Screening for Dysphagia: Perspectives and Practices of Speech and Language Therapists in the Republic of Ireland

Folia Phoniatr Logop. 2017;69(5-6):226-238. doi: 10.1159/000486031. Epub 2018 Mar 22.

Abstract

Objective: Clinical guidelines place considerable emphasis on early swallow screening, as it has significant impact on patient outcomes. This study aims to examine perspectives and practices of speech and language therapists (SLTs) in the Republic of Ireland on swallow screening, exploring challenges in screening methods to improve practice and facilitate research.

Methods: An 18-item web-based survey was devised targeting SLTs working in dysphagia in Republic of Ireland. Perspectives were sought on definitions of screening, models of practice, tests used, and factors influencing decision-making.

Results: Fifty-eight SLTs responded, representing a cross section of clinical settings, populations, and experience. Screening tests most frequently employed were personal screening tests (80%). Important considerations reported in test selection were patient safety (100%), ease of use (97%), staffing (97.5%), and diagnostic accuracy (97.5%). Perceived challenges were staff training associated with screening.

Conclusions: It is concerning that while diagnostic accuracy was recognised as important, most respondents used tests lacking in diagnostic accuracy. While the survey response rate was low, it is hypothesised that findings reflect practice. There is a need for SLTs to equip themselves with the skills to discern which screening test is most diagnostically accurate for clinical populations with further research to improve practice.

Keywords: Dysphagia; Screening; Speech and language therapy; Survey.

MeSH terms

  • Attitude of Health Personnel*
  • Australasia
  • Clinical Competence
  • Cross-Sectional Studies
  • Deglutition Disorders / diagnosis*
  • Europe
  • Forecasting
  • Guidelines as Topic
  • Humans
  • Ireland
  • Language Therapy*
  • Mass Screening* / methods
  • Mass Screening* / standards
  • Models, Theoretical
  • North America
  • Sensitivity and Specificity
  • Singapore
  • South Africa
  • Speech Therapy*
  • Surveys and Questionnaires