| Abstract [eng] |
There are no standardized tools for the assessment of dysphagia and the readiness to remove a nasogastric tube (NGT) in Lithuanian health care institutions. A theoretical analysis has shown that in the early stage of the disorder, examinations performed in a patient's ward are sufficiently accurate and do not require radiological evaluation, and the choice of appropriate SLT methods depends on the individual case. The paper examines the evaluation of oropharyngeal dysphagia in the patient's ward and the possibilities of overcoming it using an individual SLT program. A case study was chosen as a qualitative research strategy in which theoretical analysis and interview as well as content analysis and researcher’s reflection methods were applied. The aim of the study was to reveal the assessment of swallowing disorders of adults fed by NGT in the ward and the possibility of overcoming them using an individual SLT program. Study participants were selected based on age (adults), feeding method (NGT), and disorder (dysphagia). The study included four people aged 35 – 80 years. A NGT was inserted to all study participants. The empirical part evaluates the dynamics of the swallowing function. An individual SLT program was created for each research participant. Main findings of the study: 1. Enteral feeding improves feeding quality, but it restricts patient's movements, complicates communication, induces isolation. Accurate assessment of dysphagia can be made by performing a swallowing sample in the patient’s ward. When developing SLT program, it is important to assess patient's individual abilities, needs, readiness, motivation to perform the planned activities, and the involvement and assistance of relatives. 2. Assessment of swallowing function takes into account masticatory muscle function, movements of lips, tongue and soft palate, swallowing, cough and gag reflex, oral control, oral residue, voice quality after swallowing and aspiration risk. 3. In all cases swallowing disorder caused limitations in subjects' activities, mobility, self-care, communication and participation, and a reduced quality of life. 4. The dynamics of dysphagia were positive in three of the four cases. When assessing the patients’ recovery, it was observed that an individual SLT program was effective for all subjects in the study. |
