Third party disability of family members of adults with dysphagia

Background: Third-party disability (TPD) has been studied in multiple patients including those with aphasia and hearing loss. Only one study has been done in relation to caregivers of adults with dysphagia. Third-party disability has been analysed using the International Classification of Function and Disability (ICF) framework. This study, therefore, used the ICF model to explore TPD of caregivers of adults with dysphagia for the context of Johannesburg in South Africa. Objectives: To describe how caregivers experience TPD when caring for adults with a dysphagia in Johannesburg. Methods: Data were collected from five primary adult caregivers, who were all family members, from government clinics in Johannesburg. This article reports the findings from the interviews that were analysed thematically using a top-down analysis approach. Results: Caregivers experienced challenges related to TPD mostly related to difficulties of being able to do activities of daily living for themselves, their household chores and attending social engagements. The use of body structure and function from the ICF model was not overtly applicable to the caregiver population. A new visual representation has been suggested to highlight the key themes to augment the social and psychological changes as seen on the ICF framework and demonstrated the specific interaction that these factors had on one another. Conclusion: Third-party disability is present in caregivers of patients with dysphagia. Healthcare workers need to be aware of the impact that this can have when preparing home management strategies. This newly devised representation can assist in creating a locally relevant patient-centred care approach but requires future input.

Determinants of dysphagia following stroke

Background:Swallowing is affected following stroke. Many studies focus on various aspects of swallowing difficulties (dysphagia) following stroke. However, there are not many studies on the determinants of dysphagia following stroke. The aim of the present study is to establish the association between various factors with the severity of dysphagia. Methods: After screening for Mann Assessment of Swallowing Ability (MASA),110 patients, post-stroke were selected using consecutive sampling to assess the common risk factors, namely the presence of diabetes mellitus, dyslipidemia, hypertension, alcohol usage and smoking habits. Additionally, other variables such as age, gender, type of lesion, side of lesion, tobacco chewing, speech disorders, arterial dysfunction, lobe involvement and Brunnstrom's stages, were also evaluated using a structured interview method. 2 (chi-squared) analysis was carried outto find out the association between the selected determinants and severity of dysphagia following stroke.Results: It was found that age and Brunnstrom's stages are the determinants of dysphagia, as analysis showed a strong association with a p value < 0.001. A marginal association between post-stroke dysphagia and type of lesion with a p value of 0.056 was also observed.Conclusions: Among15 factors evaluated, age, type of lesion and Brunnstrom's stages showed a significant association with the severity of dysphagia following stroke. This study advocates early dysphagia management for elderly patients with high Brunnstrom's grading, for those who are not expected to spontaneously recover following stroke, and for earlier and better community rehabilitation

Knowledge of Nurses Regarding Dysphagia in Patients Post Stroke in Namibia

Background: Stroke patients commonly experience dysphagia post stroke. Complications of dysphagia include aspiration leading to chest infection and pneumonia; malnutrition; dehydration; and a subsequent increased risk of death. Its early diagnosis and management is an important prerequisite for recovery from stroke during the rehabilitation phase. As nurses are the first health personnel that interact with a patient post stroke; it is important that they are knowledgeable and skilled in the screening of these patients for dysphagia. Objective: The aim of the study was to determine the knowledge and factors associated with knowledge of nurses regarding dysphagia in stroke patients. Methods: The study used a quantitative survey to determine the knowledge of the nurses employed at an intermediate hospital in Namibia. A convenient sample of 182 participants completed a self-administered questionnaire with closed-ended questions; which was developed by the researcher. The data was analysed using descriptive and inferential statistics. Results: The findings of the study confirmed that nurses have a moderate knowledge of the signs; symptoms; and complications of dysphagia; but poor knowledge about its management.Training and experience in the care of dysphagia patients was a stronger predictor of knowledge than the initial qualification or years of experience as a nurse. Conclusion: Post basic training in dysphagia would better equip nurses to manage stroke patients in the acute phase

Pattern of dysphagia in Calabar

A retrospective study of dysphagia in 55 children; aged between six months and 12 years (mean age 4.3 years) in Calabar; has revealed foreign body impaction in the throat to be the commonest cause; occurring in 40.0 percent of the cases. Children; aged between five and 10 years; were commonly involved in foreign body impaction which was caused by coins and food (meat and fish bones) in 31.8 and 27.3 percent respectively; of the 22 cases. Oesophageal stricture due to accidental ingestion of caustic soda was found in 14.5 percent of the cases and involved children in the age group; six to eight years. The cause of dysphagia was however; unknown in 25.5 percent of the patients. Malnutrition (56.4 percent) and aspiration pneumonia (27.3 percent) were the major complications in the series. It is concluded that most of the causes of dysphagia in the series are preventable