The safe swallow; a difficult act to follow. Prevalence, professional practice, and patient perspectives in swallowing disorders (oropharyngeal dysphagia).

Prevalence, professional practice, and patient perspectives in swallowing disorders (oropharyngeal dysphagia)The doctoral candidate defended her thesis in June. Submitted changes in the project have been approved which will allow the completion of study II which was postponed due to difficulties from COVID. This study aims to establish an estimated prevalence of OD in adults admitted to rehabilitation hospitals in South-Eastern Norway.This project has resulted in the completion of a PhD in the field of oropharyngeal dysphagia (OD), the first of it's kind in Norway. OD is difficulty with the mastication and swallowing of food and/or liquids from the mouth to the esophagus. The mouth and pharynx (throat) are not only responsible for the transportation of food and liquids to the esophagus, but also for the production of speech and respiration. Thus, swallowing is a complex neurological process for which small anatomical or physiological changes in swallowing function can result in serious medical and psychosocial problems. These problems, such as, malnutrition, dehydration, aspiration pneumonia, fear for eating, anxiety during mealtimes and sosial isolation have a negative effect quality of life. OD is commonly seen in the elderly and is a result of a number of underlying diseases or injuries, such as stroke, head injury, Parkinson's disease or head and neck cancer. The prevalence of OD may vary depending on several factors such as age, diagnosis, timing and type of screening or assessment. While the majority of prevalence studies in the literature have estimated prevalence of OD in relation to age or diagnosis, the first study of this project, estimated the prevalence of OD in adults admitted to healthcare settings. The main findings of this systematic review and meta-analysis showed a high estimated overall prevalence of OD in all healthcare settings with percentages increasing from the hospital, to rehabilitation, and with the highest prevalence occuring in the nursing home setting. This study was published online in May 2022 and results also highlighted a need for more prevalence research in rehabilitation and palliative healthcare settings. The second study of this project aims to estimate the prevalence of OD in adults admitted to rehabilitation hospitals in South-Eastern Norway. As mentioned in the 2022 e-rapport, this study has beed postponed due to COVID. Time constraints of the allotted PhD period required that the doctoral candidate complete an external study, thus postponing study II. However, approval for changes in the project have been granted and preparations to carry out this study in 2024-2025 have begun. Due to the complexity of OD, it is common for many different healthcare professions to be involved in it's management. The third study of this project contributed to knowledge about the current level of training, skills and service practices provided by healthcare professionals working with adults with OD in the Nordic countries. This study was published in February 2023 and revealed that professionals central in the assessment and treatment of adults with OD, specifically nurses, occupational therapists (OTs) and speech language pathologists (SLPs), had a minimal amount of educational and practical training in OD. In addition, the use of valid tools for the identification and assessment of OD and use of evidence-based rehabilitative treatment methods were limited. Findings indicated a need for guidelines that help improve the educationl and practical requirements needed for healthcare professionals responsible in the management of OD. The fourth study of this project - was a validation study of the Norwegian version of the Swallowing Quality of Life (Nor-SWAL-QOL) was published in 2019. Access to this tool will help shed light on the perspectives of people with OD and how it effects thier quality of life.