Abstract
People with chronic obstructive pulmonary disease (COPD) or chronic respiratory disease demonstrate an increased prevalence of oropharyngeal dysphagia as a consequence of impaired coordination between respiration and swallowing function. To date, the effect of patient education and intervention on the management of oropharyngeal dysphagia within pulmonary rehabilitation programs has not been reported or evaluated. Data were collected on participants who were enrolled in the Outpatient Pulmonary Rehabilitation Program and who received dysphagia intervention. Intervention consisted of some or all of the following: (1) a 1-hour dysphagia education program, (2) screening for oropharyngeal dysphagia, and (3) individual comprehensive oropharyngeal dysphagia assessment and management if a screening assessment was failed. A statistically significant improvement was found in participants’ knowledge of dysphagia and COPD (P < 0.001). Participants’ retention of this knowledge 4 days post education remained statistically significant (P < 0.001). Twenty-seven percent of participants who were screened had symptoms of oropharyngeal dysphagia. Fifty-five (53%) participants receiving further individual dysphagia assessment/management correctly completed pre/post swallowing-related quality-of-life surveys (SWAL-QOL). Statistically significant improvement was found in the following subscales: Burden of Dysphagia (P < 0.009), Physical Problems of Dysphagia (P < 0.012) and Managing Diet Options/Food Selection (P < 0.016). Dysphagia education, screening, and management in a pulmonary rehabilitation program improved participants’ swallowing-related quality of life and overall self-management of chronic respiratory disease and dysphagia.
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Acknowledgments
The authors gratefully acknowledge Dr. Catherine Hill, Tanis Cameron, and Professor Alison Perry for their contributions to this article, and Sophie Rogers for her statistical analysis of the data. This study was approved by the Human Research Ethics Committee, Austin Hospital, Melbourne, Australia.
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Appendix Education Session Questionnaire
Appendix Education Session Questionnaire
Name (Please print): _________________________________ DOB: ______________
Yes | No | Unsure | |
|---|---|---|---|
1. Are people with breathing difficulties more likely to be at risk of swallowing problems? | □ | □ | □ |
2. Can swallowing problems cause pneumonia? | □ | □ | □ |
3. The term “aspiration” means food or drink going into the lungs? | □ | □ | □ |
4. Can we breath in and out as we swallow? | □ | □ | □ |
5. If you cough during a meal, is that a possible sign of swallowing problems? | □ | □ | □ |
6. Is a cough always triggered when food/drink goes down the wrong way? | □ | □ | □ |
7. Can chest infections cause swallowing problems? | □ | □ | □ |
8. Can an X-ray determine the safety of your swallow function? | □ | □ | □ |
9. If you need oxygen to help your breathing, should you take it off when eating and drinking? | □ | □ | □ |
10. Do we hold our breath for about 5 seconds when we swallow? | □ | □ | □ |
11. Are liquids always safer to swallow than solids? | □ | □ | □ |
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McKinstry, A., Tranter, M. & Sweeney, J. Outcomes of Dysphagia Intervention in a Pulmonary Rehabilitation Program. Dysphagia 25, 104–111 (2010). https://doi.org/10.1007/s00455-009-9230-3
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DOI: https://doi.org/10.1007/s00455-009-9230-3