LANGUAGE IN INDIA

Strength for Today and Bright Hope for Tomorrow

Volume 24:9 September 2024
ISSN 1930-2940

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         B. Mallikarjun, Ph.D.
         A. R. Fatihi, Ph.D.
         G. Baskaran, Ph.D.
         T. Deivasigamani, Ph.D.
         Pammi Pavan Kumar, Ph.D.
         Soibam Rebika Devi, M.Sc., Ph.D.

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Bedside Assessment of Dysphagia:
A Retrospective Study at a Tertiary Care Hospital in Nepal

Ms. Prabha Dawadee and Bebek Bhattarai

Abstract

The bedside assessment of dysphagia is a crucial method for gaining essential insights into a patient's ability to swallow. This evaluation involves a thorough examination of the patient's medical and swallowing history, a detailed assessment of the anatomy of the mouth, throat, and voice box, and an evaluation of sensory and motor functions, behavior, cognitive abilities, and language skills, along with trying different foods and fluids. Despite being in the early stages of development in Nepal, addressing and treating swallowing disorders are vital efforts. The aim of this study is to document the data obtained from the bedside assessment of dysphagia, using a protocol developed at TUTH. Conducted retrospectively at a tertiary care facility, the evaluation included comprehensive history-taking and trials with food and fluids, along with the use of standardized outcome measures such as the FOIS and RBHOMRS. The results show that 114 out of 121 patients had varying degrees of dysphagia. Therefore, the bedside assessment protocol emerges as a reliable tool for evaluating dysphagia, especially in regions like Nepal where instrumental assessments for swallowing are not yet widely available.

Keywords: Dysphagia, Bedside evaluation, Swallowing, Deglutition, Speech-Language Pathologist

Introduction

Dysphagia, characterized by difficulty in swallowing, often stems from either structural or neuromuscular issues affecting the oro-pharynx or esophagus. Following a stroke, dysphagia is a prevalent concern, with estimates ranging from 22% to 78% depending on various factors such as the underlying cause and timing post-stroke(O’Horo et al., 2015; Sk et al., 2000). This condition significantly contributes to complications like aspiration pneumonia, malnutrition, dehydration, heightened mortality rates, and prolonged hospital stays. Identifying and addressing dysphagia early on is crucial to mitigate the risk of pneumonia, reduce hospitalization duration, and enhance cost-effectiveness by minimizing the need for prolonged medical care.

Nepal, a small and developing country in South Asia, is still in the early stages of understanding swallowing disorders and dysphagia. A survey on the awareness of role of Speech-Language Pathologists (SLPs) for managing dysphagia among medical professionals in Nepal revealed a significant lack of awareness. Approximately 78.4% of professionals admitted to rarely referring patients with dysphagia to SLPs (Dawadee et al., 2017). Similarly, nurses working in tertiary care hospitals in Nepal displayed only a moderate level (62.39%) of knowledge about dysphagia (Nepal & Sherpa, 2019). The lack of research on the incidence and prevalence of dysphagia in Nepal may be attributed to a shortage of professionals interested in dysphagia feild or the aforementioned lack of awareness. However, globally, the community prevalence of dysphagia ranges from 2% to 20% (Adkins et al., 2020)

This is only the beginning part of the article. PLEASE CLICK HERE TO READ THE ENTIRE ARTICLE IN PRINTER-FRIENDLY VERSION.

Ms. Prabha Dawadee
Speech-Language Pathologist, Lecturer
Maharajgunj Medical Campus
Institute of Medicine, TU, Nepal
prabhadawadee@gmail.com

Bebek Bhattarai
Pediatric Audiologist
Royal Hospital for Children Glasgow, Scotland, United Kingdom
bebek.bhattarai@gmail.com
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