Knowledge and practice concerning swallowing disorders in hemiplegic patients among nurses of Bobo–Dioulasso urban primary health care centers in Burkina Faso

Abstract

IntroductionThe quality of management of swallowing disorders (SD) from admission onwards influences the patients' nutritional status and their prognosis. Neurological diseases are the main causes of SD, affecting one in three patients with hemiplegia (Hp). In Burkina Faso (BF), primary health care center (PHCC) nurses are the first to manage these patients, but there are no data related to their management of SD. The study aimed to assess knowledge and practices regarding SD in Hp among PHCC nurses in Bobo–Dioulasso, a main center for care of Hp in BF.MethodsThis cross-sectional study was performed August 1–September 15 2014. Subjects underwent a standardized survey to determine their knowledge and practices concerning SD in Hp.ResultsOf 125 nurses surveyed (83.3% of the targeted workers), 82.4% had experience of caring for Hp. The role of the central nervous system in cases of Hp and SD was recognized by 56.8% of nurses; 42.3% knew that SD can cause aspiration, and 36.0% were aware of rescue techniques to use when aspiration occurs; 39.2% correctly assessed the impact on nutritional status of SD. Knowledge in this area was better among respondents who recently completed training school. 65.6% and 1.6% respectively knew about the impact of posture and the texture of food on the ability to swallow. Among the 103 nurses with experience of treating Hp, 68.0% considered clinical interview the best way to detect SD, and 30.1% did not give the patient advice in this area. In multivariate analysis, detection of SD was associated with good knowledge of the value of voice disorders (OR = 3.5, 95% CI = 1.4–8.1; p = 0.005).ConclusionFew nurses had been warned of the connection between Hp and SD, which are classic issues and potential complications. Practices varied, but most were not in accord with what are recognized as good strategies for SD screening and management. In order to improve care of Hp, neurological and nutritional training should be accompanied by specific training in SD, emphasizing screening and simple management.

Contextualised evidence-based rehabilitation recommendations to optimise function in African people with stroke

“…The personal system barriers identified as deficiencies in knowledge, skills and attitudes can significantly affect the standard of care provided to persons with stroke who present with communication difficulties and dysphagia. There was a consistent lack of familiarity with SLT terminology found across the three studies, which is congruent with findings in the current literature (Albini et al 2013;Diendéré et al 2016; Dziewas et al Familiarity with terms such as 'dysphagia' could be because of increased exposure to the condition, and its related terms in the workplace, as other healthcare professionals such as medical doctors might use similar terminology during interaction with nurses. Dysphagia terminology might also be perceived as important, as inadequate management of dysphagia could contribute to life-threatening complications, whilst poor knowledge of communication terminology does not generally pose a risk to patients' physical health.…”

“…Research has identified a lack of nurses' knowledge regarding best practices for the rehabilitation of persons with stroke, as well as lack of knowledge regarding SLT diagnoses and terminology. This is supported by international research (Albini et al 2013;Diendéré et al 2016;Dziewas et al 2017;Wang, Lu & Chang 2014) and African research (Rhoda & Pickel-Voigt 2015). Furthermore, issues of nurses disagreeing with SLT recommendations (Hadely, Power & O-Halloran 2014) and their feelings of inadequacy when working with patients with communication or dysphagia diagnoses (McGinnis et al 2019;Smith et al 2015) have been identified.…”

Registered Nurse's Competency To Screen Dysphagia Among Stroke Patients: Literature Review

“…Several researchers have described registered nurses competency in term of knowledge and skills regarding screening dysphagia [30, 31, 35, 38, 39]. McHale, Phipps, Horvath, Schmelz, (1998) conducted a study to describe the practical knowledge of expert twelve nurses.…”

“…They found that few nurses understood the importance of screening dysphagia [38]. In order to improve care among stroke patients, Diendéré, et al .…”

“…Nurses conducted the swallowing screening test inconsistently and without a standard procedure, caused chiefly by the lack of knowledge and skills on dysphagia screening, and the absence of training programs [32]. Several researchers emphasis on nurses for training the dysphagia screening [30, 31, 33, 35, 38, 39]. …”