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Sherly K, Divya S. Development of Symptom Specific Dysphagia Quality of Life Questionnaire in Tamil. Indian J Gastroenterol 2024:10.1007/s12664-024-01662-7. [PMID: 39259451 DOI: 10.1007/s12664-024-01662-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 07/29/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Swallowing intricately involves sensorimotor systems, pivotal for integrating upper digestive and respiratory functions. Dysphagia, challenging swallowing, often precipitates anxiety and depression, deeply affecting the quality of life (QOL). Understanding patient-centric symptoms is vital for assessing dysphagia's QOL impact. AIM This study aimed at developing and validating the Symptom Specific Dysphagia Quality of Life Questionnaire in Tamil (SSDQOL-T). METHOD SSDQOL-T was developed in Tamil and underwent rigorous content validation. This questionnaire was administered to 120 normal individuals and 32 dysphagia patients, assessing various swallowing difficulties and their QOL impact. RESULTS Results indicate SSDQOL-T's good internal consistency (Cronbach's α = 0.78). Significant differences in swallowing ability and QOL were noted across age groups, with older adults experiencing heightened symptoms. A high significance in mean score was obtained between healthy adults and dysphagia across all sub-domains with a 'p-value' of 0.0005. Symptoms that were found to have high significance were cough/gag reflex, regurgitation, odynophagia, globus sensation, heartburn and tiredness when compared between mechanical and degenerative dysphagia group. Strong correlations were found between SSDQOL-T scores and the Dysphagia Handicap Index in Tamil (r = 0.89). CONCLUSION The SSDQOL-T questionnaire provides a robust tool for evaluating dysphagia-related QOL in the Tamil-speaking population. Its validation underscores its clinical relevance and utility for understanding the multidimensional impact of dysphagia. This study emphasizes the importance of culturally sensitive assessment tools in comprehensively evaluating dysphagia's QOL implications.
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Affiliation(s)
- K Sherly
- Kovai Medical Centre and Hospital, Coimbatore, 641 014, India
| | - S Divya
- Department of Audiology and Speech Language Pathology, SRM Medical College Hospital and Research Centre, SRMIST, Kattankulathur, 603 203, India.
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Orr E, Perera R, Sayner A, Thompson A, Pang M, Entesari-Tatafi D, Dalgleish G, Nguyen L, Cliffe L, McDonald I, Than K, Keage M, Clapham RP. Impacts of a Dysphagia Screening Questionnaire on Speech Pathology Input Using a Transdisciplinary Approach for Patients with Chronic Obstructive Pulmonary Disease in a Pulmonary Rehabilitation Program. Dysphagia 2024:10.1007/s00455-024-10713-2. [PMID: 38951236 DOI: 10.1007/s00455-024-10713-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/19/2024] [Indexed: 07/03/2024]
Abstract
Patients with chronic obstructive pulmonary disease (COPD) in pulmonary rehabilitation programs (PRPs) are not routinely screened for dysphagia. An Australian regional health service audit revealed that patients with COPD are frequently referred to speech pathology during acute admissions, rather than proactively to mitigate the risk of dysphagia-related consequences. Referral patterns to speech pathology using a novel transdisciplinary approach for identifying at risk for dysphagia patients in a PRP were explored. The aim of this study was to investigate the impact of a transdisciplinary dysphagia screening questionnaire on speech pathology referrals within a cohort of patients with COPD enrolled in a PRP. This quasi-experimental study introduced a dysphagia screening questionnaire in a PRP using a transdisciplinary approach. A retrospective audit of PRP patients (n = 563) between 01/01/2014 and 31/12/2018 was conducted to identify the frequency of referrals to speech pathology for dysphagia. Data was compared to a cohort of patients (n = 50) enrolled in the PRP (from 01/02/21 to 30/11/21) after introduction of the questionnaire using Fisher's exact test. Less than 1% (n = 4/563) of PRP patients were referred to speech pathology prior to implementation of the questionnaire. Following the implementation, referrals to speech pathology significantly increased to 16% (8/50) (X2 = 7.72, P < 0.05; odds ratio = 7.89 95% CI [1.94, 32.1]). Introducing a dysphagia screening questionnaire increased referrals to speech pathology from a PRP. This study demonstrated the potential for a transdisciplinary approach in early screening for patients at risk of dysphagia for patients with COPD. Further research is encouraged to explore patient motivation towards speech pathology input with COPD-related dysphagia and clinicians' perceived self-efficacy in using the questionnaire.
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Affiliation(s)
- Ellie Orr
- Speech Pathology Department, Grampians Health-Ballarat, 1 Drummond St., Ballarat, VIC, 3350, Australia.
| | - Rishni Perera
- Speech Pathology Department, Austin Health, Studley Road, Heidelberg, Melbourne, VIC, 3084, Australia
| | - Alesha Sayner
- Primary and Community Care, Grampians Health-Ballarat, 1 Drummond St., Ballarat, VIC, 3350, Australia
- Deakin Rural Health, Warrnambool, VIC, Australia
| | - Acushla Thompson
- Speech Pathology Department, Grampians Health-Ballarat, 1 Drummond St., Ballarat, VIC, 3350, Australia
| | - Michael Pang
- Physiotherapy Department, Grampians Health-Ballarat, 1 Drummond St., Ballarat, VIC, 3350, Australia
| | - Damoon Entesari-Tatafi
- Specialist Outpatient Clinics, Grampians Health-Ballarat, 1 Drummond St., Ballarat, VIC, 3350, Australia
| | - Gerard Dalgleish
- Specialist Outpatient Clinics, Grampians Health-Ballarat, 1 Drummond St., Ballarat, VIC, 3350, Australia
| | - Lisa Nguyen
- Audiology and Speech Pathology, Melbourne University, 550 Swanston St., Melbourne, VIC, 3000, Australia
| | - Lucy Cliffe
- Audiology and Speech Pathology, Melbourne University, 550 Swanston St., Melbourne, VIC, 3000, Australia
| | - Isobel McDonald
- Audiology and Speech Pathology, Melbourne University, 550 Swanston St., Melbourne, VIC, 3000, Australia
| | - Kylie Than
- Audiology and Speech Pathology, Melbourne University, 550 Swanston St., Melbourne, VIC, 3000, Australia
| | - Megan Keage
- Audiology and Speech Pathology, Melbourne University, 550 Swanston St., Melbourne, VIC, 3000, Australia
| | - Renee P Clapham
- Speech Pathology Department, St. Vincent's Health, 41 Victory Parade, Fitzroy, VIC, 3065, Australia
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Nagshabandi BS, Zinnershine L, Shune SE. A Review of Factors Contributing to Adults' Adherence to Dysphagia Dietary Recommendations Through an Ecological Lens. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:341-357. [PMID: 36450148 DOI: 10.1044/2022_ajslp-21-00351] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE The purpose of this review was to identify the factors affecting adherence to dysphagia dietary recommendations, a necessary contributor to the effectiveness of this compensatory strategy. METHOD A rapid review of two electronic databases was conducted in April 2021. Studies were included based on the following criteria: (a) were empirical studies published in English, (b) included data from the adult population, and (c) measured adherence to dietary recommendations. The ecological model and the health belief model were used as frameworks during the analysis process. RESULTS The literature search resulted in 930 unique abstracts, of which 14 articles were included based on the final criteria. Across the literature, multiple factors were identified as having an influence on adherence, classified according to three unique levels: the individual (e.g., dissatisfaction), the caregiver (e.g., knowledge), and the environment (e.g., institutional policies and values). CONCLUSIONS Improving adherence to dysphagia dietary recommendations is crucial for the effectiveness of those recommendations. As suggested by the current review, increased adherence will require careful attention to the multiple levels of factors that likely play a role, acknowledging the multifaceted nature of this complex behavior. Furthermore, characterizing the multilevel factors that influence adherence can contribute to future theoretical models, which could help guide speech-language pathologists in their clinical practices.
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Affiliation(s)
| | - Lauren Zinnershine
- Communication Disorders and Sciences Program, University of Oregon, Eugene
| | - Samantha E Shune
- Communication Disorders and Sciences Program, University of Oregon, Eugene
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4
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Waters AM, Patterson J, Bhat P, Phillips AW. Investigating dysphagia in adults: symptoms and tests. BMJ 2022; 379:e067347. [PMID: 36252961 DOI: 10.1136/bmj-2021-067347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- A M Waters
- Department of Otolaryngology, Freeman Hospital, Newcastle upon Tyne, UK
| | - J Patterson
- School of Health Sciences, Institute of Population Heath, University of Liverpool, UK
| | | | - A W Phillips
- Northern Oesophagogastric Unit, Royal Victoria Infirmary, Newcastle upon Tyne, UK
- School of Medical Education, Newcastle University, Newcastle upon Tyne, UK
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Lu HY, Zhang R, Chang Y, Zhang XN, Zhao J, Li XD, Feng XK. A structural equation model-based study on the status and influencing factors of acute exacerbation readmission of elderly patients with chronic obstructive pulmonary disease within 30 days. BMC Pulm Med 2022; 22:299. [PMID: 35927662 PMCID: PMC9354368 DOI: 10.1186/s12890-022-02093-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
Objective To investigate the circumstances that lead to acute exacerbation readmission of elderly patients with chronic obstructive pulmonary disease (COPD) within 30 days and to explore the influencing factors of readmission using a structural equation model to provide evidence for medical staff so that effective intervention measures can be taken. Methods The convenience sampling method was used to select 1120 elderly patients with COPD from the respiratory departments of thirteen general hospitals in the Ningxia region, China, from April 2019 to August 2020, who then completed a survey questionnaire. The survey questionnaire contained a general data questionnaire and the modified Medical Research Council, activities of daily living, geriatric depression scale and COPD assessment test scales. Results The readmission rate of patients with COPD presenting with acute exacerbation within 30 days was determined to be 21.52%. Therefore, the modified model measures data accurately. The results showed that seasonal factors, family rehabilitation, age factors and overall health status were direct factors in the acute exacerbation readmission of patients with COPD within 30 days of hospital discharge. Smoking is not only a direct factor for acute exacerbation readmission within 30 days but also an indirect factor through disease status; disease status and chronic disease are not only direct factors for acute exacerbation readmission within 30 days but also indirect factors through the patient’s overall health status. Conclusions The rate of patients with COPD presenting with acute exacerbation within 30 days is high; while taking measures to prevent readmission based on influencing factors that directly impact admission rates, attention should also be paid to the interaction between these factors.
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Affiliation(s)
- Hong-Yan Lu
- Department of Nursing, The General Hospital of Ningxia Medical University, No. 804 Shengli Street, Xingqing District, Yinchuan, 750004, China.
| | - Rui Zhang
- Department of Nursing, The General Hospital of Ningxia Medical University, No. 804 Shengli Street, Xingqing District, Yinchuan, 750004, China.
| | - Yan Chang
- Department of Nursing, The General Hospital of Ningxia Medical University, No. 804 Shengli Street, Xingqing District, Yinchuan, 750004, China
| | - Xiao-Na Zhang
- Department of Nursing, The General Hospital of Ningxia Medical University, No. 804 Shengli Street, Xingqing District, Yinchuan, 750004, China
| | - Jie Zhao
- Department of Nursing, The General Hospital of Ningxia Medical University, No. 804 Shengli Street, Xingqing District, Yinchuan, 750004, China
| | - Xin-Dan Li
- Department of Nursing, The General Hospital of Ningxia Medical University, No. 804 Shengli Street, Xingqing District, Yinchuan, 750004, China
| | - Xiang-Kai Feng
- Department of Nursing, XiangYang First People's Hospital, XiangYang, 441002, China
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6
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Ghaddar Z, Matar N, Noujaim J, Diep AN, Tohmé A, Pétré B. Consensus on the Objectives of an Educational Intervention for Patients with Oropharyngeal Dysphagia and Their Informal Caregivers: A Delphi Study. Patient Prefer Adherence 2022; 16:1511-1524. [PMID: 35769338 PMCID: PMC9236548 DOI: 10.2147/ppa.s364520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/27/2022] [Indexed: 11/29/2022] Open
Abstract
Purpose In the absence of literature allowing for an evidence-based approach to therapeutic patient education (TPE) in Oropharyngeal Dysphagia (OD), this study aims to reach a consensus of experts on the content of a competency framework of an educational program for OD patients and their informal caregivers (ICGs). Methods We used the Delphi consensus-building method. Four categories of experts were recruited: 12 patients, 17 ICGs, 46 healthcare professionals (HCP) (experienced in OD, not necessarily certified in TPE), and 19 experts in TPE (trained individuals to set up and run TPE programs not necessarily HCPs). The content of the questionnaire of the first round (R) was established according to the result of a scoping review and the opinion of an expert committee. We carried out three rounds. In R1 and R2, we collected the opinions on the relevance (7-point Likert-type scale) and on comprehensiveness (YES/No question and asking participants to propose additional content). Participants were also invited to leave comments on each objective. In R3, we asked the participants to give their opinion about the relevance of the objectives again and asked them to rank the themes from highest to lowest priority. Results Objectives were considered relevant for all participants if they reached consensus when the interquartile (IQR) ≤ 1, and if the median indicated agreement (Mdn ≥ 6) (6= appropriate, 7 = totally appropriate). Following three rounds, the final content of the educational program is composed of 23 educational objectives organized in 13 themes with an agreement about relevance amongst all participants (Mdn ≥ 6; IQR ≤ 1). The comprehensiveness criterion received also a consensus (IQR ≤ 1). The participants ranked the theme "normal swallowing vs difficulty swallowing" as the highest priority. Conclusion This Delphi study resulted in a consensus, on the content of a competency framework of an educational program for OD patients and their ICGs. Further steps are needed to construct learning activities based on these objectives before testing their feasibility and efficacy.
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Affiliation(s)
- Zahya Ghaddar
- Department of Public Health, University of Liège, Liege, Belgium
- Doctoral School of Sciences and Health, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
- Department of Higher Institute of Speech and Language Therapy, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Nayla Matar
- Department of Higher Institute of Speech and Language Therapy, Saint Joseph University of Beirut, Beirut, Lebanon
- Department of Otolaryngology-Head and Neck Surgery, University Hospital Center Hotel-Dieu de France, Affiliated to Saint-Joseph University, Beirut, Lebanon
| | - Joyce Noujaim
- Department of Higher Institute of Speech and Language Therapy, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Anh Nguyet Diep
- Department of Public Health, University of Liège, Liege, Belgium
| | - Aline Tohmé
- Department of Internal Medicine and Clinical Immunology, University Hospital Center Hotel-Dieu de France, Affiliated to Saint-Joseph University, Beirut, Lebanon
| | - Benoit Pétré
- Department of Public Health, University of Liège, Liege, Belgium
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Drulia T, Hodge A. Clinical Practice Patterns of Speech-Language Pathologists Delivering Dysphagia Services to Persons with COPD: Analysis of Survey Outcomes. Semin Speech Lang 2021; 42:363-383. [PMID: 34729725 DOI: 10.1055/s-0041-1735846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Swallowing impairments co-occur with chronic obstructive pulmonary disease (COPD) leading to aspiration, disease exacerbations, and malnutrition. This pilot survey study aimed to identify current clinical practice patterns for swallowing evaluation and treatment in persons with COPD. A 35-question Qualtrics survey was deployed to medical speech-language pathology (SLP) social media sites and professional boards; flyers were distributed at a professional conference. Forty-eight SLPs completed the study. SLPs routinely include a clinical swallow examination (96%), videofluoroscopic swallowing study (79%), adjunctive respiratory measures (respiratory rate [83%], and pulse oximetry [67%], respiratory-swallow pattern [77%]) but less frequently include fiberoptic endoscopic evaluation of swallowing (23%). Self-reported advanced clinical experience and expert respiratory analysis skills were associated with adjunctive respiratory measure (respiratory rate, pulse oximetry) inclusion during assessment. Compensatory strategy training (77%) is a preferred treatment for dysphagia in COPD; however, respiratory-swallow pattern training and expiratory muscle strength training are increasing in use. SLPs self-report a comprehensive, individualized patient-centered care approach with inclusion of adjunctive respiratory-focused methods in dysphagia evaluation and treatment practice in persons with COPD. Advances in the identification of the integral role of respiratory function in swallowing integrity may be translating to clinical practice methods for dysphagia management in persons with COPD.
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Affiliation(s)
- Teresa Drulia
- Davies School of Communication Sciences and Disorders, Texas Christian University, Harris College of Nursing and Health Sciences, Fort Worth, Texas
| | - Alexis Hodge
- Davies School of Communication Sciences and Disorders, Texas Christian University, Harris College of Nursing and Health Sciences, Fort Worth, Texas.,Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin
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8
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Drulia TC, Kamarunas E, O'Donoghue C, Ludlow CL. An Exploration of Lung Volume Effects on Swallowing in Chronic Obstructive Pulmonary Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2155-2168. [PMID: 34411488 DOI: 10.1044/2021_ajslp-20-00389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) limits respiration, which may negatively impact airway safety during swallowing. It is unknown how differences in lung volume in COPD may alter swallowing physiology. This exploratory study aimed to determine how changes in lung volume impact swallow duration and coordination in persons with stable state COPD compared with older healthy volunteers (OHVs). Method Volunteers ≥ 45 years with COPD (VwCOPDs; n = 9) and OHVs (n = 10) were prospectively recruited. Group and within-participant differences were examined when swallowing at different respiratory volumes: resting expiratory level (REL), tidal volume (TV), and total lung capacity (TLC). Participants swallowed self-administered 20-ml water boluses by medicine cup. Noncued (NC) water swallows were followed by randomly ordered block swallowing trials at three lung volumes. Estimated lung volume (ELV) and respiratory-swallow patterning were quantified using spirometry and respiratory inductive plethysmography. Manometry measured pharyngeal swallow duration from onset of base of tongue pressure increase to offset of negative pressure in the pharyngoesophageal segment. Results During NC swallows, the VwCOPDs swallowed at lower lung volumes than OHVs (p = .011) and VwCOPDs tended to inspire after swallows more often than OHVs. Pharyngeal swallow duration did not differ between groups; however, swallow duration significantly decreased as the ELV increased in VwCOPDs (p = .003). During ELV manipulation, the COPD group inspired after swallowing more frequently at REL than at TLC (p = .001) and at TV (p = .002). In conclusion, increasing respiratory lung volume in COPD should improve safety by reducing the frequency of inspiration after a swallow.
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Affiliation(s)
- Teresa C Drulia
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
- Davies School of Communication Sciences and Disorders, Texas Christian University, Fort Worth
| | - Erin Kamarunas
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
| | - Cynthia O'Donoghue
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
| | - Christy L Ludlow
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
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Siddiq MAB, Rathore FA, Clegg D, Rasker JJ. Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic. Turk J Phys Med Rehabil 2020; 66:480-494. [PMID: 33364571 PMCID: PMC7756838 DOI: 10.5606/tftrd.2020.6889] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/31/2020] [Indexed: 02/06/2023] Open
Abstract
The novel coronavirus-2019 (COVID-19) pandemic primarily affects the respiratory system. Elderly individuals with comorbidity are severely affected. Survivors weaned from mechanical ventilation are at a higher risk of developing post-intensive care syndrome (PICS). This scoping review, based on 40 recent publications, highlights pulmonary rehabilitation (PR) in COVID-19. There is a paucity of high-quality research on this topic. However, rehabilitation societies including the Turkish Society of Physical Medicine and Rehabilitation have issued PR recommendations in COVID-19 pneumonia with productive cough can benefit from diaphragmatic breathing, pursed-lip breathing, and resistance-breathing training. Besides, those in mechanical ventilation and post-PICS COVID-19 cases, oxygen therapy, early mobilization, airway clearance, aerobic exercise, gradual-graded limb muscle resistance exercise, nutritional and psychological interventions should be consideration. During PR, careful evaluation of vital signs and exercise-induced symptoms is also required. When in-person PR is not possible, telerehabilitation should be explored. However, the long-term effects of PR in COVID-19 need further evaluation.
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Affiliation(s)
- Md Abu Bakar Siddiq
- Department of Physical Medicine and Rehabilitation, Brahmanbaria Medical College, Brahmanbaria, Bangladesh
- School of Health Sports and Professional Practice, University of South Wales, Pontypridd, United Kingdom
| | - Farooq Azam Rathore
- Department of Rehabilitation Medicine, PNS Shifa Hospital, Karachi, Pakistan
| | - Danny Clegg
- School of Health and Social Care, London South Bank University, London, United Kingdom
| | - Johannes J. Rasker
- Department of Psychology, Health and Technology, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, the Netherlands
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10
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Yoshimatsu Y, Tobino K, Nagami S, Yagi N, Oku Y. Breathing-Swallowing Discoordination and Inefficiency of an Airway Protective Mechanism Puts Patients at Risk of COPD Exacerbation. Int J Chron Obstruct Pulmon Dis 2020; 15:1689-1696. [PMID: 32764914 PMCID: PMC7381778 DOI: 10.2147/copd.s257622] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/02/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Dysphagia is a newly acknowledged multifactorial risk factor for the exacerbation of chronic obstructive pulmonary disease (COPD). Effective screening methods are awaited. We performed a prospective study to evaluate the impact of musculature and breathing-swallowing discoordination on the exacerbation of COPD with a novel swallowing monitor using a piezoelectric sensor. Patients and Methods This was the second part of a prospective study of patients with COPD from the Iizuka COPD cohort. Seventy patients with stable COPD underwent dysphagia screening, skeletal muscle mass index (SMI) and tongue pressure measurements, and swallowed 3 mL and 30 mL of water while wearing a swallowing monitor. Patients were followed for one year. Results During the follow-up period, 28 patients experienced exacerbations (E group), and 42 had none (non-E group). There was no significant difference in tongue pressure measurements between the two groups. The SMI in the E group was significantly lower than that in the non-E group. Among the swallowing monitor measurements, the 3 mL I-SW% (the percentage of swallows in which inspiration preceded the swallow [out of ten 3 mL swallows]) was significantly lower in the E group than in the non-E group. Conclusion Breathing-swallowing coordination is an independent factor related to the exacerbation of COPD. Not only the presence of discoordination but also the inability to produce an airway protection mechanism may contribute to more frequent aspiration and exacerbations.
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Affiliation(s)
- Yuki Yoshimatsu
- Department of Respiratory Medicine, Iizuka Hospital, Iizuka, Fukuoka, Japan.,Department of Physiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Kazunori Tobino
- Department of Respiratory Medicine, Iizuka Hospital, Iizuka, Fukuoka, Japan.,Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shinsuke Nagami
- Department of Speech Language Pathology and Audiology, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
| | - Naomi Yagi
- Department of Physiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.,Department of Neurology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Department of Medical Engineering, Himeji Dokkyo University, Himeji, Hyogo, Japan
| | - Yoshitaka Oku
- Department of Physiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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11
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Yoshimatsu Y, Tobino K, Sueyasu T, Nishizawa S, Ko Y, Yasuda M, Ide H, Tsuruno K, Miyajima H. Repetitive Saliva Swallowing Test Predicts COPD Exacerbation. Int J Chron Obstruct Pulmon Dis 2019; 14:2777-2785. [PMID: 31824143 PMCID: PMC6900275 DOI: 10.2147/copd.s226268] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/11/2019] [Indexed: 12/12/2022] Open
Abstract
Introduction Predicting phenotypes at risk of chronic obstructive pulmonary disease (COPD) exacerbation is extremely important. Dysphagia is becoming recognized as one of these phenotypes. A convenient method of screening for dysphagia and COPD exacerbation risk is desired. The repetitive saliva swallowing test (RSST) is one of the least invasive dysphagia screening methods. We previously reported the possible relation between the RSST result and COPD exacerbation in a retrospective study. Based on this, we performed a prospective study to evaluate the efficacy of RSST as a predictor of COPD exacerbation and to determine its optimal cut-off value for COPD. Methods Seventy patients with COPD were recruited. Patients underwent the following dysphagia screening tests: the 10-item Eating Assessment Tool, Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease, RSST, water swallowing test, and simple swallow provocation test. After one year, they were classified into two groups according to the presence of COPD exacerbation during the follow-up period. Results Twenty-seven patients had one or more exacerbations in the past year. During the follow-up period, 28 patients had one or more exacerbations (E group), and 42 had none (non-E group). There were no significant differences between the groups except for the presence of past exacerbations and the results of the RSST, when the cut-off value was set at 2, 3, 4, or 5 swallows. The number of swallows in the RSST was significantly lower in the E group than in the Non-E group. A cut-off value of 5 was the most effective. The time to first exacerbation was significantly longer in those with an RSST value of >5. The RSST was more reliable for differentiating the E group and non-E group than the presence of exacerbation in the past year (hazard ratios: 13.78 and 2.70, respectively). Conclusion An RSST cut-off value of 5 may be a strong predictor of COPD exacerbation.
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Affiliation(s)
- Yuki Yoshimatsu
- Department of Respiratory Medicine, Iizuka Hospital, Fukuoka 820-8505, Japan
| | - Kazunori Tobino
- Department of Respiratory Medicine, Iizuka Hospital, Fukuoka 820-8505, Japan.,Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8431, Japan
| | - Takuto Sueyasu
- Department of Respiratory Medicine, Iizuka Hospital, Fukuoka 820-8505, Japan
| | - Saori Nishizawa
- Department of Respiratory Medicine, Iizuka Hospital, Fukuoka 820-8505, Japan
| | - Yuki Ko
- Department of Respiratory Medicine, Iizuka Hospital, Fukuoka 820-8505, Japan
| | - Mina Yasuda
- Department of Respiratory Medicine, Iizuka Hospital, Fukuoka 820-8505, Japan
| | - Hiromi Ide
- Department of Respiratory Medicine, Iizuka Hospital, Fukuoka 820-8505, Japan
| | - Kosuke Tsuruno
- Department of Respiratory Medicine, Iizuka Hospital, Fukuoka 820-8505, Japan
| | - Hiroyuki Miyajima
- Department of Respiratory Medicine, Iizuka Hospital, Fukuoka 820-8505, Japan
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12
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Cvejic L, Bardin PG. Swallow and Aspiration in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2019; 198:1122-1129. [PMID: 29939762 DOI: 10.1164/rccm.201804-0704pp] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Lydia Cvejic
- Monash Lung & Sleep, Monash Hospital and University and Hudson Institute, Melbourne, Victoria, Australia
| | - Philip G Bardin
- Monash Lung & Sleep, Monash Hospital and University and Hudson Institute, Melbourne, Victoria, Australia
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Simonÿ C, Riber C, Bodtger U, Birkelund R. Striving for Confidence and Satisfaction in Everyday Life with Chronic Obstructive Pulmonary Disease: Rationale and Content of the Tele-Rehabilitation Programme >C☺PD-Life>>. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183320. [PMID: 31505861 PMCID: PMC6766220 DOI: 10.3390/ijerph16183320] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 12/31/2022]
Abstract
Background: More feasible rehabilitation programmes for patients with chronic obstructive pulmonary disease (COPD) are warranted. Even so, still in its infancy, telerehabilitation to COPD patients reveals promising results, wherefore it is anticipated to contribute significant value to the current challenges of rehabilitation to these patients. To expand useful knowledge in the field, more sophisticated telerehabilitation interventions must be developed and appraised, but first and foremost, thoroughly described. Aims and methods: The aim of this article is to give a detailed description of the rationale and content of the >C☺PD-Life>> programme, within the bounds of the checklist of Template for Intervention Description and Replication (TIDieR). Approach:>C☺PD-Life>> is a telerehabilitation programme for COPD patients delivered as a study intervention by an interprofessional team of clinicians collaborating from both the hospital and the municipal healthcare system. Making use of two-way audio and visual communication software, 15 patients participated in the intervention via a tablet computer from their private setting. The programme was a six-month-long empowerment-based rehabilitation that aimed to support COPD patients in leading a satisfactory and confident life with appropriate physical activity and high disease management. Conclusions: A long-term interprofessional cross-sectoral telerehabilitation programme has been justified and described. The intervention was tested in 2017–2018 and the qualitative appraisal, along with an analysis of case-based measurements of development in physical capacity, COPD Assesment Test, and health management, is currently under production.
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Affiliation(s)
- Charlotte Simonÿ
- Department of Physiotherapy and Occupational Therapy, Slagelse Hospital, Faelledvej 7, 4200 Slagelse, Denmark.
- Institute of the Regional Health Services Research, University of Southern Denmark, 5230 Odense, Denmark.
| | - Claus Riber
- Department of Physiotherapy and Occupational Therapy, Slagelse Hospital, Faelledvej 7, 4200 Slagelse, Denmark.
| | - Uffe Bodtger
- Institute of the Regional Health Services Research, University of Southern Denmark, 5230 Odense, Denmark.
- Department of Respiratory Medicine, Naestved Hospital, Ringstedgade 61, 4700 Naestved, Denmark.
- Department of Respiratory Medicine, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark.
| | - Regner Birkelund
- Institute of the Regional Health Services Research, University of Southern Denmark, 5230 Odense, Denmark.
- Department of Health Research, Lillebaelt Hospital, University Hospital of Southern Denmark, Beriderbakken 4, 7100 Vejle, Denmark.
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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.
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Affiliation(s)
- Sarah Minshall
- Team Leader of the Adult Community Team, Speech and Language Therapy
| | - Sue Pownall
- Head of Speech and Language Therapy and Clinical Lead in Dysphagia, both at Sheffield Teaching Hospitals NHS Foundation Trust
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Yoshimatsu Y, Tobino K, Sueyasu T, Nishizawa S, Goto Y, Murakami K, Munechika M, Yoshimine K, Miyajima H. Repetitive saliva swallowing test and water swallowing test may identify a COPD phenotype at high risk of exacerbation. CLINICAL RESPIRATORY JOURNAL 2019; 13:321-327. [DOI: 10.1111/crj.13014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/16/2019] [Accepted: 02/24/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Yuki Yoshimatsu
- Department of Respiratory Medicine Iizuka Hospital Fukuoka Japan
| | - Kazunori Tobino
- Department of Respiratory Medicine Iizuka Hospital Fukuoka Japan
- Department of Respiratory Medicine Juntendo University Graduate School of Medicine Tokyo Japan
| | - Takuto Sueyasu
- Department of Respiratory Medicine Iizuka Hospital Fukuoka Japan
| | - Saori Nishizawa
- Department of Respiratory Medicine Iizuka Hospital Fukuoka Japan
| | - Yuki Goto
- Department of Respiratory Medicine Iizuka Hospital Fukuoka Japan
| | - Kojin Murakami
- Department of Respiratory Medicine Iizuka Hospital Fukuoka Japan
| | - Miyuki Munechika
- Department of Respiratory Medicine Iizuka Hospital Fukuoka Japan
| | - Kohei Yoshimine
- Department of Respiratory Medicine Iizuka Hospital Fukuoka Japan
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16
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Vespasiani-Gentilucci U, Pedone C, Muley-Vilamu M, Antonelli-Incalzi R. The pharmacological treatment of chronic comorbidities in COPD: mind the gap! Pulm Pharmacol Ther 2018; 51:48-58. [PMID: 29966745 DOI: 10.1016/j.pupt.2018.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 06/27/2018] [Accepted: 06/29/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is commonly associated with other chronic diseases, which poses several diagnostic and therapeutic problems. Indeed, important comorbidities frequently remain unrecognized and, then, untreated, whereas respiratory drugs may have non respiratory side effects, and selected non respiratory drugs may variably affect the respiratory function. OBJECTIVE to describe: how COPD affects the presentation and contributes to the diagnostic challenges of its most common comorbidities; how coexisting COPD impacts the therapeutic approach to selected comorbidities and viceversa. METHODS we distinguish comorbidities of COPD depending upon whether they are complications of COPD or share risk factors, mainly smoke, with it or, finally, aggravate COPD. We describe atypical presentations of and diagnostic clues to comorbidities and suggest screening procedures. Finally, the main therapeutic problems, as resulting from the risk of untoward effects of therapies of COPD and its comorbidity, with special attention to drug-drug interactions and possible overdosages, are described. RESULTS selected complications of COPD, such as osteoporosis, sarcopenia and dysphagia, are rarely recognized and treated, likely due to the poor awareness of them. Important comorbidities, such as coronary artery disease, chronic heart failure, obstructive sleep apnoea syndrome and chronic renal failure, also should be systematically searched for because of their commonly variant presentation. Disease-related symptoms should be distinguished from drug effects or drug-drug interaction effects. CONCLUSIONS a truly comprehensive view of the complex COPD patient, hopefully capitalizing on multidimensional geriatric assessment, is needed to dissect the many components of health status impairment and to provide the optimal care. Selected screening procedures are highly desirable to identify frequently missed comorbidities. Pharmacosurveillance is an essential part of the approach to COPD and its comorbidities.
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Affiliation(s)
| | - Claudio Pedone
- Internal Medicine and Geriatrics Area, University Campus Bio-Medico of Rome, Italy
| | - Moises Muley-Vilamu
- Internal Medicine and Geriatrics Area, University Campus Bio-Medico of Rome, Italy
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17
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Tahaineh L, Wazaify M. Difficulties in swallowing oral medications in Jordan. Int J Clin Pharm 2017; 39:373-379. [PMID: 28281225 DOI: 10.1007/s11096-017-0449-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 02/25/2017] [Indexed: 10/20/2022]
Abstract
Background Difficulties swallowing oral medications can affect patient compliance and consequently can compromise patient health. Objective To investigate the prevalence of difficulties in swallowing oral medications among a sample of the Jordanian population and the techniques used to overcome such difficulties. Setting The study was carried out in outpatient pharmacies in the north of Jordan. Method Adult patients who were taking at least one solid oral dosage form for at least 1 month were interviewed using a questionnaire. The questionnaire included demographic details, current medication use, questions about swallowing difficulties, and patient strategies to overcome such difficulties. Main outcome measure The study measured the number of patients reporting difficulties in swallowing oral medications and the techniques used to overcome swallowing difficulties. Results In this study 1250 patients were interviewed and 130 patients reported that they experienced or were currently experiencing difficulties in swallowing oral medications (10.4%). In order to overcome swallowing difficulties, 112 patients (86.2%) stated that they drink more water while 22 patients (16.9%) stated that they cut or crush their solid dosage forms, and 13 patients stated that they open their capsules. Forty-five patients (34.6%) stated that they sometimes skip their doses due to swallowing difficulties. The majority of participants with swallowing difficulties did not discuss their difficulties with their physicians or pharmacists (85.4%). Conclusion Difficulties in swallowing oral medications is a problem that is encountered in Jordan. Techniques used to overcome swallowing difficulties such as crushing or opening capsules can compromise medication efficacy and negatively impact patient health outcomes. Non-compliance due to swallowing difficulties raises a major concern.
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Affiliation(s)
- Linda Tahaineh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology (JUST), Irbid, Jordan.
| | - Mayyada Wazaify
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan
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18
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Maki N, Takahashi H, Nakata T, Wakayama S, Hasegawa D, Sakamoto H, Fujita Y, Takata Y, Sukada T, Sato Y, Yanagi H. The Effect of Respiratory Rehabilitation for the Frail Elderly: a Pilot Study. J Gen Fam Med 2016. [DOI: 10.14442/jgfm.17.4_289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Ginocchio D, Alfonsi E, Mozzanica F, Accornero AR, Bergonzoni A, Chiarello G, De Luca N, Farneti D, Marilia S, Calcagno P, Turroni V, Schindler A. Cross-Cultural Adaptation and Validation of the Italian Version of SWAL-QOL. Dysphagia 2016; 31:626-34. [PMID: 27444734 DOI: 10.1007/s00455-016-9720-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 06/15/2016] [Indexed: 11/24/2022]
Abstract
The aim of the study was to evaluate the reliability and validity of the Italian SWAL-QOL (I-SWAL-QOL). The study consisted of five phases: item generation, reliability analysis, normative data generation, validity analysis, and responsiveness analysis. The item generation phase followed the five-step, cross-cultural, adaptation process of translation and back-translation. A group of 92 dysphagic patients was enrolled for the internal consistency analysis. Seventy-eight patients completed the I-SWAL-QOL twice, 2 weeks apart, for test-retest reliability analysis. A group of 200 asymptomatic subjects completed the I-SWAL-QOL for normative data generation. I-SWAL-QOL scores obtained by both the group of dysphagic subjects and asymptomatic ones were compared for validity analysis. I-SWAL-QOL scores were correlated with SF-36 scores in 67 patients with dysphagia for concurrent validity analysis. Finally, I-SWAL-QOL scores obtained in a group of 30 dysphagic patients before and after successful rehabilitation treatment were compared for responsiveness analysis. All the enrolled patients managed to complete the I-SWAL-QOL without needing any assistance, within 20 min. Internal consistency was acceptable for all I-SWAL-QOL subscales (α > 0.70). Test-retest reliability was also satisfactory for all subscales (ICC > 0.7). A significant difference between the dysphagic group and the control group was found in all I-SWAL-QOL subscales (p < 0.05). Mild to moderate correlations between I-SWAL-QOL and SF-36 subscales were observed. I-SWAL-QOL scores obtained in the pre-treatment condition were significantly lower than those obtained after swallowing rehabilitation. I-SWAL-QOL is reliable, valid, responsive to changes in QOL, and recommended for clinical practice and outcome research.
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Affiliation(s)
- Daniela Ginocchio
- Audiology Unit, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Enrico Alfonsi
- Department of Neurophysiology and Neurorehabilitation, National Institute of Neurology, "C. Mondino" Foundation IRCCS, University of Pavia, Pavia, Italy
| | - Francesco Mozzanica
- Phoniatric Unit, Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | | | - Antonella Bergonzoni
- Department of Rehabilitation Medicine, San Giorgio Hospital, University of Ferrara, Ferrara, Italy
| | - Giulia Chiarello
- Department of Otorhinolaryngology, University Hospital of Ferrara, Ferrara, Italy
| | - Nicoletta De Luca
- Department of Otorhinolaryngology, University Hospital of Ferrara, Ferrara, Italy
| | | | - Simonelli Marilia
- Speech and Swallowing Rehabilitation Service, "Santa Lucia" Foundation IRCCS, Rome, Italy
| | - Paola Calcagno
- Speech and Swallowing Rehabilitation Service, "Santa Lucia" Foundation IRCCS, Rome, Italy
| | | | - Antonio Schindler
- Phoniatric Unit, Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy.
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20
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Nazarko L. Considering the difficulties with dysphagia: an overview for community nurses. Br J Community Nurs 2016; 21:226-30. [PMID: 27170406 DOI: 10.12968/bjcn.2016.21.5.226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Linda Nazarko
- Nursing Consultant, Physical Healthcare, West London Mental Health Trust
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21
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Abstract
Dysphagia impacts on the health and quality of life of individuals and contributes to the cost of health care. This paper summarises current literature regarding the nature, assessment and management of acquired oro-pharyngeal dysphagia in older adults. It examines the aetiology, prevalence and consequences of dysphagia, as well as issues regarding medication administration. Assessment of dysphagia is explored in terms of multidisciplinary screening, speech and language therapist clinical swallowing evaluation and instrumental assessment.
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Affiliation(s)
- John Lancaster
- Senior Lecturer in Speech Pathology and Therapy, Manchester Metropolitan University
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22
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Cassiani RA, Santos CM, Baddini-Martinez J, Dantas RO. Oral and pharyngeal bolus transit in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2015; 10:489-96. [PMID: 25784795 PMCID: PMC4356708 DOI: 10.2147/copd.s74945] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patients with respiratory diseases, such as chronic obstructive pulmonary disease (COPD), may have swallowing dysfunction. OBJECTIVE The aim of this investigation was to evaluate the oral and pharyngeal phases of swallowing in patients with COPD. METHODS We studied 16 patients with clinical manifestations and pulmonary function tests diagnosis of COPD (mean age: 68 years) and 15 nonsmoking healthy volunteers (mean age: 65 years) with normal pulmonary function tests. All subjects were submitted to clinical and videofluoroscopic evaluation of swallowing. Each subject performed in duplicate swallows of 5 mL and 10 mL of liquid bolus, paste bolus, and a solid bolus. RESULTS In general, the duration of the events of the pharyngeal phase of swallowing was longer in COPD patients than controls. The difference was significant in the laryngeal vestibular closure, hyoid movement, and pharyngeal transit with swallows of both volumes of liquid bolus; in oral-pharyngeal transit with 5 mL paste bolus; and in pharyngeal and oral-pharyngeal transit with solid bolus. The difference between the duration of maximal laryngeal elevation and the duration of pharyngeal transit was higher in control subjects than in patients with COPD. CONCLUSION The results suggested that patients with COPD have a longer pharyngeal swallowing phase than normal subjects, which is associated with a decrease in the difference between the duration of maximal laryngeal elevation and the duration of pharyngeal transit.
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Affiliation(s)
- Rachel Aguiar Cassiani
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carla Manfredi Santos
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - José Baddini-Martinez
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Roberto Oliveira Dantas
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Steidl E, Ribeiro CS, Gonçalves BF, Fernandes N, Antunes V, Mancopes R. Relationship between Dysphagia and Exacerbations in Chronic Obstructive Pulmonary Disease: A Literature Review. Int Arch Otorhinolaryngol 2014; 19:74-9. [PMID: 25992155 PMCID: PMC4392502 DOI: 10.1055/s-0034-1376430] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 04/01/2014] [Indexed: 12/31/2022] Open
Abstract
Introduction The literature presents studies correlating chronic obstructive pulmonary disease to dysphagia and suggesting that the aspiration laryngeal phenomenon related to changes in the pharyngeal phase contributes significantly to the exacerbation of symptoms of lung disease. Objectives This study aimed to conduct a literature review to identify the relation between dysphagia and exacerbations of chronic obstructive pulmonary disease. Data Synthesis We found 21 studies and included 19 in this review. The few studies that related to the subject agreed that the presence of dysphagia, due to lack of coordination between swallowing and breathing, may be one of the triggering factors of chronic obstructive pulmonary disease exacerbation. Conclusions The review noted that there is a relationship between dysphagia and exacerbations of chronic obstructive pulmonary disease, identified by studies demonstrating that the difficulties associated with swallowing may lead to exacerbation of the disease. There was difficulty in comparing studies by their methodological differences. More research is needed to clarify the relationship between dysphagia and exacerbations of chronic obstructive pulmonary disease, making it possible to develop multiprofessional treatment strategies for these patients, catered to specific needs due to the systemic manifestations of the disease.
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Affiliation(s)
- Eduardo Steidl
- Post-Graduation Student, Department of Speech Therapy, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Carla Simone Ribeiro
- Department of Physiotherapy, Centro Universitário Franciscano, Santa Maria, RS, Brazil
| | - Bruna Franciele Gonçalves
- Post-Graduation Student, Department of Speech Therapy, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Natália Fernandes
- Department of Speech Therapy, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Vívian Antunes
- Department of Physiotherapy, Centro Universitário Franciscano, Santa Maria, RS, Brazil
| | - Renata Mancopes
- Department of Speech Therapy, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
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Pinchot SN, Youngwirth L, Rajamanickam V, Schaefer S, Sippel R, Chen H. Changes in swallowing-related quality of life after parathyroidectomy for hyperparathyroidism: a prospective cohort study. Oncologist 2012; 17:1271-6. [PMID: 22829568 DOI: 10.1634/theoncologist.2012-0203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To prospectively evaluate the impact of parathyroidectomy on swallowing-related quality of life using the Swallowing Quality Of Life (SWAL-QOL) validated outcomes assessment tool. BACKGROUND Many patients with primary hyperparathyroidism report nonspecific symptoms, such as fatigue, irritability, cognitive impairment, sleep disturbances, and dysphagia. To date, there have been no prospective studies evaluating swallowing function before and after parathyroid surgery. METHODS Patients undergoing parathyroidectomy from September 2007 to January 2009 completed the SWAL-QOL questionnaire before and one year after surgery. Data were collected on demographic and clinicopathologic variables. Comparisons were made to determine the effect of surgery on patients' perceptions of swallowing function. RESULTS Of 151 eligible patients, 102 (68%) completed the study. The mean patient age was 60 years, and 79% were female. A total of 73 patients (67%) had minimally invasive parathyroidectomies, whereas the remainder had bilateral explorations. In all, 83 patients (81%) had a parathyroid adenoma, 16 patients (16%) had hyperplasia, and 3 patients (3%) had a double adenoma on final pathologic interpretation. Mean preoperative SWAL-QOL scores were <90 for 4 of the 11 domains, indicating the perception of oropharyngeal dysphagia and diminished quality of life. Following parathyroidectomy, significant improvements were demonstrated in eight SWAL-QOL domains. CONCLUSIONS Many patients with parathyroid disease have the perception of abnormal swallowing function. In these patients with symptoms of dysphagia, parathyroid surgery leads to significant improvements in many aspects of swallowing-related quality of life measured by the SWAL-QOL instrument. This study represents the first use of a condition-specific instrument to assess swallowing-related quality of life for patients with parathyroid disease before and after parathyroid surgery.
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Affiliation(s)
- Scott N Pinchot
- F.A.C.S., K3-705 Clinical Science Center, 600 Highland Avenue, Madison, Wisconsin 53792, USA
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Finizia C, Rudberg I, Bergqvist H, Rydén A. A cross-sectional validation study of the Swedish version of SWAL-QOL. Dysphagia 2011; 27:325-35. [PMID: 22006366 DOI: 10.1007/s00455-011-9369-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2010] [Accepted: 09/23/2011] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to evaluate the psychometric properties of the Swedish version of the Swallowing Quality of Life questionnaire (SWAL-QOL). The study design was cross-sectional and the study was performed in patients with subjective oropharyngeal dysphagia due to head and neck (H&N) cancer (n = 85) or neurological disease (n = 30) and in a sample of age- and gender-matched controls (mean age = 63 years, 57% males) without subjective dysphagia (n = 115). The Short-Form 36 (SF-36) and Hospital Anxiety and Depression Scale (HADS) questionnaires were used for assessment of convergent and discriminant validity. The Swedish version of SWAL-QOL was well accepted, the response rate was high (>90%), and the number of missing items were very low (<1%). Overall, the questionnaire showed good to excellent psychometric properties, including floor and ceiling effects (range = 0-16 and 0-21%), internal consistency [Cronbach's α > 0.70 for all domains except Eating Duration (0.69) and Sleep (0.68)], test-retest reliability (intraclass correlations = 0.75-0.98) and convergent and discriminant validity as assessed by correlations between SWAL-QOL and SF-36 and HADS. SWAL-QOL also proved able to differentiate between dysphagic and nondysphagic patients (P < 0.00001) (known-groups validity) and sensitive to disease severity as measured by different food textures.
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Affiliation(s)
- Caterina Finizia
- Department of Otolaryngology, Sahlgrenska University Hospital, Gothenburg University, Gothenburg, Sweden.
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Effects of pulmonary rehabilitation on quality of life in chronic obstructive pulmonary disease patients. Curr Opin Pulm Med 2011; 17:62-71. [PMID: 21206273 DOI: 10.1097/mcp.0b013e328343521c] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Pulmonary rehabilitation plays a key role in the management of chronic obstructive pulmonary disease (COPD). Although the American Thoracic Society recently provided a grade of 1A for evidence of health-related quality of life (HRQoL) benefits related to pulmonary rehabilitation, knowledge about the psychological and behavioral processes explaining the impact of pulmonary rehabilitation on HRQoL in COPD patients remains limited. This review describes the state of knowledge over the past year concerning HRQoL benefits after pulmonary rehabilitation and suggests avenues for future research. RECENT FINDINGS HRQoL outcomes related to pulmonary rehabilitation explores five themes: optimizing pulmonary rehabilitation components to improve HRQoL; characterization of a responder phenotype; suitability of pulmonary rehabilitation following acute exacerbations; exploration of psychological and behavioral mechanisms explaining pulmonary rehabilitation benefits; and long-term maintenance of HRQoL benefits after pulmonary rehabilitation. SUMMARY Evidence supports the use of pulmonary rehabilitation to improve HRQoL in patients with moderate-to-severe COPD. However, it is unclear how pulmonary rehabilitation improves HRQoL and which characteristics confer the greatest HRQoL benefits. Moreover, most studies failed to provide a compelling theoretical rationale for the intervention employed. Future research should focus on improving the understanding of the psychological mechanisms implicated in the adoption and maintenance of healthy behavior.
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