HC 1 General framework Flashcards
What’s the importance of getting the whole ICF picture in treating dysphagia?
Because of the great importance for the patient of the unobservable aspects of the dysphagia: the embarrasment, not having fun eating, the effort,…
=> so you need to work on this in therapy as well!
What do we understand in “body functions and structures”? Which team member could be involved here?
- structure of the tongue
- esophagus
- vocal folds
- sucking, biting, chewing, manipulation of food in mouth
- consciousness & attention
- taste & smell function
- …
==> SLP, doctors, phsyical therapist,…
What do we understand in “activity”. Which team member could be involved here?
- eating
- drinking
- meal preparing
- coughing, choking
- consistencies
- reflexes, habits
==> SLP, doctors, dietitian,…
What do we understand in “participation”? Which team member could be involved here?
- family at the dinner table
- going to a restaurant
- have/attend a birthday party
- weddingcake
- …
==> patients associations
What do we understand in “environmental factors”? Which team member could be involved here?
- availability of aids
- food adjustments
- medication
- other treatments
- …
==> SLP, social worker, psychologist, nurse, occupational therapist,…
What do we understand in “personal factors”? Which team member could be involved here?
- patients preferences in food and drinks
- cultural or religious food choices
- …
==> psychologist, social worker, dietitian,…
Why do we use - besides ICF - EBP as a frame of reference?
Because it leads to the
- best assessment
- best treatment
- best advice
for your patient
Explain the 5 steps of EBP
- ASK: convert the need for information into an aswerable clinical question
- ACQUIRE: track down the best evidence for answering your question
- APPRAISE: critically appraise the evidence for validity, impact and applicability
- APPLY: integrate the evidence into your clinical decision making
- AUDIT: evaluatie steps 1-4 and seek ways to improve next time
We set SMART goals and will achieve it by a SMARTER process. Explain
- SMART: specific, measurable, achievable, realistic and time-bound
- SMARTER: shared, monitored, accessible, relevant, transparent, evolving and relationship-centered
What elements are mandatory to talk about dysphagia?
- structures critical for swallowing are involved: abnormalities in the structures or in their movements
- transport/movement is involved: from mouth to stomach
- safety is involved: (risk of) choking, undernutrition or aspiration pneumonia
How can we classify dysphagia?
1. by age:
- pediatric - adults - presbyphagia
2. by stage:
- oropharyngeal dysphagia: preparation phase, transport phase, pharyngeal phase (mouth & throat)
- esophageal dysphagia: esphageal phase (disturbed peristalsis or obstruction)
3. by etiology:
- neurologic (acute, chronic, degenerative)
- structural (pathology [congenital or acquired] or therapy)
- iatrogenic
- presbyphagia (primary or secondary)
- psychogenic
In which groups is there a high prevalence of dysphagia?
- stroke (acute & chronic)
- stroke brainstem
- TBI (= traumatic brain injury)
- progressive diseases
- head-neck carcinoma
- dementia
- elderly
What are the main medical consequences of dysphagia? Why?
- undernutrition: lower energy levels (important to sustain a swallow), negative effect on immune system => infection, sepsis, death
- aspiration pneumonia: treatment is costly, increased lenght of stay in hospital, greater disability, poorer nutritional status
- dehydration: increase mental confusion + organ system failure => negative effect on swallowing (vicious circle)
==> higher morbidity, higher mortality
What does a SLP have to think about when treating dysphagia?
- is it safe? Airway protection
- is it adequate? Nutrition, hydration
- quality of life
What psychosocial consequences come with dysphagia?
- social interactions: limitations
- affects spouses and family too
- stress when preparing special meals
- increased cost for dietary supplements
