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- Gonzalez Lindh, Margareta, 1965-, et al.
(author)
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Subjective swallowing symptoms and related risk factors in COPD
- 2019
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In: ERJ Open Research. - : European Respiratory Society. - 2312-0541. ; 5:3
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Journal article (peer-reviewed)abstract
- Objectives: This study aimed to investigate the prevalence of subjective (i.e. self-reported) swallowing symptoms in a large cohort of patients with stable chronic obstructive pulmonary disease (COPD) and to identify potential related risk factors.Methods: A total of 571 patients with COPD, investigated in a stable phase, participated in this multicentre study (335 females, 236 males; mean age: 68.6 years (sd 7.7)). Data were derived from spirometry, a questionnaire and a 30-metre walking test.Results: In total, 33% (n=186) patients reported at least some degree of swallowing problem. The most frequently reported symptom was food lodging in the throat (23%). A significant relationship was found between swallowing symptoms and dyspnoea, assessed as modified Medical Research Council (mMRC) ≥2 compared with <2 (46% versus 22%; p<0.001) and health-related quality of life, assessed as the COPD Assessment Test (CAT) ≥10 (40% versus 19%; p<0.001). Swallowing problems were also related to lower physical capacity (p=0.02) but not to lung function (p>0.28).Conclusion: Subjective swallowing symptoms seem to be a common problem in patients with stable COPD. This problem is seen in all stages of the disease, but is more common in symptomatic patients and in patients with lower physical capacity.
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- Blom Johansson, Monica, 1965-, et al.
(author)
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SLP services in Sweden and in Finland : A comparative study
- 2019
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Conference paper (peer-reviewed)abstract
- Background: About ten years ago surveys were conducted in Sweden and Finland in order to investigate SLP services for people with aphasia [1, 2] and their significant others [3]. Both in Sweden and Finland there are national legislations that demands evidence-based practice. Although there are still no national clinical guidelines on aphasia rehabilitation in Sweden, such evidence-based guidelines can be found internationally, such as Australian Aphasia Rehabilitation Practice [4]. In addition, Simmons-Mackie et al. [5] has through an extensive consensus work developed the top ten best practice statements for aphasia rehabilitation.Aim: The overall aim of this study was to describe and compare how speech-language pathologists (SLPs) in Sweden and Finland work with persons with aphasia and their significant others and if these speech-language pathology (SLP) practices differ from those reported about ten years ago. Of special interest was if and how the services followed evidence-based clinical guidelines about aphasia rehabilitation.Methods: The study was conducted as a web-based survey in Sweden and Finland in September 2018. The 43-item questionnaire was responded to by 141 (78 Swedish and 63 Finnish) SLPs working with persons with aphasia and their significant others. Quantitative data were analyzed with descriptive and comparative statistics. Qualitative data (answers to open-ended questions) were analyzed with qualitative content analysis.Results: The findings suggested that despite some commonalities (such as allocated time for different types of interventions), SLP services differed both within and between the countries. Most within-countries differences were found in relation to in which rehabilitation phase (acute, sub-acute, and chronic) the participants worked but also between private or public SLP services (Finland) or between regions of the countries (Sweden). Differences between the countries concerned for instance time allocated for assessment, measures, goal setting, total number of sessions, the use of specific treatment methods, and the contact with significant others. The majority of the participants, particularly in Sweden, expressed dissatisfaction with the resources allocated to people with aphasia and their significant others. Other expressed barriers to SLP services were lack of treatment material, lack of courses for further education, long distances, too short treatment periods, and lack of SLP services after discharge from hospitals. When comparing today’s SLP services in Sweden and Finland with internationally agreed on aphasia rehabilitation guidelines several gaps were found, particularly regarding duration and intensity of interventions. Moreover, the participants expressed difficulties with evidence-based practice; barriers such as lack of psychometric sound measures, lack of evidence-based treatment methods, and the need for individual adaptations of treatment methods and materials were mentioned. In comparison with the studies of Blom Johansson et al [1, 3] and Klippi et al [2] some positive trends could be identified but no major differences were found.Conclusion:Today’s SLP services to people with aphasia and their relatives in Sweden and Finland do not fulfill internationally recommended clinical guidelines. To change SLP services and implement clinical guidelines seems to be a time-consuming process that encounters several barriers.
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- Blom Johansson, Monica, 1965-, et al.
(author)
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Språk, tal och kommunikation samt sväljning
- 2015. - 1:1
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In: Rehabiliteringsmedicin. - Lund : Studentlitteratur. - 9789144101965 ; , s. 273-286
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Book chapter (other academic/artistic)
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- Cruice, Madeline, et al.
(author)
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Reporting Interventions in Communication Partner Training : A Critical Review and Narrative Synthesis of the Literature
- 2018
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In: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 32:10, s. 1135-1166
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Journal article (peer-reviewed)abstract
- Background: Communication partner training (CPT) is an umbrella term for a complex behavioural intervention for communications partners (CPs) of people with aphasia (PWA) and possibly PWA themselves, with many interacting components, deployed in flexible ways. Recent systematic reviews (Simmons-Mackie, Raymer, Armstrong, Holland, & Cherney, 2010; Simmons-Mackie, Raymer, & Cherney, 2016) have highlighted the effectiveness of CPT in addressing the skills of conversation partners and the communicative participation of people with aphasia but have suggested that CPT has been variably delivered, with no clear picture of what the essential elements of CPT are and how CPT is expected to achieve its results through hypothesised mechanisms of change (Coster, 2013).Aim: This paper aims broadly to consider specification of CPT and describes how CPT has been conducted overall and in relation to treatment recipients. Recommendations for CPT and areas for future research are considered.Methods & Procedures: A critical review and narrative synthesis was carried out through: (i) the systematic application of the 12-item TIDieR checklist (Hoffmann et al., 2014) to the 56 studies appraised in the Simmons-Mackie et al. (2010, 2016)) reviews, providing a quantitative overview of the completeness of CPT intervention reporting; and (ii) a qualitative synthesis of the reviewed CPT literature according to TIDieR items.Outcomes & Results: Half of the TIDieR checklist items were reported by 71% or more of the studies, and the rest of the items were reported by 0–63% of studies. TIDieR items relating to the treatment (goal, rationale or theory of essential elements, materials and procedures) and provision (provider, mode, timing, dose) were more frequently reported; however, the level of detail provided was often inadequate or incomplete. The interventions were insufficiently specified to enable replication for most of the studies considered. The most infrequently reported items were: name, location, intervention tailoring and modification, and planned and actual intervention adherence/fidelity.Conclusion: For a better understanding of an intervention, it is necessary to identify and describe potentially central elements and perhaps especially in complex interventions as CPT, where it is likely also more difficult. Whilst the reviewed CPT studies are on average reporting on slightly more than half of the TIDieR items, they are overall insufficiently detailed. Some items appear easier to report on, whereas other items have not been attended to, are too complex in nature to give a full report on, or simply have not been relevant for the individual study to include.
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- Gonzalez Lindh, Margareta, 1965-, et al.
(author)
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Prevalence of swallowing dysfunction screened in Swedish cohort of COPD patients
- 2017
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In: The International Journal of Chronic Obstructive Pulmonary Disease. - 1176-9106 .- 1178-2005. ; 12, s. 331-337
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Journal article (peer-reviewed)abstract
- Background: COPD is a common problem associated with morbidity and mortality. COPD may also affect the dynamics and coordination of functions such as swallowing. A misdirected swallow may, in turn, result in the bolus entering the airway. A growing body of evidence suggests that a subgroup of people with COPD is prone to oropharyngeal dysphagia. The aim of this study was to evaluate swallowing dysfunction in patients with stable COPD and to determine the relation between signs and symptoms of swallowing dysfunction and lung function (forced expiratory volume in 1 second percent predicted). Methods: Fifty-one patients with COPD in a stable phase participated in a questionnaire survey, swallowing tests, and spirometry. A post-bronchodilator ratio of the forced expiratory volume in 1 second/best of forced vital capacity and vital capacity,0.7 was used to define COPD. Swallowing function was assessed by a questionnaire and two swallowing tests (water and cookie swallow tests). Results: Sixty-five percent of the patients reported subjective signs and symptoms of swallowing dysfunction in the questionnaire and 49% showed measurable ones in the swallowing tests. For the combined subjective and objective findings, 78% had a coexisting swallowing dysfunction. No significant difference was found between male and female patients. Conclusion: Swallowing function is affected in COPD patients with moderate to severe airflow limitation, and the signs and symptoms of this swallowing dysfunction were subjective, objective, or both.
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