Current evaluation of upper oesophageal sphincter opening in dysphagia practice: an international SLT survey

Authors

  • Julie Regan,

    1. SLT Department, Adelaide and Meath Hospital, AMNCH, Tallaght, Dublin, Ireland
    2. Department of Clinical Medicine, Trinity College Dublin, Dublin 2, Ireland
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  • Margaret Walshe,

    1. Clinical Speech and Language Studies, Trinity College Dublin, Dublin 2, Ireland
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  • Barry P. McMahon

    1. Medical Physics & Clinical Engineering, Adelaide and Meath Hospital, AMNCH, Tallaght, Dublin 24, Ireland
    2. Department of Clinical Medicine, Trinity College Dublin, Dublin 2, Ireland
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Julie Regan, SLT Department, Adelaide and Meath Hospital, AMNCH, Tallaght, Dublin 24, Ireland; e-mails: reganju@tcd.ie and julie.regan@amnch.ie

Abstract

Background: The assessment of adequate upper oesophageal sphincter (UOS) opening during swallowing is an integral component of dysphagia evaluation.

Aims: To ascertain speech and language therapists’ (SLTs) satisfaction with current methods for assessing UOS function in people with dysphagia and to identify challenges encountered by SLTs with UOS evaluation.

Methods & Procedures: A survey was disseminated to 82 SLT managers in Ireland; to two dysphagia Special Interest Groups in the UK; and to the Royal College of Speech & Language Therapists’Bulletin periodical. A survey link was also posted on the American Speech and Hearing Association (ASHA) Division 13 (Dysphagia) web forum.

Outcomes & Results: Surveys from 224 SLTs with active dysphagia caseloads were included in data analysis. Only 17.9% (40/224) of SLTs were satisfied with the accuracy and reliability of UOS evaluations currently being employed in dysphagia practice. Satisfaction with current UOS evaluation was not associated with the level of clinical experience (r= 0.078; p= 0.246). Eighty-seven per cent (195/224) of SLTs working with dysphagia experience challenges in UOS evaluation. Challenges reported include lack of resources/equipment (55.9%), limited quantitative information (45.6%), lack of training (41%) and knowledge (39%) in UOS function, and limited multidisciplinary team involvement (34%).

Conclusions & Implications: SLTs across all levels of clinical experience are not satisfied with current UOS evaluation in dysphagia practice. Based on the specific challenges identified, recommendations to progress SLT evaluation of UOS function in people with dysphagia are proposed.

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