A service evaluation of cough reflex testing to guide dysphagia management in the postsurgical adult head and neck patient population

Holmes, Sam

doi:10.1097/moo.0000000000000256

Cited by 10 publications

(6 citation statements)

References 26 publications

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“…From a psychosocial perspective, the findings of this study suggest that the introduction of CRT has the potential to increase clinicians’ confidence in identifying patients who require instrumental swallow assessments and those whose dysphagia can be managed clinically. This is consistent with findings from recent studies (Holmes 2016, Field et al . 2018).…”

Section: Discussionsupporting

confidence: 94%

Cough reflex testing in acute stroke: A survey of current UK service provision and speech and language therapist perceptions

Trimble

Patterson

2020

Intl J Lang & Comm Disor

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Background Silent aspiration (SA)—airway entry of food, drink or other material without a cough response—is common post‐stroke. Clinical swallowing examination misses up to 40% of dysphagic patients with SA. This may put these patients at risk of aspiration pneumonia, prolonged length of hospital stay and increased healthcare costs. After stroke, the laryngeal cough reflex is frequently impaired with significant relationships between pneumonia rates and reduced cough strength and sensitivity. There has been a significant amount of recent interest in cough reflex testing (CRT) as a potential means to improve clinical identification of patients at risk of SA. However, there is a lack of consensus regarding the methodology and protocols for use of CRT with widely varying outcomes reported in the literature. Aims To provide an overview of current practice in the UK with regards to clinical use of CRT by speech and language therapists (SLTs) in acute stroke settings and to explore the perceptions regarding its potential application in clinical dysphagia management and the barriers and facilitators associated with adopting CRT in clinical practice. Methods & Procedures A cross‐sectional web‐based survey was developed, piloted and delivered. The survey targeted all UK‐based SLTs working in acute stroke settings. Outcomes & Results A total of 129 SLTs with varying levels of experience of CRT from all regions of the UK responded. Only four SLT services in the UK were reported to be currently using CRT clinically with acute stroke patients. A total of 29% of respondents who were not using CRT were considering introducing CRT into their service's dysphagia protocol. Variation was reported in the procedures and protocols. Overall, users reported improved confidence in the clinical detection of SA and felt that the introduction of CRT had improved their patient‐related outcomes. Issues included difficulties procuring citric acid, implications for SLT time (including service set‐up and delivery of CRT) and restricted access to instrumental assessments. Conclusions & Implications This survey gives valuable insight into the current practice and perceptions of SLTs in the UK working in acute stroke settings in relation to CRT. It highlights discrepancies between reported approaches and recommendations from existing guidelines and validation studies. The variation in responses indicates a need to develop a consensus statement and further research to guide practice.

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Section: Discussionsupporting

confidence: 94%

Cough reflex testing in acute stroke: A survey of current UK service provision and speech and language therapist perceptions

Trimble

Patterson

2020

Intl J Lang & Comm Disor

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“…Several methods of rehabilitation for dysphagia in HNC were highlighted in a review [ 42 ]. Most of the rehabilitation of HNC patients with dysphagia has focused on the pathophysiology of dysphagia, including objective assessment (videoendoscopic evaluation of swallowing, videofluoroscopic examination of swallowing, dysphagia severity scale, and the FOIS) [ 43 ]. However, a psychosocial approach should be emphasized for the cancer patients with dysphagia.…”

Section: Discussionmentioning

confidence: 99%

Relationship between the Functional Oral Intake Scale (FOIS) and the Self-Efficacy Scale among Cancer Patients: A Cross-Sectional Study

2020

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A few studies have provided detailed reports suggesting that subjective swallowing disorders may be related to dysphagia. Therefore, we verified the relationship between oral health-related self-efficacy and dysphagia severity in cancer treatment using a cross-sectional study. Participants included patients undergoing treatment for cancer at Shimane University Hospital in Shimane, Japan, and those receiving outpatient treatment at the hospital’s Oral Care Center between August 2018 and April 2019. In all, 203 participants enrolled in the study and completed the Functional Oral Intake Scale (FOIS), the Self-efficacy Scale for Advanced Cancer (SEAC), and the Oral Health-related Self-Efficacy Scale for Patients with Cancer (OSEC). Multivariate analysis showed a statistically significant correlation between the low FOIS score and the SEAC subscales of Activities of Daily Living Self-efficacy (ADE) (odds ratio 1.04, 95% [CI] 1.00–1.07) and Symptom Coping Self-efficacy (SCE) (odds ratio 0.61, 95% [CI] 0.42–0.88). Based on the Jonckheere-Terpstra test, the SEAC and the OSEC tended to increase as the category of the FOIS progressed. To conclude, self-efficacy played an important role in dysphagia and may affect the severity of dysphagia in cancer patients.

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“…A review highlighted several methods of rehabilitation for dysphagia in head and neck cancer, and their effectiveness was evidenced by a randomized control trial [42]. However, most of the rehabilitation efforts for head and neck cancer patients with dysphagia focus on the pathophysiology of dysphagia, including objective assessment (videoendoscopic evaluation of swallowing, video uoroscopic examination of swallowing, dysphagia severity scale, and the FOIS) [43]. However, a psychosocial approach should be emphasized for cancer patients with dysphagia.…”

Section: Intervention For Cancer Patients Suffering From Swallowing Dmentioning

confidence: 99%

Relationship between the Functional Oral Intake Scale and Self-efficacy Scale among Patients with Cancer: A Cross-sectional study

Matsuda

Karino

Kanno

2020

Preprint

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Background: A few studies suggest that self-efficacy pertaining to swallowing ability can lead to dysphagia. Therefore, this cross-sectional study verified the relationship between oral health-related self-efficacy and dysphagia severity during cancer treatment. Methods: Participants included patients undergoing treatment for cancer at Shimane University Hospital, Shimane, Japan, and those receiving outpatient treatment at the hospital’s Oral Care Center between August 2018 and April 2019. In all, 203 participants enrolled in the study and completed the Functional Oral Intake Scale (FOIS), Self-efficacy Scale for Advanced Cancer (SEAC), and Oral Health-related Self-Efficacy Scale for Patients with Cancer (OSEC). Results: A multivariate analysis showed a statistically significant correlation between the low FOIS score category and the SEAC subscales of Activities of Daily Living Self-efficacy (ADE) (odds ratio 1.04, 95% confidence interval [CI] 1.00–1.07) and Symptom Coping Self-efficacy (SCE) (odds ratio 0.61, 95% [CI] 0.42–0.88). Based on the Jonckheere-Terpstra test, the SEAC and OSEC scores tended to increase as the FOIS category progressed. Conclusion: These findings suggest that self-efficacy played an important role in dysphagia and it may affect the severity of dysphagia.

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A service evaluation of cough reflex testing to guide dysphagia management in the postsurgical adult head and neck patient population

Cited by 10 publications

References 26 publications

Cough reflex testing in acute stroke: A survey of current UK service provision and speech and language therapist perceptions

Cough reflex testing in acute stroke: A survey of current UK service provision and speech and language therapist perceptions

Relationship between the Functional Oral Intake Scale (FOIS) and the Self-Efficacy Scale among Cancer Patients: A Cross-Sectional Study

Relationship between the Functional Oral Intake Scale and Self-efficacy Scale among Patients with Cancer: A Cross-sectional study

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