Valid Items for Screening Dysphagia Risk in Stroke Patients: A Systematic Review

2.50
Hdl Handle:
http://hdl.handle.net/10755/243534
Category:
Full-text
Type:
Presentation
Title:
Valid Items for Screening Dysphagia Risk in Stroke Patients: A Systematic Review
Author(s):
Willson, Pamela
Lead Author STTI Affiliation:
Houston, Texas
Author Details:
Willson, Pamela, RN, PhD, FNP, BC, CNE, pcwillson@mac.com;
Abstract:
Purpose:

Early detection of dysphagia in acute stroke is critical as it allows for immediate intervention, thereby reducing mortality, morbidity, length of hospitalization, and healthcare costs. These findings have led to the recommendation to screen swallowing ability in all acute stroke patients, regardless of stroke severity. A systematic review of the literature was undertaken to determine the evidence-based validity of dysphagia screening items using instrumental evaluation as the reference standard.

Methods:

Four databases from 1985 through March, 2011 were searched using the terms cerebrovascular disease, stroke deglutition disorders, and dysphagia. Eligibility criteria were: homogeneous stroke population, comparison to instrumental examination, clinical examination without equipment, outcome measures of dysphagia and aspiration, and validity for screening items reported or able to be calculated. Articles meeting inclusion criteria were evaluated for methodological rigor. Sensitivity, specificity, and predictive capabilities were calculated for each item.   

Results:

Total source documents numbered 832; 86 were reviewed in full, and 16 met inclusion criteria. Study quality was variable. Testing swallowing, generally with water, was most common. Swallowing protocols, nor sensitivity and specificity were consistent across studies. Non-swallowing behaviors were also identified as predictive of aspiration.  

Conclusion:

Numerous behaviors were identified that were associated with aspiration. The best combination of non-swallowing and swallowing items as well as the best swallowing protocol remains unclear. Findings of this review will assist in development of valid clinical screening instruments that can be used by nurses to identify dysphagia among stroke patients.

Keywords:
Dysphagia screening; Stroke; Validity
Repository Posting Date:
12-Sep-2012
Date of Publication:
12-Sep-2012 ; 12-Sep-2012
Conference Date:
2012
Conference Name:
23rd International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Brisbane, Australia

Full metadata record

DC FieldValue Language
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleValid Items for Screening Dysphagia Risk in Stroke Patients: A Systematic Reviewen
dc.contributor.authorWillson, Pamelaen
dc.contributor.departmentHouston, Texasen
dc.author.detailsWillson, Pamela, RN, PhD, FNP, BC, CNE, pcwillson@mac.com;en
dc.identifier.urihttp://hdl.handle.net/10755/243534-
dc.description.abstract<b>Purpose: </b> <p>Early detection of dysphagia in acute stroke is critical as it allows for immediate intervention, thereby reducing mortality, morbidity, length of hospitalization, and healthcare costs. These findings have led to the recommendation to screen swallowing ability in all acute stroke patients, regardless of stroke severity. A systematic review of the literature was undertaken to determine the evidence-based validity of dysphagia screening items using instrumental evaluation as the reference standard. <p><b>Methods: </b> <p>Four databases from 1985 through March, 2011 were searched using the terms cerebrovascular disease, stroke deglutition disorders, and dysphagia. Eligibility criteria were: homogeneous stroke population, comparison to instrumental examination, clinical examination without equipment, outcome measures of dysphagia and aspiration, and validity for screening items reported or able to be calculated. Articles meeting inclusion criteria were evaluated for methodological rigor. Sensitivity, specificity, and predictive capabilities were calculated for each item. &nbsp;&nbsp; <p><b>Results: </b> <p>Total source documents numbered 832; 86 were reviewed in full, and 16 met inclusion criteria. Study quality was variable. Testing swallowing, generally with water, was most common. Swallowing protocols, nor sensitivity and specificity were consistent across studies. Non-swallowing behaviors were also identified as predictive of aspiration.&nbsp;&nbsp; <p><b>Conclusion: </b> <p>Numerous behaviors were identified that were associated with aspiration. The best combination of non-swallowing and swallowing items as well as the best swallowing protocol remains unclear. Findings of this review will assist in development of valid clinical screening instruments that can be used by nurses to&nbsp;identify dysphagia among stroke patients.en
dc.subjectDysphagia screeningen
dc.subjectStrokeen
dc.subjectValidityen
dc.date.available2012-09-12T09:23:37Z-
dc.date.issued2012-09-12-
dc.date.issued2012-09-12en
dc.date.accessioned2012-09-12T09:23:37Z-
dc.conference.date2012en
dc.conference.name23rd International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationBrisbane, Australiaen
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