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Practice Patterns and Attitudes Among Speech–Language Pathologists Treating Stroke Patients with Dysphagia: A Nationwide Survey

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Abstract

Dysphagia management is a core component of quality stroke care. Speech–Language Pathologists (SLPs) play a key role in the management of post-stroke dysphagia. We sought to elicit perceptions, attitudes, and practice patterns regarding post-stroke dysphagia management among SLPs in the United States. We conducted a survey among SLPs registered with the American Speech–Language–Hearing Association who indicated that they care for acute stroke patients. A total of 336 participants completed the survey. Over half of the participants (58.6%) indicated that they obtain objective swallow testing in ≥ 60% of their post-stroke dysphagia patients. Almost 1 in 5 SLPs indicated that they are often unable to perform objective dysphagia testing due to limited resources (18.8% indicated resource limitations; 78.9% indicated no resources limitations; 2.4% were unsure). SLPs in hospitals without stroke center certification had higher odds of indicating limited resources compared to SLPs in certified stroke centers (OR 2.08, 95% CI 1.11–3.87). Over 75% indicated that percutaneous endoscopic gastrostomy (PEG) tubes after stroke are placed too early. SLPs who obtain objective swallow testing in ≥ 60% of patients had higher odds of indicating that PEG tubes are placed too early (OR 1.70, 95% CI 1.13–2.56). While 19.4% indicated that the optimal timing for PEG after stroke is < 7 days after admission, 25.0% indicated that the optimal timing is > 12 days. Almost 35% indicated that health care system pressures influence their recommendations, and 47.6% indicated that ≥ 25% of PEGs could be avoided if patients were given up to 7 more days for swallowing recovery.

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Funding

Dr. Faigle is supported by a National Institute of Neurological Disorders and Stroke career development award (K23NS101124).

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Author notes

  1. Bridget J. Chen and Deji Suolang have contributed equally.

Authors and Affiliations

  1. Department of Neurology, Johns Hopkins University School of Medicine, 600 N Wolfe Street, Phipps 484, Baltimore, MD, 21287, USA

    Bridget J. Chen, Deji Suolang & Roland Faigle

  2. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Nicole Frost

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  1. Bridget J. Chen
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  2. Deji Suolang
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  4. Roland Faigle
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Correspondence to Roland Faigle.

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Chen, B.J., Suolang, D., Frost, N. et al. Practice Patterns and Attitudes Among Speech–Language Pathologists Treating Stroke Patients with Dysphagia: A Nationwide Survey. Dysphagia 37, 1715–1722 (2022). https://doi.org/10.1007/s00455-022-10432-6

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