Oropharyngeal dysphagia in adults: Prevalence, professional practices, patient perspectives and treatment outcomes
Abstract
Background: Oropharyngeal dysphagia (OD) is defined as any disruption in the
transportation of food/liquids safely and efficiently from the mouth, through the
pharynx and into the esophagus. The underlying causes of OD in adults are numerous
and the consequences may have devastating effects on a person’s health and quality of
life.
Overall aim: Contribute to a stronger evidence base for the identification and
treatment of OD in adults.
Results: Study I was a cultural adaptation and validation study resulting in the first
valid and reliable dysphagia-specific health related quality of life questionnaire for the
Norwegian population. Study II was a systematic review and meta-analyses that
revealed considerable heterogeneity in the definition of OD and type and quality of
outcome measures used to determine prevalence. Estimated pooled OD prevalence of
36.5%, 42.5% and 50.2% in the hospital, rehabilitation and nursing home settings,
respectively. There were no eligible studies identified for OD prevalence in palliative
care. In Study III survey results from 396 nurses, occupational therapists and speech-
language pathologists in the Nordic countries showed notable professional role
differences between countries, minimal education and practical training in OD, and
limited use of evidence-based practice in screening, assessments and rehabilitative
treatment for OD. Study IV was an exploratory randomised control study including 15
participants with Parkinson’s disease or multiple sclerosis. Findings revealed no
change in swallowing function following expiratory muscle strength training, as
assessed by flexible endoscopy, despite significantly improved maximal expiratory
pressure and positive results from patient-reported outcome measures.
Conclusions: There is a high prevalence of OD in healthcare settings. Currently,
education curriculums and use of existing evidence-based outcome measures and
rehabilitative treatment in the management of adults with OD in the Nordic countries
are minimal. The inclusion of patient-reported outcomes in the management of OD is
needed along with continued research in the use of rehabilitative treatments of OD in
people with Parkinson’s disease or multiple sclerosis.
Parts of work
I. Rivelsrud, M. C., Kirmess, M., & Hartelius, L. (2019). Cultural adaptation and validation
of the Norwegian version of the swallowing quality of life questionnaire (SWAL-QOL).
Health and quality of life outcomes, 17(1), 179.
https://doi.org/10.1186/s12955-019-1248-0 II. Rivelsrud, M. C., Hartelius, L., Bergström, L., Løvstad, M., & Speyer, R. (2023).
Prevalence of oropharyngeal dysphagia in adults in different healthcare settings: a
systematic review and meta-analyses. Dysphagia, 38(1), 76–121.
https://doi.org/10.1007/s00455-022-10465-x III.Rivelsrud, M.C., Hartelius, L., Speyer, R., & Løvstad, M. Qualifications, professional roles and service practices of nurses, occupational therapists and speech-language pathologists in the management of adults with oropharyngeal dysphagia: a Nordic survey, Logoped PhoniatrVocol. 2023 Feb 14:1-13. https://doi.org/10.1080/14015439.2023.2173288 IV. Rivelsrud, M.C., Antonsson, M., Løvstad, M., Speyer, R., Johansson, K., & Hartelius, L. Effects of expiratory muscle strength training on swallowing function in people with Parkinson’s disease or multiple sclerosis as assessed by flexible endoscopic evaluation of swallowing. Manuscript
Degree
Doctor of Philosophy (Medicine)
University
University of Gothenburg. Sahlgrenska Academy
Institution
Institute of Neuroscience and Physiology. Department of Health and Rehabilitation
Disputation
Onsdagen den 14 juni 2023, kl. 9.00, Hälsovetarbacken rum 2119 (hus 2, ingång F), Arvid Wallgrens backe
https://gu-se.zoom.us/j/67375947219?pwd=NHNHbHJMcVFnTnBmUEhPeUZjN3hTZz09
Date of defence
2023-06-14
Date
2023-05-25Author
Caya Rivelsrud, Maribeth
Keywords
Swallowing
assessment
rehabilitation
quality of life
evidence base
Publication type
Doctoral thesis
ISBN
978-91-8069-286-1 (PDF)
978-91-8069-285-4 (PRINT)
Language
eng