Instrumental Swallowing Assessment in Adults in Residential Aged Care Homes: A Scoping Review

Birchall, Olga; Bennett, Michelle; Lawson, Nadine; Cotton, Sue; Vogel, Adam P.

doi:10.1016/j.jamda.2020.08.028

Cited by 9 publications

(7 citation statements)

References 63 publications

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“…Most of the studies in this review performed instrumental assessments, including the use of the FEES and VFSS, which are regarded as gold standards for the assessment of swallowing function. Whilst instrumental assessments can visualise the swallowing process and provide detailed information on the anatomy and physiology of swallowing, there are barriers to their implementation, such as the need to move the patient, the cost burden, the exposure to ionising radiation (Ingleby et al, 2021) and the difficulty in access (Birchall et al, 2021). Therefore, simple and sensitive non‐instrumental assessments, such as the volume‐viscosity swallow test (VVST) and water swallowing test (WST), which can be carried out at the bedside, should be considered in future studies.…”

Section: Discussionmentioning

confidence: 99%

Predictors of complete oral feeding resumption after feeding tube placement in patients with stroke and dysphagia: A systematic review

Zhang

et al. 2022

Journal of Clinical Nursing

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Aims:The aim was to synthesise and discuss predictors of complete oral feeding resumption after feeding tube placement in stroke patients with dysphagia.Design: This was a systematic review, following the PRISMA 2020 checklist. Data sources: Eight databases (PubMed, Web of Science, Embase, Cochrane, CINAHL, CNKI, WanFang and Vip) were searched for eligible studies from inception up to June 2021. Review methods:The JBI Manual for Evidence Synthesis was used to guide this systematic review. Any cross-sectional survey, longitudinal study, cohort study or casecontrol study that explored the recovery from tube feeding to complete oral feeding in patients with dysphagia after stroke was included. Qualitative studies, review articles, case reports and conference abstracts were excluded. Two reviewers independently screened and appraised the studies. The Newcastle-Ottawa scale was used for quality assessment. Content analysis was used to categorise factors predicting feeding tube removal in stroke patients with dysphagia.Results: This review included a total of 15 studies consisting of 1746 participants, of which 2 were case-control studies and 13 were cohort studies. Four studies were rated as having low risk of bias, and the other 11 had high risk of bias. The factors examined in the studies were categorised into demographic characteristics (age and sex), swallowing function (instrumental assessments and non-instrumental assessments), stroke characteristics (stroke severity, past stroke history and location of the stroke), functional status (cognitive function and physical function) and clinical measures (body mass index, geriatric nutritional risk index, white blood cell count and Creactive protein level). Conclusions:The major limitation of this review is the failure to identify predictors of different tube feeding types. Although the current evidence is insufficient to support or oppose the predictive effect of any single factor, these factors are still valuable data for clinical staff that provide information that researchers can use in developing prognostic models. Rigorously designed and high-quality research is needed to further explore the predictive value of these factors.

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Section: Discussionmentioning

confidence: 99%

Predictors of complete oral feeding resumption after feeding tube placement in patients with stroke and dysphagia: A systematic review

Zhang

et al. 2022

Journal of Clinical Nursing

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“…Since then, FEES has been taken up by clinicians all around the world. Thus, FEES is regularly performed by SLPs and different medical professions, in particular neurologists, phoniatricians, otolaryngologists, geriatricians, pediatricians and intensivists, and is used in a variety of settings, such as outpatient care, acute-care hospitals, including stroke units and intensive care units, rehabilitation facilities and nursing homes [ 2 – 4 ]. Over the last years, education in FEES has undergone systematic formalization in various countries, including the United States [ 5 ], Great Britain [ 6 ], Germany [ 3 , 7 ] and Japan [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Systematic approach to contextualize findings of flexible endoscopic evaluation of swallowing in neurogenic dysphagia– towards an integrated FEES report

Dziewas,

Warnecke,

Labeit

et al. 2024

Neurol. Res. Pract.

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Flexible endoscopic evaluation of swallowing (FEES) is one of the most important methods for instrumental swallowing evaluation. The most challenging part of the examination consists in the interpretation of the various observations encountered during endoscopy and in the deduction of clinical consequences. This review proposes the framework for an integrated FEES-report that systematically moves from salient findings of FEES to more advanced domains such as dysphagia severity, phenotypes of swallowing impairment and pathomechanisms. Validated scales and scores are used to enhance the diagnostic yield. In the concluding part of the report, FEES-findings are put into the perspective of the clinical context. The potential etiology of dysphagia and conceivable differential diagnoses are considered, further diagnostic steps are proposed, treatment options are evaluated, and a timeframe for re-assessment is suggested. This framework is designed to be adaptable and open to continuous evolution. Additional items, such as novel FEES protocols, pathophysiological observations, advancements in disease-related knowledge, and new treatment options, can be easily incorporated. Moreover, there is potential for customizing this approach to report on FEES in structural dysphagia.

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“…Timely, personalised dysphagia assessment and management in older adults minimises dysphagia‐associated complications including choking, dehydration, malnutrition, sarcopenia, aspiration, psychosocial sequalae and death 3 . Instrumental swallowing assessments (ISA), including videofluoroscopic swallowing studies and flexible endoscopic evaluation of swallowing (FEES), are commonly used in community and hospital settings to obtain more information about swallow anatomy/physiology than is possible through a clinical swallowing evaluation alone 4–8 . Instrumental swallowing assessments may be performed when indications for ISA 6 (e.g.…”

Section: Introductionmentioning

confidence: 99%

“… 3 Instrumental swallowing assessments (ISA), including videofluoroscopic swallowing studies and flexible endoscopic evaluation of swallowing (FEES), are commonly used in community and hospital settings to obtain more information about swallow anatomy/physiology than is possible through a clinical swallowing evaluation alone. 4 , 5 , 6 , 7 , 8 Instrumental swallowing assessments may be performed when indications for ISA 6 (e.g. suspected aspiration, sensations of globus, vague dysphagia symptoms) align with treatment goals and consumer choice.…”

Section: Introductionmentioning

confidence: 99%

Instrumental swallowing assessment in adults in residential aged care homes: Practice patterns and opportunities

et al. 2022

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Objective: To describe practice patterns in the use of instrumental swallowing assessment (ISA) for older adults in residential aged care homes (RACHs). Methods:A retrospective audit of medical records of residents living in RACHs in Melbourne, Australia to extract data on speech-language pathologist (SLP) involvement, indications for ISA and ISA practice patterns.Results: Medical files of 323 residents across four Melbourne facilities were reviewed. 36% (n = 115) of residents were referred to SLP for swallowing assessment.Referral to SLP was related to length of stay (U = 7393.00, p < 0.001), dementia status (χ 2 [1] = 7.06, p = 0.008), texture modification (χ 2 [1] = 93.34, p < 0.001) and an existing dysphagia diagnosis (χ 2 [1] = 112.89, p < 0.001). There were no referrals for ISA and no instances of ISA being used. Among 115 residents who were referred to SLP for swallowing assessment, there were 33 instances where ISA might be clinically relevant according to ISA indicators.Conclusions: Instrumental swallowing assessment is not being used for the management of swallowing in RACHs in Australia despite a clinical need for ISA and a potential role for ISA to improve swallowing care quality. Lack of timely ISA may fail to meet the complex health-care needs of older adults living with

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Instrumental Swallowing Assessment in Adults in Residential Aged Care Homes: A Scoping Review

Cited by 9 publications

References 63 publications

Predictors of complete oral feeding resumption after feeding tube placement in patients with stroke and dysphagia: A systematic review

Predictors of complete oral feeding resumption after feeding tube placement in patients with stroke and dysphagia: A systematic review

Systematic approach to contextualize findings of flexible endoscopic evaluation of swallowing in neurogenic dysphagia– towards an integrated FEES report

Instrumental swallowing assessment in adults in residential aged care homes: Practice patterns and opportunities

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