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Dysphagia in progressive supranuclear palsy: A scoping review protocol 进行性核上性麻痹的吞咽困难:一项范围审查方案
Pub Date : 2022-10-26 DOI: 10.3233/acs-220007
Éadaoin Flynn, J. Regan, Julia Radtkeaaa, S. O’Dowd, M. Walshe
BACKGROUND: One of the most prevalent types of atypical parkinsonian syndromes is progressive supranuclear palsy (PSP). PSP is associated with early onset of dysphagia which can result in malnutrition, dehydration, and aspiration pneumonia, affecting quality of life and increasing mortality rate. To date, research describing dysphagia in PSP and its impact is scant. OBJECTIVE: The objective of this scoping review is to determine the characteristics of dysphagia in PSP, differences in dysphagia presentation according to PSP subtype, principal methods used for identifying and diagnosing dysphagia and the impact dysphagia has on quality of life in individuals with PSP. METHODS: The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews. The Preferred Reporting Items for Systematic Reviews and Meta Analysis extension for scoping reviews (PRISMA-ScR) will be used to guide the reporting of the review (Tricco et al., 2018). Articles completed at any time, which include participants with dysphagia and a clinical diagnosis of PSP will be included. Studies involving participants who have a co-morbidity/morbidities which could cause dysphagia and secondary research will excluded. Relevant electronic databases, trial registries and grey literature without any date or language restrictions will be searched. Two independent reviewers will assess articles for eligibility and will extract relevant data. CONCLUSIONS: This scoping review will provide important evidence on dysphagia and PSP. It will describe the principal methods used for identifying and diagnosing dysphagia in this population. The results will guide future research in dysphagia and PSP.
背景:进行性核上性麻痹(PSP)是最常见的非典型帕金森综合征之一。PSP与早期发生的吞咽困难有关,吞咽困难可导致营养不良、脱水和吸入性肺炎,影响生活质量并增加死亡率。迄今为止,描述PSP患者吞咽困难及其影响的研究还很少。目的:本综述的目的是确定PSP患者吞咽困难的特征、不同亚型的吞咽困难表现差异、识别和诊断吞咽困难的主要方法以及吞咽困难对PSP患者生活质量的影响。方法:拟议的范围审查将按照JBI范围审查方法进行。系统评价的首选报告项目和范围评价的元分析扩展(PRISMA-ScR)将用于指导评价的报告(Tricco等人,2018)。在任何时间完成的文章,包括有吞咽困难和PSP临床诊断的参与者将被纳入。排除伴有可能导致吞咽困难的合并症/并发症的研究和二次研究。检索相关电子数据库、试验登记和无日期或语言限制的灰色文献。两名独立审稿人将评估文章的合格性并提取相关数据。结论:本综述将为吞咽困难和PSP的研究提供重要证据。它将描述用于识别和诊断该人群吞咽困难的主要方法。研究结果对今后吞咽困难和PSP的研究具有指导意义。
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引用次数: 0
Fiberoptic endoscopic evaluation of swallow as a tool to facilitate dysphagia rehabilitation following a salvage hemi-glossectomy: Case report 纤维内镜评估吞咽作为一种工具,以促进补救性半舌切除术后吞咽困难的康复:病例报告
Pub Date : 2022-10-17 DOI: 10.3233/acs-220006
Gavriella Simson, R. Govender
Background: Dysphagia is a common consequence of tongue cancer and its treatment, with the possibility of long-term diet modification and feeding tube dependence. This is likely to have an impact on the activity, participation and psychological wellbeing of the individual. Objective: This case report presents the use of fiberoptic endoscopic evaluation of swallow (FEES) as a tool to support dysphagia rehabilitation through providing visual feedback following a salvage hemi-glossectomy for management of a recurrent squamous cell carcinoma (SCC) in the right anterolateral tongue. Methods: Clinician-rated and patient-reported outcome measures were used to assess the effectiveness of FEES as a tool to facilitate dysphagia rehabilitation. These measures include the: Performance Status Scale for Head and Neck (PSS-HN) cancer patients, 100 mL water swallow test (WST), Penetration-Aspiration Scale (PAS), the Yale Pharyngeal Residue Severity Rating Scale, and the Functional Intraoral Glasgow Scale (FIGS). Results: No Statistical tests were performed on this single case, however the results demonstrate a notable clinical improvement in all postoperative outcome measures at 12-months when compared with those taken two-months postoperatively. Conclusion: Use of sequential FEES could enhance patient engagement and inform dysphagia rehabilitation following hemi-glossectomy.
背景:吞咽困难是舌癌及其治疗的常见后果,可能需要长期改变饮食习惯和依赖饲管。这可能会对个人的活动、参与和心理健康产生影响。目的:本病例报告介绍了使用纤维内镜吞咽评估(FEES)作为一种工具,通过提供视觉反馈,支持吞咽困难康复后补偿性半舌切除术(SCC)在右侧舌前外侧复发性鳞状细胞癌(SCC)的管理。方法:采用临床评价和患者报告的结果测量来评估FEES作为促进吞咽困难康复工具的有效性。这些测量包括:头颈部癌症患者行为状态量表(PSS-HN)、100ml吞水试验(WST)、渗透-吸入量表(PAS)、耶鲁咽部残留严重程度评定量表和口腔内功能格拉斯哥量表(FIGS)。结果:该病例未进行统计学检验,但结果显示,与术后2个月相比,术后12个月的所有预后指标均有显著的临床改善。结论:使用顺序费用可以提高患者的参与度,并为半舌切除术后吞咽困难的康复提供信息。
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引用次数: 1
It is time to talk about our relationships: Exploring the role of therapeutic alliance in speech and language therapy, with stuttering intervention as an exemplar 是时候谈谈我们的关系了:以口吃干预为例,探索治疗联盟在言语和语言治疗中的作用
Pub Date : 2022-10-06 DOI: 10.3233/acs-220009
Amy K. Connery, Tom Pender, J. Yaruss, A. McCurtin
The value of the therapeutic alliance as an essential component of psychotherapy has been recognised for several decades. For example, research has shown that the therapeutic alliance contributes positively to treatment outcomes and client satisfaction. In contrast, knowledge about the role of therapeutic alliance in speech and language therapy (SLT) remains at an emerging level, due in part to the discipline’s primary focus on the development, use and scientific validation of specific intervention methods and techniques. This paper aims to increase speech and language therapists’ (SLTs) understanding and implementation of constructive therapeutic alliances in their work with individuals with communication needs. In particular, we focus on adults who stutter, to convey the importance of fostering these alliances in clinical practice. We begin with an exploration of the meaning of the therapeutic alliance and the range of person-related and contextual variables that influence its establishment and maintenance. We continue with a discussion on what SLTs can learn from the psychotherapeutic literature on therapeutic alliance. In addition, the gaps in our knowledge that remain in terms of the need for an SLT-specific and stakeholder-informed conceptualisation of the therapeutic alliance are discussed. Finally, we provide key recommendations for fostering a therapeutic alliance with adults who stutter in order to enhance the relational competence of SLTs working in clinical practice. It is imperative and timely that the discipline of SLT redirects its attention to the role of variables beyond specific treatment techniques that influence treatment outcomes. This will ensure the design and delivery of effective stuttering interventions, and enhance treatment outcomes for those who stutter.
治疗联盟作为心理治疗的重要组成部分的价值已经被承认了几十年。例如,研究表明,治疗联盟对治疗结果和客户满意度有积极的贡献。相比之下,关于治疗联盟在言语和语言治疗(SLT)中的作用的知识仍然处于新兴水平,部分原因是该学科主要关注特定干预方法和技术的开发、使用和科学验证。本文旨在提高言语和语言治疗师(slt)的理解和实施建设性的治疗联盟在他们的工作与沟通需要的个人。我们特别关注口吃的成年人,以传达在临床实践中培养这些联盟的重要性。我们首先探索治疗联盟的意义,以及影响其建立和维持的个人相关和环境变量的范围。我们继续讨论slt可以从关于治疗联盟的心理治疗文献中学到什么。此外,本文还讨论了我们在slt特异性和利益相关者知情的治疗联盟概念化需求方面的知识差距。最后,我们提供关键的建议,以促进治疗联盟与成人口吃,以提高在临床实践中工作的slt的关系能力。SLT学科必须及时地将注意力转移到影响治疗结果的特定治疗技术之外的变量的作用上。这将确保设计和提供有效的口吃干预措施,并提高口吃者的治疗结果。
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引用次数: 2
Why should speech-language pathologists read graphic novels? A commentary on humanities as a pathway to improving patient-centred care 为什么语言病理学家要读图画小说?对人文学科作为改善以病人为中心的护理途径的评论
Pub Date : 2022-08-10 DOI: 10.3233/acs-220003
Emily Knudson-Vilaseca
Like all who work in medical or allied health professions, speech-language pathologists would benefit from supplementing their learning with humanities education, as it can help to improve diagnostic skills and to develop empathy. Graphic novels on illness and disease, conceived of by those in the medical humanities as “graphic medicine,” have an appeal for their brevity and association with humour, and for their ability to express complex thoughts and feelings through a medium that is both visual and literary. As such, they serve as an ideal resource for deepening one’s understanding of how disorders and diseases are experienced by patients and their caregivers and for helping student clinicians, therapists, and researchers recognize their shared humanity with patients and study participants. In this article, I expand on these ideas and, in order to demonstrate the benefit of closely reading graphic novels from a speech-pathology perspective, I offer my own analysis of Tangles: A Story of Alzheimer’s, My Mother, and Me by Sarah Leavitt (2012).
像所有从事医疗或相关卫生专业工作的人一样,语言病理学家将受益于人文教育的补充,因为它有助于提高诊断技能和培养同理心。关于疾病和疾病的图画小说,被医学人文学科的人认为是“图画医学”,因为它们的简洁和幽默,以及它们通过视觉和文学的媒介表达复杂思想和情感的能力,而具有吸引力。因此,它们是加深人们对患者及其护理人员如何经历紊乱和疾病的理解的理想资源,并帮助临床医生、治疗师和研究人员认识到他们与患者和研究参与者共同的人性。在这篇文章中,我扩展了这些观点,为了从语言病理学的角度证明仔细阅读图画小说的好处,我提供了我自己对Sarah Leavitt(2012)的《缠结:阿尔茨海默氏症,我母亲和我的故事》的分析。
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引用次数: 0
Cough reflex testing in clinical dysphagia practice 咳嗽反射检测在临床吞咽困难中的应用
Pub Date : 2022-08-06 DOI: 10.3233/acs-220008
E. Wallace, Maggie-Lee Huckabee, Phoebe Macrae
The addition of cough reflex testing (CRT) to a comprehensive clinical swallowing evaluation has the potential to substantially contribute to the management of patients with dysphagia, by providing insights into the integrity of the cough response to airway invasion and risk of silent aspiration. This “Spotlight on: Cough Reflex Testing in Clinical Dysphagia Practice” outlines the theoretical and practical considerations of using CRT as a screening tool to identify patients’ risk of silent aspiration. The following clinical questions are addressed: (1) What is coughing? (2) What is CRT? (3) What CRT method should I use? (4) How is the citric acid CRT conducted? (5) Can CRT be repeated to monitor changes in cough sensitivity? (6) What are the benefits of CRT in clinical dysphagia practice? This information is intended to support clinicians in implementing and interpreting CRT as a screening tool to identify patients’ risk of silent aspiration in clinical dysphagia practice.
在全面的临床吞咽评估中增加咳嗽反射测试(CRT),通过提供对气道侵犯和无声吸入风险的咳嗽反应的完整性的见解,有可能对吞咽困难患者的管理做出实质性贡献。这篇“聚焦:临床吞咽困难实践中的咳嗽反射测试”概述了使用CRT作为筛查工具来识别患者无声误吸风险的理论和实践考虑。(1)什么是咳嗽?(2) CRT是什么?(3)我应该使用什么CRT方法?(4)柠檬酸阴极射线管是如何进行的?(5)是否可以重复CRT来监测咳嗽敏感性的变化?(6) CRT在临床吞咽困难实践中的好处是什么?该信息旨在支持临床医生实施和解释CRT作为筛查工具,以识别临床吞咽困难实践中患者无声误吸的风险。
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引用次数: 1
Introduction to Advances in Communication and Swallowing Volume 25, Issue 1 介绍交流和吞咽的进展卷25,第1期
Pub Date : 2022-05-28 DOI: 10.3233/acs-229003
J. Regan, I. Walsh
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引用次数: 0
Speech and language therapist and interpreter collaboration with the paediatric population: A systematized review 言语和语言治疗师和口译员与儿科人群的合作:一个系统的回顾
Pub Date : 2022-05-12 DOI: 10.3233/acs-220001
Amanda Ancell, Suzanne C. Hopf
BACKGROUND: There is a mismatch between languages spoken by speech and language therapists (SLTs) and their clients. Consequently, SLTs are required to collaborate with interpreters to provide equitable services to multilingual clients. OBJECTIVE: This systematized review aimed to identify the barriers and facilitators to SLT and interpreter collaboration within the paediatric population. METHODS: A systematic and comprehensive search of literature was conducted. Selected literature underwent quality assessment and thematic analysis resulting in a narrative synthesis of included literature. RESULTS: Fifteen research studies were identified to be included in the review. Five themes were identified: (1) Frequency of interpreter and paediatric SLT collaboration; (2) training of SLTs and interpreters for speech therapy paediatric practice; (3) type of interpreters used during SLT paediatric sessions; (4) paediatric SLTs’ confidence when collaborating with interpreters; and, (5) policy influencing SLT and interpreter collaboration during management of paediatric clients. CONCLUSION: The review revealed limited direct research on the barriers and facilitators to SLT interpreter collaboration in the multilingual paediatric setting. Findings indicate that: (1) many SLTs consider their training in working with interpreters to be inadequate; (2) there is a lack of available professional interpreters and the use of family members as interpreters is common with paediatric clients. Further research is required to explore the specifics of training provided to interpreters and the factors that contribute to the lack of availability of professional interpreters for paediatric clients.
背景:言语和语言治疗师(slt)和他们的客户使用的语言之间存在不匹配。因此,语言翻译人员需要与口译人员合作,为多语种客户提供公平的服务。目的:本系统综述旨在确定儿童群体中语言翻译和口译合作的障碍和促进因素。方法:进行系统、全面的文献检索。选定的文献进行了质量评估和主题分析,从而对纳入的文献进行了叙事综合。结果:15项研究被纳入本综述。确定了五个主题:(1)口译员和儿科语言翻译合作的频率;(2)为儿童言语治疗工作培训语言治疗师和口译员;(3)儿童语言辅助教学期间使用的口译员类型;(4)儿童语言口译员与口译员合作时的自信心;(5)影响儿童客户管理中语言翻译和口译合作的政策。结论:该综述显示,在多语种儿科环境中,语言翻译译员合作的障碍和促进因素的直接研究有限。研究结果表明:(1)许多口译员认为他们在与口译员合作方面的培训不足;(2)缺乏可用的专业口译员,使用家庭成员作为口译员在儿科客户中很常见。需要进一步研究,以探讨向口译员提供培训的具体情况,以及导致儿科客户缺乏专业口译员的因素。
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引用次数: 0
Utility of side-lying posture in a patient with severe dysphagia secondary to oropharyngeal cancer surgery: A single case report 侧卧位在口咽癌术后严重吞咽困难患者中的应用:1例报告
Pub Date : 2022-04-09 DOI: 10.3233/acs-210039
Asako Kaneoka, H. Inokuchi, A. Yamauchi, T. Sakai, Yuki Saito, N. Haga
INTRODUCTION: Few studies have documented the utility of side-lying in dysphagia management. We report on a patient who benefitted from the side-lying posture for safe and efficient oral intake. PATIENT: The patient underwent resections of the left tongue base, the left lateral pharyngeal wall, and a left marginal mandibulectomy for oropharyngeal cancer. The Videofluoroscopic Swallowing Study (VFSS) on Postoperative Day (POD) 10 confirmed significant pyriform sinus residue and post-swallow aspiration. Techniques including bolus modification, the 45-degree reclining position, head rotation to the left, and the Mendelsohn maneuver did not prevent post-swallow aspiration of severe pyriform sinus residue. Instead of the 45-degree reclining position, when fed in the side-lying posture with head rotation to the left and the Mendelsohn maneuver, residue clearance was improved on the second VFSS on POD 34. The patient started taking gelatin jelly and continued swallowing exercises in side-lying with head rotation to the left and the Mendelsohn maneuver. With the same techniques, aspiration was not observed in the third VFSS on POD 50. We upgraded the patient’s diet to a pureed diet two months after surgery. The patient resumed taking a regular diet sitting upright by four months after the operations with no aspiration pneumonia. CONCLUSION: The use of side-lying posture, when combined with other techniques, has compensated for the unilateral pharyngeal dysmotility after cancer resection. This preliminary finding suggests that side-lying posture may be an option as a transitional compensatory technique for safe and effective swallowing until the patient returns to full oral intake.
引言:很少有研究证明侧躺在吞咽困难治疗中的效用。我们报告了一个患者受益于侧卧姿势安全有效的口服摄入。患者:患者因口咽癌行左舌根切除、左咽侧壁切除和左下颌缘切除术。术后第10天(POD)的影像透视吞咽研究(VFSS)证实了明显的梨状窦残留和吞咽后误吸。包括丸化、45度卧位、头部向左旋转和Mendelsohn手法在内的技术并不能防止吞咽后严重梨状窦残留的误吸。在POD 34的第二次VFSS上,当以侧卧姿势、头部向左旋转和Mendelsohn手法饲喂时,残渣清除得到改善,而不是45度斜倚位。患者开始服用明胶果冻,并继续侧躺,头部向左旋转和Mendelsohn手法吞咽练习。使用相同的技术,在POD 50的第三次VFSS中未观察到吸痰。手术后两个月,我们把病人的饮食改为泥状饮食。术后4个月,患者恢复正常饮食,坐直,无吸入性肺炎。结论:侧卧位配合其他技术可补偿肿瘤切除后单侧咽部运动障碍。这一初步发现表明,侧躺姿势可能是一种过渡性代偿技术,可以安全有效地吞咽,直到患者完全恢复口服摄入。
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引用次数: 0
Spotlight on: Humanities in speech and language therapy 焦点:言语和语言治疗中的人文学科
Pub Date : 2022-02-25 DOI: 10.3233/acs-210040
I. Walsh, Alexandra Mallinson
In this ‘Spotlight on: Humanities in speech and language therapy’, we argue the case for the arts and humanities to find its way into speech and language therapy (SLT) course curricula, clinical practicum, and other areas related to SLT professional practice. We have a long-held belief that the arts and humanities have much to offer the discipline of speech and language therapy. This review begins with a consideration of what is meant by health humanities, within the more traditionally termed ‘medical humanities’. Considerations for curricular inclusion are also presented. An example from a literary autobiographical work is used to illustrate the possibility and potential of integrating a humanities’ approach to a speech and language therapy curriculum in order to better understand and appreciate communication and communication breakdown. Finally, although the case is made in this review for the discipline of speech and language therapy to embrace the humanities, by implication, there is no reason why other healthcare programmes cannot consider the possibility, where better understanding of the human condition of health and illness is core to teaching and learning.
在这篇“聚焦:语言和语言治疗中的人文学科”中,我们讨论了艺术和人文学科在语言和语言治疗(SLT)课程、临床实习和其他与语言和语言治疗专业实践相关的领域中的应用。长期以来,我们一直认为艺术和人文学科可以为语言治疗学科提供很多帮助。本综述首先考虑健康人文学科的含义,在更传统的“医学人文学科”范围内。课程纳入的考虑也提出。本文以一部文学自传体作品为例,说明了将人文学科方法与语言治疗课程相结合的可能性和潜力,以便更好地理解和欣赏沟通和沟通破裂。最后,尽管在本综述中提出了语言和语言治疗学科拥抱人文学科的案例,但言下之意是,其他医疗保健项目没有理由不能考虑这种可能性,因为更好地理解人类的健康和疾病状况是教学的核心。
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引用次数: 1
Foreword to advances in communication and swallowing volume 24, issue 2 《沟通与吞咽进展》第24卷第2期前言
Pub Date : 2022-01-20 DOI: 10.3233/acs-229001
J. Regan, I. Walsh
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引用次数: 0
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Advances in communication and swallowing
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