Speech-language pathologists’ perspectives of dysphagia following reperfusion therapies: An Australian mixed-methods study

Abstract

Purpose

To investigate speech-language pathologists’ (SLPs) perceptions and clinical experiences of dysphagia management following reperfusion therapies.

Method

A multi-staged mixed approach involving a two-phase cross-sectional design was used. Data generated during phase 1 (a purpose-built, online survey) guided the development of phase 2 (semi-structured interviews). Sixty-two SLPs participated in phase 1 and six SLPs participated in phase 2.

Result

SLPs in both phases reported perceived changes in dysphagia presentation according to the success of reperfusion therapy administered and had concerns regarding worsened dysphagia following unsuccessful procedures. Fluctuations in dysphagia were more frequently reported in the acute stage post-stroke. SLPs reported increased workload demands due to increased interhospital transfers between ECR/thrombolysis centres and referring facilities. The optimal timing for swallowing screening and assessment was not identified, with initial SLP involvement ranging from during the administration of thrombolysis to up to 24 hours post-reperfusion therapy.

Conclusion

Preliminary evidence suggests that SLPs perceive that the presentation of post-stroke dysphagia is changing, with increasing fluctuations and complexities in the acute stage of post-stroke care, within the context of increasing use of reperfusion therapies. There is a critical need for research investigating the trajectory of dysphagia in the acute stage to inform dysphagia management within this patient population.

Keywords:

• Stroke
• thrombolysis
• endovascular clot retrieval
• dysphagia
• speech-language pathology

Acknowledgements

The authors wish to thank the Royal Brisbane and Women’s Hospital and Princess Alexandra Hospital Speech Pathology Departments for their assistance with development of the survey arm. Multiple speech pathologists of varying levels of experience (rotational, clinical positions, and higher managerial positions) were involved in reviewing survey questions prior to pilot testing. The authors also wish to thank the SLPs who contributed their time and knowledge through participation in this study. In addition, the authors acknowledge the administrators of Speech Pathology Email ChatS (SPECS) and dysphagia interest groups for dissemination of the study.

Declaration of interest

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed at https://doi.org/10.1080/17549507.2022.2140830.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.

Additional information

Funding

The first author was supported by the Royal Brisbane and Women’s Hospital (RBWH) Foundation Postgraduate Scholarship.