Dysphagia in cervical spinal cord injury: How international literature trends can guide South African practice patterns - A scoping review.

IF 1 Q4 REHABILITATION South African Journal of Physiotherapy Pub Date : 2021-05-10 eCollection Date: 2021-01-01 DOI:10.4102/sajp.v77i1.1542
Kim A Coutts
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引用次数: 1

Abstract

Background The limited data regarding dysphagia in high-level spinal cord injuries (SCIs) stem from economically developed countries. Dysphagia is prevalent in patients with cervical SCI; however, in a South African context, speech-language pathologists (SLPs) are not seen as key when managing this population. This may result in patients not being screened or identified early, leading to possible complications. The literature could provide useful insight on how best to address this clinical gap. Objectives The aim of my study was to conduct a scoping review on the description of dysphagia, the risk factors for developing dysphagia post-SCI and the practice patterns of team members working with dysphagia in cervical SCIs. Methods A five-step scoping review was undertaken. Data were analysed by using descriptive statistics as well as a thematic analysis by using a top-down approach. Results Through the process of screening according to the inclusion and exclusion criteria, 25 articles were included. Primarily, the pharyngeal phase was affected, which can lead to an aspiration pneumonia. The key risk factors were the presence of a tracheostomy tube, the use of ventilation and anterior spinal cord surgery. There was little mention regarding specific practice patterns, but an interdisciplinary approach was suggested as the most efficient model. Conclusions Specific guidelines and management options need to be considered for a South African context, given the high incidence of trauma-related injuries. There needs to be locally produced research, providing suggestions on how different team members can screen and identify dysphagia within this population. Solutions need to be unique, and contextually responsive and appropriate. Clinical implications The team members and the roles of these different team members need to be re-examined in order to ensure the early identification and management of cervical SCI patients who are at risk of developing a dysphagia.

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颈脊髓损伤的吞咽困难:国际文献趋势如何指导南非的实践模式-范围审查。
背景:关于高水平脊髓损伤(SCIs)中吞咽困难的有限数据来自经济发达国家。吞咽困难在颈椎脊髓损伤患者中很常见;然而,在南非的背景下,语言病理学家(slp)在管理这一人群时并不被视为关键。这可能导致患者没有得到筛查或早期发现,从而导致可能的并发症。这些文献可以为如何最好地解决这一临床差距提供有用的见解。目的:我的研究目的是对吞咽困难的描述、脊髓损伤后发生吞咽困难的危险因素以及治疗颈椎脊髓损伤患者吞咽困难的团队成员的实践模式进行范围综述。方法:采用五步范围审查。数据分析采用描述性统计和专题分析采用自上而下的方法。结果:按照纳入和排除标准进行筛选,共纳入25篇文献。首先,咽部阶段受到影响,这可能导致吸入性肺炎。主要的危险因素是气管造口管的存在、通气的使用和脊髓前路手术。很少提及具体的实践模式,但建议采用跨学科的方法作为最有效的模式。结论:鉴于南非创伤相关损伤的高发生率,需要考虑具体的指导方针和管理方案。需要在当地进行研究,为不同的团队成员如何在这一人群中筛查和识别吞咽困难提供建议。解决方案必须是独特的,并在上下文中响应和适当。临床意义:需要重新审视团队成员和这些不同团队成员的角色,以确保早期识别和管理有发生吞咽困难风险的颈椎脊髓损伤患者。
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来源期刊
CiteScore
1.70
自引率
9.10%
发文量
35
审稿时长
30 weeks
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