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Instrumental swallowing assessment in adults in residential aged care homes : A scoping review

Birchall, Olga
Bennett, Michelle
Lawson, Nadine
Cotton, Susan M.
Vogel, Adam P.
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Abstract
Objectives To systematically describe evidence on the use of instrumental swallowing assessment for residents of aged care homes. Design Scoping review using the Joanna Briggs Institute methodology for scoping reviews. Setting and Participants Published peer-reviewed and gray literature written in English between 2000 and 2020 about instrumental swallowing assessment (ISA) in adults in residential aged care homes (RACHs). Measures A systematic, 3-tiered search of databases including Medline, CINAHL, Embase, Scopus, and Cochrane Database of Systematic Reviews, and gray literature databases was conducted. Content analysis identified common themes. Results Forty-two sources, 30 from peer-reviewed journals, 12 gray literature publications, and 66 websites of mobile ISA providers that discussed videofluoroscopic swallowing studies (VFSS) and/or fiberoptic endoscopic evaluation of swallowing (FEES) use in RACHs were included. Most peer-reviewed sources were referenced narratives or surveys of speech pathology practice patterns (53.3%). Researchers in 3 studies used onsite mobile FEES and in 2 studies off-site VFSS, with adults living in RACHs, as part of their research design (16.7%). There were 66 mobile instrumental swallowing assessment provider websites, based within the United States. Three countries (Australia, United States, United Kingdom) had professional guidelines that stipulated minimal requirements for the safe and appropriate provision of ISA services across settings. Themes identified across sources included (1) the approach to swallowing management and clinical indicators for ISA, (2) the role of ISA, (3) service and consumer influences on ISA, and (4) mobile FEES. Conclusions and Implications There is a paucity of quality research on instrumental swallowing assessment in adults living in RACHs. There are broad regional and international variances in the way that videofluoroscopy and FEES are accessed and used. A more robust evidence base is required to guide health professionals to design tailored ISA care pathways for residents of RACHs, to achieve high-quality health, social, and economic outcomes.
Keywords
dysphagia, fiberoptic endoscopic evaluation of, swallowing, videofluoroscopy, older adult, nursing, residential
Date
2021
Type
Journal article
Journal
Journal of the American Medical Directors Association (JAMDA): long-term care: management, applied research and clinical issues
Book
Volume
22
Issue
2
Page Range
372-379
Article Number
ACU Department
School of Allied Health
Faculty of Health Sciences
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Open Access Status
License
All rights reserved
File Access
Controlled
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