Dysphagia Management Practices Among Speech-Language Pathologists in Malaysia

Abstract

In Malaysia, speech pathology services for dysphagia management are yet to be fully established.Detailed knowledge of current practices is necessary to inform future training and infrastructure needs. Therefore, the current study aimed to (a) explore current practice for dysphagia The most noticeable areas of inconsistency of practice between the two groups related to the proportion of active caseload dedicated to dysphagia management, the use of a team approach to dysphagia management, involvement in making diagnoses, and differences regarding the nature and frequency of use of instrumental diagnostic tools. Despite identifying a number of areas DYSPHAGIA MANAGEMENT PRACTICES IN MALAYSIA 2 which require further education and training, overall the current study demonstrated that the dysphagia service in Malaysia is moving towards standards of practice largely comparable to more established services. The findings provide an insight into patterns of service development for other countries developing dysphagia services.

Impact of Dysphagia Severity on Clinical Decision Making via Telerehabilitation

“…Although it is recognized that CSEs can produce false-positives and lack the sensitivity to detect silent aspiration, 8,9 the CSE remains the clinician's primary initial tool in the process of dysphagia assessment and diagnosis. 10 Although early diagnosis and intervention are recognized as integral to reducing dysphagia-related patient morbidity and mortality, [11][12][13] there are multiple challenges impacting the provision of timely and equitable dysphagia services. Although not an exhaustive list, key issues impacting services globally include remoteness, distance, access, lack of skilled professionals, paucity of local and specialist services, and increasing population demands.…”

Medical Officers’ Awareness, Involvement and Training in Dysphagia Management

“…The awareness of the SLPs' role in dysphagia management varied significantly among the medical officers. In brief, the SLPs role incorporates conducting clinical and instrumental swallowing examinations with relevant professionals, planning for swallowing management and treatment, referral to relevant professionals, counseling of patients and their caregivers, educating other professionals, working as a team member, and participating in research activities (Mustaffa Kamal et al 2012). Yet among the medical officers in the present study, especially in the family medicine and surgery department, low awareness of the SLPs role in dysphagia management was exhibited.…”

“…This is as most dysphagia cases are managed by SLPs who are recognized as the main professionals in dysphagia management (Logemann 1998). However, in Malaysia, there is a large service deficit which resulted in an unclear picture of which professionals within the clinical setting manage patients with dysphagia (Mustaffa Kamal, Ward & Cornwell 2012). Understanding this predicament, further investigation is needed to shed light on the clinicians' role in the management of patients with dysphagia, and reasons explaining the lack of SLPs involvement within the clinical setting in comparison to their international counterparts.…”

“…The assessment results are then used to establish a professional diagnosis, identify the need for intervention, determine the focus of treatment, identify the frequency and length of treatment, and aid referral to other professionals (Shipley & McAfee 1998). Other areas of dysphagia management undertaken by SLPs include educating and making appropriate referrals to other relevant professionals, counseling patients and caregivers, and conducting research activities to increase knowledge (Mustaffa Kamal et al 2012). The management of dysphagia is vital as patients with dysphagia often present with an increased risk of developing other medical conditions or complications related to aspiration pneumonia.…”

“…In Hospital USM, speech and language pathology services are provided by the Audiology and Speech Pathology Unit that was established on the 1 st of December 2010, located in the Otorhinolaryngology department. To this date, a limited number of studies (e.g., Mustaffa Kamal et al 2012; have been conducted in Malaysia regarding dysphagia management, and none have specifically focused on determining the awareness, involvement and training of medical officers from frontline departments which manage dysphagia in a teaching hospital. Investigation into the awareness, training and involvement of medical officers in dysphagia management is required in order to comprehend the lack of referrals to SLPs.…”