<div> <section> <h3> Background</h3> <p>The MD Anderson Dysphagia Inventory (MDADI) is a widely used patient-reported outcome measure (PROM) which assesses dysphagia-related quality of life (QoL) in head and neck cancer (HNC). Despite its common use in HNC research and clinical practice, few of its psychometric properties have been reappraised since its inception. The aim of this study was to perform a survey-based qualitative analysis of UK HNC clinicians’ perceptions of the content validity of the MDADI, evaluating it across the parameters of relevance, comprehensiveness and comprehensibility as per the COSMIN guideline for PROM assessment.</p> </section> <section> <h3> Results</h3> <p>Four themes relating to the content validity of the MDADI were identified: (1) MDADI items lack clarity of definition of the terms ‘swallowing’, ‘eating’ and ‘dysphagia’; (2) the MDADI is perceived to be overly negative in tone including items that service users may find distressing or disempowering; (3) items in the tool are exclusory to specific subgroups of patients, such as those who are nil by mouth or socially isolated; and (4) modifications to the MDADI were suggested and encouraged to make it more clinically useful and patient-centred.</p> </section> <section> <h3> Conclusions</h3> <p>This study indicates that MDADI's content validity is ‘insufficient’ when rated by COSMIN parameters. This has significant implications for its continued use in HNC research and clinical practice. Further re-evaluation of the content validity of the MDADI is warranted, with potential future amendment of items being indicated if the results of this study are corroborated in subsequent research.</p> </section> <section> <h3> What this paper adds</h3> <section> <h3> What is already known on the subject</h3> <div> <ul> <li>The MD Anderson Dysphagia Inventory (MDADI) patient-reported outcome measure of dysphagia-related quality of life is widely used in clinical practice and international clinical trials. Content validity is considered to be the most important property of a tool when assessing its psychometric strengths and weaknesses; however, the MDADI's content validity has not been reappraised since its initial development.</li> </ul> </div> </section> <section> <h3> What this paper adds to existing knowledge</h3>
{"title":"Assessment of patients with head and neck cancer using the MD Anderson Dysphagia Inventory: Results of a study into its comprehensiveness, comprehensibility and relevance to clinical practice","authors":"Kate Toft, Catherine Best, Jayne Donaldson","doi":"10.1111/1460-6984.13026","DOIUrl":"10.1111/1460-6984.13026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The MD Anderson Dysphagia Inventory (MDADI) is a widely used patient-reported outcome measure (PROM) which assesses dysphagia-related quality of life (QoL) in head and neck cancer (HNC). Despite its common use in HNC research and clinical practice, few of its psychometric properties have been reappraised since its inception. The aim of this study was to perform a survey-based qualitative analysis of UK HNC clinicians’ perceptions of the content validity of the MDADI, evaluating it across the parameters of relevance, comprehensiveness and comprehensibility as per the COSMIN guideline for PROM assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four themes relating to the content validity of the MDADI were identified: (1) MDADI items lack clarity of definition of the terms ‘swallowing’, ‘eating’ and ‘dysphagia’; (2) the MDADI is perceived to be overly negative in tone including items that service users may find distressing or disempowering; (3) items in the tool are exclusory to specific subgroups of patients, such as those who are nil by mouth or socially isolated; and (4) modifications to the MDADI were suggested and encouraged to make it more clinically useful and patient-centred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study indicates that MDADI's content validity is ‘insufficient’ when rated by COSMIN parameters. This has significant implications for its continued use in HNC research and clinical practice. Further re-evaluation of the content validity of the MDADI is warranted, with potential future amendment of items being indicated if the results of this study are corroborated in subsequent research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> What this paper adds</h3>\u0000 \u0000 <section>\u0000 \u0000 <h3> What is already known on the subject</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>The MD Anderson Dysphagia Inventory (MDADI) patient-reported outcome measure of dysphagia-related quality of life is widely used in clinical practice and international clinical trials. Content validity is considered to be the most important property of a tool when assessing its psychometric strengths and weaknesses; however, the MDADI's content validity has not been reappraised since its initial development.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> What this paper adds to existing knowledge</h3>\u0000 ","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"59 5","pages":"1691-1700"},"PeriodicalIF":1.5,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1460-6984.13026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Previous studies on language production in normal ageing have primarily focused on distinct dimensions of older adults’ spoken language performance, such as fluency and complexity. However, little attention has been paid to the complex, interconnected relations between these dimensions. Additionally, older adults have been treated as a homogeneous group, with little consideration for the differential characteristics of language performance across different stages of ageing.</p> </section> <section> <h3> Aims</h3> <p>This study aims to investigate how increasing age impacts Chinese seniors’ oral language performance, focusing on fluency (articulation rate and dysfluency rate), complexity (lexical and syntactic) and the potential interactions between these dimensions.</p> </section> <section> <h3> Methods & Procedures</h3> <p>Spontaneous oral narratives were collected from 60 normally ageing individuals, who were categorised into three groups: young-old (60–69 years old), middle-old (70–79 years old) and old-old (≥80 years old). Four measures for assessing language performance, namely, articulation rate, dysfluency rate, lexical complexity and syntactic complexity, were derived from the oral narratives. Dynamic systems techniques, including moving correlations, locally estimated scatterplot smoothing and Monte Carlo simulations, were employed for data analysis.</p> </section> <section> <h3> Outcomes & Results</h3> <p>This study revealed two major findings. First, across different age groups, the seniors’ oral narratives significantly differed in the aspect of articulation rate and syntactic complexity. Specifically, both the young-old and the middle-old groups exhibited significantly higher articulation rates than the old-old group; the middle-old group also demonstrated significantly higher syntactic complexity compared to the old-old group. Second, the distinct subsystems (i.e., articulation rate, dysfluency rate, lexical and syntactic complexity) of seniors’ oral narratives demonstrated varying interactions across different stages of ageing. While these subsystems tended to coordinate with each other in young-old individuals, they exhibited a greater tendency to compete in middle-old and old-old individuals.</p> </section> <section> <h3> Conclusions & Implications</h3> <p>The findings reveal that subsystems of older adults’ oral narratives display varying interactions with the increase of age, indicating that focusing solely on one dimension of language performance may result in inaccurate or mislea
{"title":"Age-related differences in the interplay of fluency and complexity in Chinese-speaking seniors’ oral narratives","authors":"Minli Wang, Min Wang","doi":"10.1111/1460-6984.13023","DOIUrl":"10.1111/1460-6984.13023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies on language production in normal ageing have primarily focused on distinct dimensions of older adults’ spoken language performance, such as fluency and complexity. However, little attention has been paid to the complex, interconnected relations between these dimensions. Additionally, older adults have been treated as a homogeneous group, with little consideration for the differential characteristics of language performance across different stages of ageing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aims to investigate how increasing age impacts Chinese seniors’ oral language performance, focusing on fluency (articulation rate and dysfluency rate), complexity (lexical and syntactic) and the potential interactions between these dimensions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods & Procedures</h3>\u0000 \u0000 <p>Spontaneous oral narratives were collected from 60 normally ageing individuals, who were categorised into three groups: young-old (60–69 years old), middle-old (70–79 years old) and old-old (≥80 years old). Four measures for assessing language performance, namely, articulation rate, dysfluency rate, lexical complexity and syntactic complexity, were derived from the oral narratives. Dynamic systems techniques, including moving correlations, locally estimated scatterplot smoothing and Monte Carlo simulations, were employed for data analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes & Results</h3>\u0000 \u0000 <p>This study revealed two major findings. First, across different age groups, the seniors’ oral narratives significantly differed in the aspect of articulation rate and syntactic complexity. Specifically, both the young-old and the middle-old groups exhibited significantly higher articulation rates than the old-old group; the middle-old group also demonstrated significantly higher syntactic complexity compared to the old-old group. Second, the distinct subsystems (i.e., articulation rate, dysfluency rate, lexical and syntactic complexity) of seniors’ oral narratives demonstrated varying interactions across different stages of ageing. While these subsystems tended to coordinate with each other in young-old individuals, they exhibited a greater tendency to compete in middle-old and old-old individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions & Implications</h3>\u0000 \u0000 <p>The findings reveal that subsystems of older adults’ oral narratives display varying interactions with the increase of age, indicating that focusing solely on one dimension of language performance may result in inaccurate or mislea","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"59 5","pages":"1672-1690"},"PeriodicalIF":1.5,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139969768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hia Datta, Laura L. Wood, Susan Alimonti, Danielle Pugliese, Hannah Butkiewicz, Francesca Jannello, Breann Rissland, Kristen Tully
<div> <section> <h3> Background</h3> <p>Persons with aphasia (PWA) experience a number of communicative and social-emotional challenges. Reported experiences of PWA include but are not limited to, being misunderstood, isolated, frustrated, and infantilised.</p> </section> <section> <h3> Aims</h3> <p>The aim of this pilot study, involving a Life Participation Approach to Aphasia (LPAA), conducted over the course of 2 years, was to understand community perceptions of aphasia while PWA engaged in an interprofessional treatment program involving speech and drama therapy.</p> </section> <section> <h3> Methods & Procedures</h3> <p>The interprofessional treatment program involved PWA participating in a therapeutic theatre program using the CoActive Therapeutic Theater (CoATT) while also receiving speech-language therapy. Each year, the PWA performed a different, original therapeutic theatre production for a public audience, at the culmination of their interprofessional treatment program. In this paper, we share data obtained from perspectives of audience members who witnessed the theatre production and aphasia education during the first year of the study and friends and family of PWA who participated in the therapeutic theatre process during the second year of the study.</p> </section> <section> <h3> Outcomes & Results</h3> <p>Responses from audience members who participated in aphasia education and witnessed the therapeutic theatre performance by the PWA during the first year, indicated an increased knowledge of aphasia. Friends and family members of PWA who witnessed their loved ones engaging in the CoATT process through interprofessional treatment, in the second year, reported that their loved ones benefited from the CoATT process, which was distinct from other therapeutic processes to their knowledge and that they were impacted by watching their loved one perform.</p> </section> <section> <h3> Conclusions & Implications</h3> <p>These initial findings create footing towards understanding impact of therapeutic theatre in combination with speech-language therapy in the lives of PWA. They help us to obtain an initial appreciation of how therapeutic theatre and aphasia education help connect PWA and their community.</p> </section> <section> <h3> WHAT THIS PAPER ADDS</h3> <section> <h3> What is already known on this subject</h3> <div> <ul> <li>Care
{"title":"Community responses to persons with aphasia participating in CoActive therapeutic theatre: A pilot study","authors":"Hia Datta, Laura L. Wood, Susan Alimonti, Danielle Pugliese, Hannah Butkiewicz, Francesca Jannello, Breann Rissland, Kristen Tully","doi":"10.1111/1460-6984.13019","DOIUrl":"10.1111/1460-6984.13019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Persons with aphasia (PWA) experience a number of communicative and social-emotional challenges. Reported experiences of PWA include but are not limited to, being misunderstood, isolated, frustrated, and infantilised.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this pilot study, involving a Life Participation Approach to Aphasia (LPAA), conducted over the course of 2 years, was to understand community perceptions of aphasia while PWA engaged in an interprofessional treatment program involving speech and drama therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods & Procedures</h3>\u0000 \u0000 <p>The interprofessional treatment program involved PWA participating in a therapeutic theatre program using the CoActive Therapeutic Theater (CoATT) while also receiving speech-language therapy. Each year, the PWA performed a different, original therapeutic theatre production for a public audience, at the culmination of their interprofessional treatment program. In this paper, we share data obtained from perspectives of audience members who witnessed the theatre production and aphasia education during the first year of the study and friends and family of PWA who participated in the therapeutic theatre process during the second year of the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes & Results</h3>\u0000 \u0000 <p>Responses from audience members who participated in aphasia education and witnessed the therapeutic theatre performance by the PWA during the first year, indicated an increased knowledge of aphasia. Friends and family members of PWA who witnessed their loved ones engaging in the CoATT process through interprofessional treatment, in the second year, reported that their loved ones benefited from the CoATT process, which was distinct from other therapeutic processes to their knowledge and that they were impacted by watching their loved one perform.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions & Implications</h3>\u0000 \u0000 <p>These initial findings create footing towards understanding impact of therapeutic theatre in combination with speech-language therapy in the lives of PWA. They help us to obtain an initial appreciation of how therapeutic theatre and aphasia education help connect PWA and their community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> WHAT THIS PAPER ADDS</h3>\u0000 \u0000 <section>\u0000 \u0000 <h3> What is already known on this subject</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Care","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"59 5","pages":"1649-1671"},"PeriodicalIF":1.5,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139969787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachael Rietdijk, Melissa Brunner, Paul Conroy, Mark Jayes, Leanne Togher
{"title":"It's a changing landscape: Complexity and innovation in cognitive-communication rehabilitation for people with acquired brain injury (ABI)","authors":"Rachael Rietdijk, Melissa Brunner, Paul Conroy, Mark Jayes, Leanne Togher","doi":"10.1111/1460-6984.13022","DOIUrl":"10.1111/1460-6984.13022","url":null,"abstract":"","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"59 2","pages":"429-432"},"PeriodicalIF":2.4,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139941091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Healthcare professionals (HCPs) have a responsibility to conduct assessments of decision-making capacity that comply with the Mental Capacity Act 2005 (MCA). Current best-practice guidance, such as the Mental Capacity Code of Practice and National Institute for Health and Care Excellence decision-making and mental capacity guidance, does not stipulate how to accomplish this in practice, for example, what questions should be asked, how options and information should be provided. In addition, HCPs struggle to assess the capacity of individuals with communication difficulties.</p> </section> <section> <h3> Aims</h3> <p>This study was a service evaluation that aimed to objectively analyse, using Conversation Analysis (CA), how real-life capacity assessments were conducted in a hospital setting with patients with acquired brain injury (ABI)-related communication difficulties. A second aim was to establish the feasibility of using CA to advance knowledge of the conduct of capacity assessment.</p> </section> <section> <h3> Methods & Procedures</h3> <p>Four naturally occurring capacity assessments were video-recorded. Recordings involved speech and language therapists, occupational therapists, neuropsychologists and patients with communication difficulties as a result of ABI. The methods and findings of CA were used to investigate the interactional behaviours of HCPs and patients during assessments of decision-making capacity. The analysis was informed by our knowledge of the MCA best practice guidance.</p> </section> <section> <h3> Outcomes & Results</h3> <p>An overall structure of capacity assessment that enacted some of the best-practice MCA guidance was identified in one recording, consisting of six phases: (i) opening, (ii) preparation, (iii) option-listing, (iv) test, (v) decision, and (vi) close. The preparation phase consisted of two sub-components: information gathering and information giving. Variation from this structure was observed across the dataset, notably in the way in which options were (or were not) presented.</p> </section> <section> <h3> Conclusions & Implications</h3> <p>CA is a feasible empirical method for exploring the structure and conduct of capacity assessments. CA identifies and provides ways of describing interactional behaviours that align with and diverge from best-practice MCA guidance. Future CA studies including a wider range of health and social care professionals and p
背景：医疗保健专业人员（HCPs）有责任按照 2005 年《心智能力法》（MCA）的规定对患者的决策能力进行评估。目前的最佳实践指南，如《心智能力行为准则》（Mental Capacity Code of Practice）和《国家健康与护理卓越研究所决策与心智能力指南》（National Institute for Health and Care Excellence decision-making and mental capacity guidance），并没有规定如何在实践中做到这一点，例如，应该提出哪些问题，如何提供选择和信息。目的：本研究是一项服务评估，旨在利用会话分析法（Conversation Analysis，CA）客观分析在医院环境中如何对与后天性脑损伤（ABI）相关的交流障碍患者进行真实的行为能力评估。第二个目的是确定使用会话分析推进能力评估知识的可行性：对四次自然发生的能力评估进行录像。录制者包括言语和语言治疗师、职业治疗师、神经心理学家以及因缺血性脑损伤而有交流障碍的患者。CA 的方法和结果被用于调查在决策能力评估过程中 HCP 和患者的互动行为。该分析参考了我们对MCA最佳实践指南的了解：在一份记录中确定了能力评估的整体结构，该结构采用了 MCA 最佳实践指南的部分内容，由六个阶段组成：(i) 开始，(ii) 准备，(iii) 选项列表，(iv) 测试，(v) 决定，(vi) 结束。准备阶段包括两个子部分：信息收集和信息提供。在整个数据集中可以观察到与这一结构不同的地方，特别是选项的展示（或不展示）方式：能力评估是探索能力评估结构和实施的一种可行的实证方法。CA识别并提供了描述互动行为的方法，这些方法与MCA最佳实践指南既有一致之处，也有不同之处。未来的CA研究将包括更广泛的医疗和社会护理专业人员及患者，有可能为进行决策能力评估的医疗和社会护理专业人员的循证培训提供信息：关于此主题的已知信息 《心智能力法案》（MCA）在实践中执行不力。医疗保健专业人员（HCPs）发现，对有沟通障碍的人进行决策能力评估具有挑战性，而在能力评估过程中，有沟通障碍的人往往被排除在外或得不到足够的支持。研究仅限于自我报告方法。需要对能力评估进行观察研究。本研究的新增内容 这是第一项使用会话分析法（Conversation Analysis，CA）探讨在医院环境中，医护人员如何对后天性脑损伤导致的沟通障碍者进行能力评估的研究。其中一个能力评估视频录像分为六个阶段，与 MCA 最佳实践指南保持一致。然而，其他能力评估则偏离了这一结构。其中一个阶段，即选项列表，在实践中存在差异，选项并不总是呈现出来。这项工作的临床意义是什么？行为能力评估揭示了与 MCA 最佳实践指南相一致和相背离的互动行为。未来有必要开展 CA 研究，以便为开展行为能力评估的医疗和社会护理专业人员的培训提供信息。
{"title":"Using Conversation Analysis to explore assessments of decision-making capacity in a hospital setting","authors":"Jessica Foulkes, Anna Volkmer, Suzanne Beeke","doi":"10.1111/1460-6984.13020","DOIUrl":"10.1111/1460-6984.13020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Healthcare professionals (HCPs) have a responsibility to conduct assessments of decision-making capacity that comply with the Mental Capacity Act 2005 (MCA). Current best-practice guidance, such as the Mental Capacity Code of Practice and National Institute for Health and Care Excellence decision-making and mental capacity guidance, does not stipulate how to accomplish this in practice, for example, what questions should be asked, how options and information should be provided. In addition, HCPs struggle to assess the capacity of individuals with communication difficulties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study was a service evaluation that aimed to objectively analyse, using Conversation Analysis (CA), how real-life capacity assessments were conducted in a hospital setting with patients with acquired brain injury (ABI)-related communication difficulties. A second aim was to establish the feasibility of using CA to advance knowledge of the conduct of capacity assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods & Procedures</h3>\u0000 \u0000 <p>Four naturally occurring capacity assessments were video-recorded. Recordings involved speech and language therapists, occupational therapists, neuropsychologists and patients with communication difficulties as a result of ABI. The methods and findings of CA were used to investigate the interactional behaviours of HCPs and patients during assessments of decision-making capacity. The analysis was informed by our knowledge of the MCA best practice guidance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes & Results</h3>\u0000 \u0000 <p>An overall structure of capacity assessment that enacted some of the best-practice MCA guidance was identified in one recording, consisting of six phases: (i) opening, (ii) preparation, (iii) option-listing, (iv) test, (v) decision, and (vi) close. The preparation phase consisted of two sub-components: information gathering and information giving. Variation from this structure was observed across the dataset, notably in the way in which options were (or were not) presented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions & Implications</h3>\u0000 \u0000 <p>CA is a feasible empirical method for exploring the structure and conduct of capacity assessments. CA identifies and provides ways of describing interactional behaviours that align with and diverge from best-practice MCA guidance. Future CA studies including a wider range of health and social care professionals and p","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"59 4","pages":"1612-1627"},"PeriodicalIF":1.5,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1460-6984.13020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Maintenance of speech outcomes following speech-language therapy (SLT) in Parkinson's disease (PD) is an unmet expectation of people with PD (PWPD) and poorly defined in SLT practice. PD Check-In, a model for supported self-managed maintenance of speech following Lee Silverman Voice Treatment (LSVT) LOUD was investigated.</p> </section> <section> <h3> Aims</h3> <p>To investigate the impact of the semi-structured component of PD Check-In on the adoption of self-management concepts and behaviours and the identification of facilitators, barriers and strategies for speech maintenance by PWPD over 24 months post-treatment.</p> </section> <section> <h3> Methods and procedure</h3> <p>Following LSVT LOUD, 16 PWPD participated in individual PD Check-In semi-structured discussions with a SLT at 6 and 12 weeks, and 6, 12 and 24 months post treatment. A two-stage qualitative content analysis was applied: directed content analysis using categories from the theoretical framework of PD Check-In followed by inductive content analysis to identify subcategories.</p> </section> <section> <h3> Outcomes and results</h3> <p>Statements from PWPD indicated adoption of seven concepts of self-management across participants and across time. Six concepts from the theoretical framework of PD Check-In (partnerships, self-reflection, maintenance barriers and facilitators, revision of LSVT LOUD skill, goal setting and maintenance strategies), and one new category, participation, emerged from the analysis. Self-reflection, maintenance facilitators and barriers and participation were most prevalent in discussions. PWPD identified facilitators, barriers and strategies for maintenance across time points.</p> </section> <section> <h3> Conclusions and implications</h3> <p>Statements from PWPD indicated a positive impact of SLT-supported self-management of speech using self-tailored strategies for sustainable maintenance according to their individual circumstances and needs.</p> </section> <section> <h3> WHAT THIS PAPER ADDS</h3> <section> <h3> What is already known on this subject</h3> <div> <ul> <li>People with Parkinson's disease (PWPD) have expressed their need for speech-language therapy (SLT) service
{"title":"The impact of PD Check-In on self-management skills for maintenance of speech after intensive treatment","authors":"Ann Finnimore, Deborah Theodoros, Anna F. Rumbach","doi":"10.1111/1460-6984.13024","DOIUrl":"10.1111/1460-6984.13024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Maintenance of speech outcomes following speech-language therapy (SLT) in Parkinson's disease (PD) is an unmet expectation of people with PD (PWPD) and poorly defined in SLT practice. PD Check-In, a model for supported self-managed maintenance of speech following Lee Silverman Voice Treatment (LSVT) LOUD was investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To investigate the impact of the semi-structured component of PD Check-In on the adoption of self-management concepts and behaviours and the identification of facilitators, barriers and strategies for speech maintenance by PWPD over 24 months post-treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and procedure</h3>\u0000 \u0000 <p>Following LSVT LOUD, 16 PWPD participated in individual PD Check-In semi-structured discussions with a SLT at 6 and 12 weeks, and 6, 12 and 24 months post treatment. A two-stage qualitative content analysis was applied: directed content analysis using categories from the theoretical framework of PD Check-In followed by inductive content analysis to identify subcategories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes and results</h3>\u0000 \u0000 <p>Statements from PWPD indicated adoption of seven concepts of self-management across participants and across time. Six concepts from the theoretical framework of PD Check-In (partnerships, self-reflection, maintenance barriers and facilitators, revision of LSVT LOUD skill, goal setting and maintenance strategies), and one new category, participation, emerged from the analysis. Self-reflection, maintenance facilitators and barriers and participation were most prevalent in discussions. PWPD identified facilitators, barriers and strategies for maintenance across time points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and implications</h3>\u0000 \u0000 <p>Statements from PWPD indicated a positive impact of SLT-supported self-management of speech using self-tailored strategies for sustainable maintenance according to their individual circumstances and needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> WHAT THIS PAPER ADDS</h3>\u0000 \u0000 <section>\u0000 \u0000 <h3> What is already known on this subject</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>People with Parkinson's disease (PWPD) have expressed their need for speech-language therapy (SLT) service","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"59 4","pages":"1628-1646"},"PeriodicalIF":1.5,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1460-6984.13024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacinda Choy, Fereshteh Pourkazemi, Hans Bogaardt, Caitlin Anderson, Shing Yee Chai, Roxanna N. Pebdani
<div> <section> <h3> Background</h3> <p>Dysphagia affects over half of adults after stroke. Dysphagia rehabilitation aims to improve swallowing and reduce negative outcomes for these adults. However, significant variability exists in dysphagia rehabilitation. Research is needed to explore the underlying clinician-specific and workplace factors that contribute to variability in dysphagia rehabilitation after stroke.</p> </section> <section> <h3> Aim</h3> <p>To explore factors influencing speech pathology practice in dysphagia rehabilitation after stroke.</p> </section> <section> <h3> Methods & Procedures</h3> <p>We used a phenomenological approach with an interpretivist perspective. Twenty speech pathologists working in dysphagia rehabilitation participated from different workplace settings around Australia. Five semi-structured focus groups were conducted online. Data were inductively analysed using thematic analysis with a coding reliability method.</p> </section> <section> <h3> Outcomes & Results</h3> <p>Four themes were discussed within focus groups: (1) relationship between experienced and less experienced clinicians: ‘Following what other people have done’, (2) need for collaborative learning: ‘A safe space to share and train’, (3) variation between settings impacts on continuity of care: ‘There's a difference between community and acute’, and (4) working effectively with multidisciplinary teams (MDT): ‘An MDT which can listen to the voice of speech pathology’.</p> </section> <section> <h3> Conclusions & Implications</h3> <p>Relationships between senior and junior speech pathologists, within speech pathology and MDT, and across inpatient and community settings influenced speech pathology practice. Flattened hierarchies in speech pathology, collaborative learning in workplaces, mutual respect within teams and connection across inpatient and community settings could improve the quality and consistency of dysphagia rehabilitation after stroke.</p> </section> <section> <h3> WHAT THIS PAPER ADDS</h3> <section> <h3> What is already known on this subject</h3> <div> <ul> <li>Dysphagia rehabilitation can improve swallowing after a stroke. However, dysphagia rehabilitation is characterised by variabi
{"title":"Factors influencing speech pathology practice in dysphagia after stroke: A qualitative focus group study","authors":"Jacinda Choy, Fereshteh Pourkazemi, Hans Bogaardt, Caitlin Anderson, Shing Yee Chai, Roxanna N. Pebdani","doi":"10.1111/1460-6984.13017","DOIUrl":"10.1111/1460-6984.13017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dysphagia affects over half of adults after stroke. Dysphagia rehabilitation aims to improve swallowing and reduce negative outcomes for these adults. However, significant variability exists in dysphagia rehabilitation. Research is needed to explore the underlying clinician-specific and workplace factors that contribute to variability in dysphagia rehabilitation after stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To explore factors influencing speech pathology practice in dysphagia rehabilitation after stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods & Procedures</h3>\u0000 \u0000 <p>We used a phenomenological approach with an interpretivist perspective. Twenty speech pathologists working in dysphagia rehabilitation participated from different workplace settings around Australia. Five semi-structured focus groups were conducted online. Data were inductively analysed using thematic analysis with a coding reliability method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes & Results</h3>\u0000 \u0000 <p>Four themes were discussed within focus groups: (1) relationship between experienced and less experienced clinicians: ‘Following what other people have done’, (2) need for collaborative learning: ‘A safe space to share and train’, (3) variation between settings impacts on continuity of care: ‘There's a difference between community and acute’, and (4) working effectively with multidisciplinary teams (MDT): ‘An MDT which can listen to the voice of speech pathology’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions & Implications</h3>\u0000 \u0000 <p>Relationships between senior and junior speech pathologists, within speech pathology and MDT, and across inpatient and community settings influenced speech pathology practice. Flattened hierarchies in speech pathology, collaborative learning in workplaces, mutual respect within teams and connection across inpatient and community settings could improve the quality and consistency of dysphagia rehabilitation after stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> WHAT THIS PAPER ADDS</h3>\u0000 \u0000 <section>\u0000 \u0000 <h3> What is already known on this subject</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Dysphagia rehabilitation can improve swallowing after a stroke. However, dysphagia rehabilitation is characterised by variabi","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"59 4","pages":"1599-1611"},"PeriodicalIF":1.5,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1460-6984.13017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Purpose</h3> <p>Sociometric studies and adult reports have established that children with Language Disorder (LD) are at risk of peer relationship difficulties. However, we have limited knowledge of how children with LD understand friendship, whom they deem as a good or bad friend, and what role their friendship concepts play in their relationships with peers. This exploratory study aimed to conduct a qualitative investigation into the friendship concepts that children with LD hold and to explore their strategies for making friends.</p> </section> <section> <h3> Methods</h3> <p>We conducted multiple, art-informed interviews on the topic of friendship with 14 children with LD at the age of 6–8 years. Participating children were based in the United Kingdom and Republic of Ireland. They attended enhanced provision, specific speech and language classes and mainstream classrooms. We used framework analysis to map children's responses to Selman's (1979) developmental model of interpersonal understanding, which espouses a theory of children's social development within the context of peer relationships.</p> </section> <section> <h3> Results</h3> <p>The understanding of friendship formation in children with LD varied from physical presence to mutual support and sharing. Children's ideas about a good/bad friend represented the lowest developmental stage. Participants from the mainstream classroom demonstrated the highest stages of interpersonal understanding. Children with LD did not mention their language abilities as a barrier to making friends.</p> </section> <section> <h3> Conclusion</h3> <p>There are limited studies exploring friendship directly from children with LD, and this study provides insights into this gap, by utilising art-informed interviews. Children's immature understanding of a good/bad friend points towards a potential susceptibility to false friends, which we suggest needs further empirical validation. We also found that children with LD did not pay attention to their language difficulties when making friends, which raises questions about the ways diagnoses are shared with children.</p> </section> <section> <h3> WHAT THIS PAPER ADDS</h3> <section> <h3> What is already known on the subject</h3> <div> <ul> <li>Children with Language Disorder (LD) are at risk of peer relationship
{"title":"Exploring concepts of friendship formation in children with language disorder using a qualitative framework analysis","authors":"Lenka Janik Blaskova, Jenny L. Gibson","doi":"10.1111/1460-6984.13021","DOIUrl":"10.1111/1460-6984.13021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Sociometric studies and adult reports have established that children with Language Disorder (LD) are at risk of peer relationship difficulties. However, we have limited knowledge of how children with LD understand friendship, whom they deem as a good or bad friend, and what role their friendship concepts play in their relationships with peers. This exploratory study aimed to conduct a qualitative investigation into the friendship concepts that children with LD hold and to explore their strategies for making friends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted multiple, art-informed interviews on the topic of friendship with 14 children with LD at the age of 6–8 years. Participating children were based in the United Kingdom and Republic of Ireland. They attended enhanced provision, specific speech and language classes and mainstream classrooms. We used framework analysis to map children's responses to Selman's (1979) developmental model of interpersonal understanding, which espouses a theory of children's social development within the context of peer relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The understanding of friendship formation in children with LD varied from physical presence to mutual support and sharing. Children's ideas about a good/bad friend represented the lowest developmental stage. Participants from the mainstream classroom demonstrated the highest stages of interpersonal understanding. Children with LD did not mention their language abilities as a barrier to making friends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There are limited studies exploring friendship directly from children with LD, and this study provides insights into this gap, by utilising art-informed interviews. Children's immature understanding of a good/bad friend points towards a potential susceptibility to false friends, which we suggest needs further empirical validation. We also found that children with LD did not pay attention to their language difficulties when making friends, which raises questions about the ways diagnoses are shared with children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> WHAT THIS PAPER ADDS</h3>\u0000 \u0000 <section>\u0000 \u0000 <h3> What is already known on the subject</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Children with Language Disorder (LD) are at risk of peer relationship ","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"59 4","pages":"1578-1598"},"PeriodicalIF":1.5,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1460-6984.13021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Volkmer, Lisa Cross, Lily Highton, Connie Jackson, Chloe Smith, Emilie Brotherhood, Emma V. Harding, Cath Mummery, Jonathan Rohrer, Rimona Weil, Keir Yong, Sebastian Crutch, Chris J. D. Hardy
<div> <section> <h3> Background</h3> <p>People with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy and young onset Alzheimer's disease may experience language and communication difficulties. However, the role of speech and language interventions for people with these non-language led dementias has received little attention.</p> </section> <section> <h3> Aims</h3> <p>This study aimed to explore the experiences and perspectives of people living with these conditions, and their families, regarding their language and communication difficulties and how speech and language therapy could address these needs.</p> </section> <section> <h3> Methods</h3> <p>This study employed a qualitative design to explore the experiences of people living with or caring for somebody with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy or young onset Alzheimer's disease, and to understand their opinions about speech and language therapy. Participants were recruited from a support service connected to a dementia clinic to attend one of five focus group meetings. Videorecorded focus groups and interviews were transcribed, and reflexive thematic analysis was used to analyse data from people affected by each type of dementia.</p> </section> <section> <h3> Results</h3> <p>A total of 25 participants were recruited to the study, with representation across the different forms of non-language led dementias. The four main themes identified were: (1) communication difficulties as a key difficulty, (2) loss and loneliness, (3) speech and language therapy, and (4) the role of the caregiver. Sixteen subthemes were also identified which highlighted individual issues across disease types.</p> </section> <section> <h3> Discussion</h3> <p>Although all the forms of dementia studied here are not considered to be language-led, people with these conditions and/or their care partners identified speech, language and communication as common challenges. These communication difficulties were reported to have a negative impact on their social participation and mental health and participants felt speech and language interventions could help. There is a need for research exploring speech and language interventions developed for and with people with non-language led dementias and their care partners, to ensure they meet the needs of the people they are designed for.</p> </section>
{"title":"‘Communication is difficult’: Speech, language and communication needs of people with young onset or rarer forms of non-language led dementia","authors":"Anna Volkmer, Lisa Cross, Lily Highton, Connie Jackson, Chloe Smith, Emilie Brotherhood, Emma V. Harding, Cath Mummery, Jonathan Rohrer, Rimona Weil, Keir Yong, Sebastian Crutch, Chris J. D. Hardy","doi":"10.1111/1460-6984.13018","DOIUrl":"10.1111/1460-6984.13018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>People with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy and young onset Alzheimer's disease may experience language and communication difficulties. However, the role of speech and language interventions for people with these non-language led dementias has received little attention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to explore the experiences and perspectives of people living with these conditions, and their families, regarding their language and communication difficulties and how speech and language therapy could address these needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study employed a qualitative design to explore the experiences of people living with or caring for somebody with behavioural variant frontotemporal dementia, Lewy body dementia, posterior cortical atrophy or young onset Alzheimer's disease, and to understand their opinions about speech and language therapy. Participants were recruited from a support service connected to a dementia clinic to attend one of five focus group meetings. Videorecorded focus groups and interviews were transcribed, and reflexive thematic analysis was used to analyse data from people affected by each type of dementia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 25 participants were recruited to the study, with representation across the different forms of non-language led dementias. The four main themes identified were: (1) communication difficulties as a key difficulty, (2) loss and loneliness, (3) speech and language therapy, and (4) the role of the caregiver. Sixteen subthemes were also identified which highlighted individual issues across disease types.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Although all the forms of dementia studied here are not considered to be language-led, people with these conditions and/or their care partners identified speech, language and communication as common challenges. These communication difficulties were reported to have a negative impact on their social participation and mental health and participants felt speech and language interventions could help. There is a need for research exploring speech and language interventions developed for and with people with non-language led dementias and their care partners, to ensure they meet the needs of the people they are designed for.</p>\u0000 </section>\u0000 \u0000 ","PeriodicalId":49182,"journal":{"name":"International Journal of Language & Communication Disorders","volume":"59 4","pages":"1553-1577"},"PeriodicalIF":1.5,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1460-6984.13018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Barbara Jamróz, Maria Sobol, Joanna Chmielewska-Walczak, Magdalena Milewska, Kazimierz Niemczyk
<div> <section> <h3> Aim</h3> <p>Evidence shows that 20%–30% of patients who aspirate do so silently. Research to date has not demonstrated clear evidence to indicate which patients are at higher risk of silent aspiration. Our aim was to use univariate logistic regression analysis of retrospective case review to determine potential patterns of silent aspiration.</p> </section> <section> <h3> Materials and methods</h3> <p>We conducted a retrospective analysis of 455 fiberoptic endoscopic evaluation of swallowing (FEES) reports. The patients were divided into four groups: G1 – neurological diseases (<i>n</i> = 93), G2 – head and neck surgery (<i>n</i> = 200), G3 – gastroenterological diseases (<i>n</i> = 94) and G4 – other patients (<i>n</i> = 68). Data included the occurrence or absence of saliva penetration or aspiration, of silent fluid/solid food penetration or aspiration, type of penetration or aspiration, occurrence of cranial nerve paresis, radiotherapy and tracheostomy. Univariate logistic regression was used to evaluate independent risk factors of silent aspiration in the study population. Three models with different independent variables were considered.</p> </section> <section> <h3> Results</h3> <p>There is a statistically significant difference in the frequency of occurrence of silent penetration and aspiration within the groups (<i>p</i> < 0.001), with intraglutative being most frequent. Fluid and food penetration and aspiration correlated with saliva penetration and aspiration in all groups (<i>p</i> < 0.001). Cranial nerve paresis (IX and X), radiotherapy and tracheostomy correlate with saliva penetration and aspiration (<i>p</i> = 0.020 for cranial nerve paresis; <i>p</i> = 0.004 for radiotherapy; <i>p</i> < 0.001 for tracheostomy). One hundred and fifteen patients (45.81%) in the subgroup of patients with intraglutative aspiration had cranial nerve paresis (IX, X or IX–X).</p> </section> <section> <h3> Conclusions</h3> <p>Patients who should be prioritised or considered to be at a higher need of instrumental swallowing evaluation are those with IX and X cranial nerve paresis, tracheostomy and those who have had radiotherapy, with saliva swallowing problems, especially after paraganglioma, thyroid and parathyroid glands and middle and posterior fossa tumour surgery.</p> </section> <section> <h3> WHAT THIS PAPER ADDS</h3> <section> <h3> What is already known on the subject</h3> <div> <ul> <li>Clinical signs of p
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