Factors affecting dysphagia management and compliance with recommendations in non-metropolitan healthcare settings

Abstract

It is acknowledged that a team approach to management of stroke is essential to improving patient outcomes. For the speech-language pathologist (SLP), communication and swallowing are key concerns in stroke rehabilitation. However, little is known about how services are provided following stroke in non-metropolitan areas. This paper presents findings from a study investigating issues related to the provision of dysphagia services in non-metropolitan New South Wales (NSW) and Victoria. The theme ‘You've got to have an impact’ was one of the major themes identified from analysis of data gathered via semi-structured interviews with eight SLPs. Participants in this study highlighted compliance with recommendations as a point of breakdown in the care of the patient with dysphagia. Underlying compliance were issues related to team functioning that could hold the key to improving outcomes. These findings have implications for non-metropolitan SLPs' ability to participate within a stroke team, for the way care for patients with dysphagia is conceptualized, and for improvement of compliance with SLP recommendations.

Keywords:

• Dysphagia
• stroke
• professional issues

Acknowledgements

We would like to sincerely thank the speech-pathologists involved in the interviews undertaken for this research. We would also like to acknowledge Speech Pathology Australia Post-Graduate Grants for supporting phase 2 of this research program. This paper presents a portion of the first author's PhD research, which was supervised by the second and third authors.

This research was approved by the Charles Sturt University Human Research Ethics Committee (protocol no. 2003/184; 2003/197; 2007/002), and was conducted in accordance with the ethical standards of this committee and the Helsinki Declaration of 1975, as revised in 1983.