Exploring the Factors Affecting Speech and Language Pathologists’ Decision to Transition from Oral to Non-Oral Feeding in Patients with Dysphagia: A Qualitative Study

Year 2023, Volume: 13 Issue: 3, 431 - 440, 21.09.2023

Mariam Kavakcı , Melike Tanrıverdi , Halil Tayyip Uysal

https://doi.org/10.33631/sabd.1342814

Abstract

Aim: Speech and language pathologists (SLP) make decisions regarding the use of alternative feeding methods when oral feeding presents a vital risk for the dysphagia patients or when the patient’s food intake is deficient. This decision affects the lives of patients from physiological, psychological, and social aspects. The decision mechanisms of SLPs involve the medical status of the patient and evaluation results. This study aims to explore factors influencing the decision of SLPs to transition from oral to non-oral feeding.
Material and Methods: Our study was conducted with a phenomenological design. Nine SLPs who had experience working with dysphagia patients participated in semi-structured interviews. Data were coded on the MAXQDA program using a thematic analysis approach.
Results: Six main themes were constructed. In addition to the medical status of the patients, participants described giving importance to the reactions of patients and relatives, the moment of explaining their decision to the patient, interactions with other professionals, work environments, experiences and educational backgrounds, and the assessments and therapies patients underwent.
Conclusion: The decision mechanisms of SLPs regarding feeding are not only affected by the physiological condition of the patient, but also by factors regarding patient relatives, the SLP’s personal approaches, communication with other professionals, the assessment process, and therapy implementation. Non-oral feeding decisions are also linked to their clinical experience and educational backgrounds. It is recommended that SLPs think multi-dimensionally about feeding transitions and give critical importance to their decision processes.

Keywords

non-oral feeding, dysphagia, speech and language pathologist, phenomenological study

Thanks

The authors would like to thank Aysegul Sari and Kubra Nur Simsek for assistance and Speech and Language Therapists who participated in our study. A part of this study was presented at the 11th European Congress of Speech and Language Therapy in May 2022, Salzburg, Austria.

Dil ve Konuşma Terapistlerinin Disfajili Hastalarda Oral Beslenmeden Oral Olmayan Beslenmeye Geçiş Kararını Etkileyen Faktörlerin Araştırılması: Nitel Bir Çalışma

Abstract

Amaç: Oral beslenme disfajili hasta için yaşamsal bir risk oluşturduğunda veya hastanın besin alımı yetersiz olduğunda, farklı alternatif beslenme yöntemlerinin kullanımına ilişkin kararı dil ve konuşma terapistleri belirler. Bu önemli karar disfajili hastaların yaşamlarını fizyolojik, psikolojik ve sosyal açılardan etkilemektedir. Dil ve konuşma terapistlerinin karar mekanizmaları, hastanın tıbbi durumunu ve değerlendirme sonuçlarını içerir. Bu çalışma, dil ve konuşma terapistlerinin oral beslenmeden oral olmayan (non-oral) beslenmeye geçiş kararını etkileyen faktörleri araştırmayı amaçlamaktadır.
Gereç ve Yöntemler: Çalışmamız fenomenolojik desende yapılmıştır. Yarı yapılandırılmış görüşmelere disfajili hastalarla çalışma deneyimi olan 9 dil ve konuşma terapisti katılmıştır. Veriler tematik analiz yaklaşımı kullanılarak MAXQDA programında kodlanmıştır.
Bulgular: Altı ana tema oluşturulmuştur. Katılımcılar, hastaların medikal durumlarının ve yapılan değerlendirmelerin ve tedavilerin yanı sıra hasta ve yakınlarının tepkilerine, kararlarını hastaya açıklama anlarına, diğer profesyonellerle etkileşimlerine, çalışma ortamlarına, deneyimlerine ve eğitimlerine önem verdiklerini ifade etmişlerdir.
Sonuç: Dil ve konuşma terapistlerinin beslenmeye ilişkin karar mekanizmalarını hastanın mevcut fizyolojik durumu kadar hasta yakınları, terapistin bireysel yaklaşımları, diğer profesyonellerle iletişim, değerlendirme süreci ve tedavi uygulaması gibi faktörler de etkilemektedir. Dil ve konuşma terapistleri tarafından verilen non-oral beslenme kararları da klinik deneyimleri ve eğitim geçmişleriyle bağlantılıdır. Dil ve konuşma terapistlerinin besleme geçişleri konusunda çok boyutlu düşünmeleri ve karar süreçlerine kritik önem vermeleri önerilir.

Keywords

non oral beslenme, disfaji, dil ve konuşma terapisti, fenomonolojik çalışma

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