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Dysphagia

, Volume 19, Issue 3, pp 165–176 | Cite as

Oropharyngeal Dysphagia: Surveying Practice Patterns of the Speech–Language Pathologist

  • Rosemary Martino
  • Gaylene Pron
  • Nicholas E. Diamant
Article

Abstract

The present study was designed to obtain a comprehensive view of the dysphagia assessment practice patterns of speech–language pathologists and their opinion on the importance of these practices using survey methods and taking into consideration clinician, patient, and practice-setting variables. A self-administered mail questionnaire was developed following established methodology to maximize response rates. Eight dysphagia experts independently rated the new survey for content validity. Test–retest reliability was assessed with a random sample of 23 participants. The survey was sent to 50 speech–language pathologists randomly selected from the Canadian professional association database of members who practice in dysphagia. Surveys were mailed according to the Dillman Total Design Method and included an incentive offer. High survey (64%) and item response (95%) rates were achieved and clinicians were reliable reporters of their practice behaviors (ICC>0.60). Of all the clinical assessment items, 36% were reported with high (>80%) utilization and 24% with low (<20%) utilization, the former pertaining to tongue motion and vocal quality after food/fluid intake and the latter to testing of oral sensation without food. One-third (33%) of instrumental assessment items were highly utilized and included assessment of bolus movement and laryngeal response to bolus misdirection. Overall, clinician experience and teaching institutions influenced greater utilization. Opinions of importance were similar to utilization behaviors (r = 0.947, p = 0.01). Of all patients referred for dysphagia assessment, full clinical assessments were administered to 71% of patients but instrumental assessments to only 36%. A hierarchical model of practice behavior is proposed to explain this pattern of progressively decreasing item utilization.

Keywords

Dysphagia Practice patterns Survey Clinical Instrumental Deglutition Deglutition disorders 

Notes

Acknowledgments

The authors thank the following dysphagia experts for their involvement in item generation: Cathy Lazarus, Jeri A. Logemann, JoAnne Robbins, Barbara C. Sonies, and Jonathan Aviv.

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Rosemary Martino
    • 1
  • Gaylene Pron
    • 2
  • Nicholas E. Diamant
    • 3
  1. 1.Departments of Speech Language Pathology and the Toronto Western Research Institute, University of Toronto and Department of Speech Language PathologyUniversity Health NetworkTorontoCanada
  2. 2.Departments of Public Health Service, Clinical Epidemiology and Health Care Research ProgramUniversity of TorontoTorontoCanada
  3. 3.Departments of Speech Language Pathology, Gastroenterology Medicine, Physiology, and the Toronto Western Research InstituteUniversity of Toronto, Department of Speech Language Pathology and Gastroenterology Medicine, University Health NetworkTorontoCanada

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