Adult dysphagia intervention through telepractice : a scoping review

[摘要] ENGLISH SUMMARY : Background: Dysphagia is a serious, life-endangering disorder, experienced by an increasing number of people.Worldwide, there are a limited number of healthcare professionals to provide face-to-face dysphagia intervention.Telepractice has been suggested as a potential solution. The question this scoping review aimed to answer is: Howis telepractice applied to adult dysphagia intervention? Objective: To explore the application of telepractice toadult dysphagia intervention, at a national and international level. Inclusion criteria: Data was restricted toliterature where participants involved were over the age of 18 years, and experiencing feeding and/or swallowingdifficulties at that point in time. The core concepts were telepractice, and adult dysphagia intervention. Sourceswere only included if published during or after the year 2000, and full text was available in English. Experts wereconsulted to determine the challenges to implementation in South Africa, based on the results obtained. Expertswere required to be: registered with the Health Professions Council of South Africa, providers of adult dysphagiaintervention on a weekly basis for the last five years, practice in the Western Cape and be able to communicateeffectively in English. Search strategy: The following Boolean search string was used to search 18 databases on20 April 2018: (Telehealth OR Telecare OR Telemedicine OR Telepractice OR Teletherapy OR TelerehabilitationOR Telestroke OR Tele-dysphagia OR Tele-intervention OR 'Telephone intervention OR 'Videoconferencing) and (Dysphagia OR Swallow* OR Feeding OR Deglutition) not (Child* Or Paediatric ORPediatric OR Adolescent OR Infant). Extraction of results: Results were screened by title, and abstract to removeirrelevant articles. Remaining articles were screened by full text by the researcher and an inter-rater. Consensuswas reached on which articles to include. The reference lists of these articles were screened by title and identifiedtitles were screened by abstract and full text where necessary. The final selection of studies was charted accordingto the following categories: author(s), year of publication, location of study, areas of intervention, method oftelepractice (equipment, procedure, internet requirements, and duration), and key findings. Presentation of results:Twenty-two articles were included. Dysphagia management was detailed in six articles. Specifically, threefocused on rehabilitative management, two on compensatory management, and two on unspecified management.Instrumental assessment, was detailed in eight of the studies. Six studies focused on clinical swallowexaminations, two on screening, and one on case history. Two studies focused on dysphagia assessment in general.One study focused on referral. Experts identified lack of resources, poor internet access, and lack of legislatureabout reimbursement, as key challenges. Proposed solutions included: using existing equipment, free Wi-Fi orUSSD programmes, and developing reimbursement policies. Conclusions: Telepractice shows promisingopportunities for adult dysphagia intervention with regards to screening, assessment, management and referral.Studies are still required to investigate the use of telepractice in prevention, health promotion and counsellingpertaining to adult dysphagia. There is a need for policy development regarding reimbursement of dysphagiarelatedtelepractice services. Experts believe adult dysphagia intervention can be provided using telepractice in South Africa, if adapted to the needs of our context.

[发布机构] Stellenbosch University