There was variability in staff competences and resources to assess patients, types of medical interventions, and care processes. (4) Conclusion: There is a lack of standardisation in the way patients are assessed for dysphagia and variation in practice relating to staff competences, resources and care processes between hospitals. A range of patient, staff and service factors have the potential to impact on stroke patients being assessed within the recommended national guidelines.
    Type of Medium: Online Resource
    ISSN: 2308-3417
    URL: Article
    DOI: 10.3390/geriatrics4040060
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2934571-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 8
    Online Resource
    Online Resource
    Are Differences in Dysphagia Assessment, Oral Care Provision, or Nasogastric Tube Insertion Associated with Stroke-Associated Pneumonia? A Nationwide Survey Linked to National Stroke Registry Data
    S. Karger AG ; 2022
    In:  Cerebrovascular Diseases Vol. 51, No. 3 ( 2022), p. 365-372
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 51, No. 3 ( 2022), p. 365-372
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Stroke-associated pneumonia (SAP) is a common complication associated with poor outcomes. Early dysphagia screening and specialist assessment is associated with a reduced risk of SAP. Evidence about oral care and nasogastric tube (NGT) placement is equivocal. This study aimed to expose variations in dysphagia management practices and explore their associations with SAP. 〈 b 〉 〈 i 〉 Participants and Methods: 〈 /i 〉 〈 /b 〉 Speech pathologists from 166 stroke units in England and Wales were surveyed about dysphagia assessment and management, oral care, and NGT placement. Survey data were then linked to the Sentinel Stroke National Audit Programme (SSNAP), the national register of stroke. Univariable and multivariable linear regression models were fitted to estimate the association between dysphagia management practices and SAP incidence. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 113 hospitals completed the survey (68%). Variation was evident in dysphagia screening protocols (DSPs), oral care, and NGT practice while specialist swallow assessment data patterns were more consistent. Multivariable analysis showed no evidence of an association in incidence of SAP when using a water-only hospital DSP compared to a multiconsistency DSP (B −0.688, 95% CI: −2.912 to 1.536), when using written swallow assessment guidelines compared to not using written guidelines (B 0.671, 95% CI: −1.567 to 2.908), when teams inserted NGTs overnight compared to teams which did not (B −0.505, 95% CI: −2.759 to 1.749), and when teams had a written oral care protocol compared to those which did not (B −1.339, 95% CI: −3.551 to 0.873). 〈 b 〉 〈 i 〉 Discussion and Conclusion: 〈 /i 〉 〈 /b 〉 Variation exists in dysphagia screening and management, but there was no evidence of an association between clinical practice patterns and incidence of SAP. Further research with larger sample sizes is needed to examine association with SAP.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000519903
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1482069-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 9
    Online Resource
    Online Resource
    Management of swallowing problems in community settings
    Mark Allen Group ; 2019
    In:  British Journal of Community Nursing Vol. 24, No. 7 ( 2019-07-02), p. 323-327
    Details
    In: British Journal of Community Nursing, Mark Allen Group, Vol. 24, No. 7 ( 2019-07-02), p. 323-327
    Abstract: There is an increase in the demand for community services to provide care closer to home, and care teams are placing a growing emphasis on admission avoidance and early discharge. Community and district nurses are key professionals in this care delivery and are required to be alert to the risk factors for clinical deterioration, such as dysphagia (swallowing problems). Especially in older adults and those with frailty, dysphagia can cause a wide range of problems, from dehydration and malnutrition to respiratory tract infections that warrant antibiotic use and even hospitalisation. This article describes how dysphagia can be identified and managed in the community setting and explains the benefits and impact of speech and language therapy and wider multidisciplinary team intervention.
    Type of Medium: Online Resource
    ISSN: 1462-4753 , 2052-2215
    URL: Article
    DOI: 10.12968/bjcn.2019.24.7.323
    Language: English
    Publisher: Mark Allen Group
    Publication Date: 2019
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 10
    Online Resource
    Online Resource
    Use of thickening agents and nutritional supplements for patients with dysphagia following stroke
    Mark Allen Group ; 2017
    In:  British Journal of Neuroscience Nursing Vol. 13, No. 6 ( 2017-12-02), p. 260-268
    Details
    In: British Journal of Neuroscience Nursing, Mark Allen Group, Vol. 13, No. 6 ( 2017-12-02), p. 260-268
    Abstract: Swallowing difficulties (dysphagia) commonly occur after stroke and are associated with poor patient outcomes. Management of dysphagia often involves thickening fluids and modifications to the consistencies of food for the individual. This paper describes how thickening agents and supplements can be used effectively to address issues with swallowing safety and to ensure hydration and nutritional requirements are achieved for an individual with stroke-related dysphagia. In order to maximise quality of life for the individual and to maximise adherence to recommendations, modifications should be as unrestrictive as possible without reducing safety.
    Type of Medium: Online Resource
    ISSN: 1747-0307 , 2052-2800
    URL: Article
    DOI: 10.12968/bjnn.2017.13.6.260
    Language: English
    Publisher: Mark Allen Group
    Publication Date: 2017
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...