The role of instrumental swallowing assessment in adults in residential aged care homes : A national modified Delphi survey examining beliefs and practices

Journal article


Birchall, Olga, Bennett, Michelle, Lawson, Nadine, Cotton, Susan M. and Vogel, Adam P.. (2021). The role of instrumental swallowing assessment in adults in residential aged care homes : A national modified Delphi survey examining beliefs and practices. Dysphagia. pp. 1-13. https://doi.org/10.1007/s00455-021-10296-2
AuthorsBirchall, Olga, Bennett, Michelle, Lawson, Nadine, Cotton, Susan M. and Vogel, Adam P.
Abstract

Many adults in residential aged care homes (RACHs) live with oropharyngeal dysphagia (OD) and its physiological, psychosocial, and economic sequalae. Timely, evidence-based assessment of OD can help healthcare teams to create OD management plans that optimize consumer health and minimize healthcare costs. Instrumental swallowing assessment (ISA), specifically flexible endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallowing studies (VFSS), is generally accepted to be an important component of dysphagia assessment and management in older adults. However, its role in RACHs has not been empirically examined. This study aimed to explore the role and use of ISA in adults in RACHs from the perspective of speech–language-pathologists (SLPs) experienced in a RACH setting and/or FEES and VFSS. A three-round electronic Delphi study was conducted to guide 58 SLPs in Australia towards consensus using a combination of multiple-choice questions, statements with five-point Likert scale agreement options, and open-ended questions. Participants’ responses were analyzed using descriptive statistics and content analysis after each survey round. Feedback about group responses was provided before subsequent surveys. Consensus was defined as 70% or greater agreement. Participants reached consensus about obstacles and facilitators to the use of ISA in RACHs. Participants agreed that FEES was a valuable tool in RACHs and that a mobile service model may have advantages over standard off-site assessment. SLPs believed that appropriate governance processes, infrastructure and education were necessary to develop a safe, high-quality service. These views support equitable access to ISA across settings, aligning with person-centered care, re-ablement, and care-in-place.

Keywordsinstrumental swallowing assessment; fees; older adults; care home; dysphagia; Delphi
Year2021
JournalDysphagia
Journal citationpp. 1-13
PublisherSpringer
ISSN0179-051X
Digital Object Identifier (DOI)https://doi.org/10.1007/s00455-021-10296-2
Scopus EID2-s2.0-85104122204
Research or scholarlyResearch
Page range1-13
FunderNational Health and Medical Research Council
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusIn press
Publication dates
Online09 Apr 2021
Publication process dates
Accepted25 Mar 2021
Deposited25 Nov 2021
Grant IDNHMRC/1135683
NHMRC/1136344
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https://acuresearchbank.acu.edu.au/item/8x22w/the-role-of-instrumental-swallowing-assessment-in-adults-in-residential-aged-care-homes-a-national-modified-delphi-survey-examining-beliefs-and-practices

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