Skip to main content

Advertisement

SpringerLink
Log in

Dysphagia Management in Iran: Knowledge, Attitude and Practice of Healthcare Providers

  • Original Article
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

Despite the remarkable burden of dysphagia, appropriate multidisciplinary management is lacking in Iran and patients are often deprived of effective treatments. Obtaining a full understanding of knowledge, attitude and practice (KAP) of healthcare providers is necessary to determine the gaps in improvement of the quality of care for dysphagic patients. A questionnaire was designed covering demographic information and the parameters of KAP. Face and content validity were determined. Test–retest reliability confirmed that the questionnaire scores are stable over time (r = 0.77, p value < 0.01). Participants were healthcare providers employed in university-affiliated hospitals in three major cities of Iran; Tehran, Shiraz and Mashhad. In total, 312 healthcare professionals completed our survey. The majority (96.8%) were familiar with the term “dysphagia or swallowing disorders”. Most of the participants believed their profession (88.5%), as well as other disciplines (92.3%) can play an important role in the management of dysphagia; and this problem should be recognized in a multidisciplinary manner (96.2%). Also, 60.9% had encountered a patient with dysphagia. 52.2% had used at least one assessment method, while 49.9% had applied at least one treatment method. However, very few participants were familiar with a standard test for screening and assessment of dysphagia (11.9%). 74.7% were willing to participate in a workshop on dysphagia. As the main pitfalls of care lie in diagnosis and treatment expertise, the policy of hospitals should prioritize educating and updating the skills of healthcare professionals, encourage multidisciplinary teamwork, establishing clear guidelines and facilitate access to advanced tools.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Cho SY, Choung RS, Saito YA, Schleck CD, Zinsmeister AR, Locke G, et al. Prevalence and risk factors for dysphagia: a USA community study. Neurogastroenterol Motil. 2015;27(2):212–9. https://doi.org/10.1111/nmo.12467.

    Article  CAS  PubMed  Google Scholar 

  2. Rommel N, Hamdy S. Oropharyngeal dysphagia: manifestations and diagnosis. Nat Rev Gastroenterol Hepatol. 2016;13(1):49. https://doi.org/10.1038/nrgastro.2015.199.

    Article  PubMed  Google Scholar 

  3. Clavé P, Shaker R. Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol. 2015;12(5):259–70. https://doi.org/10.1038/nrgastro.2015.49.

    Article  PubMed  Google Scholar 

  4. Kidambi T, Toto E, Ho N, Taft T, Hirano I. Temporal trends in the relative prevalence of dysphagia etiologies from 1999-2009. World J Gastroenterol. 2012;18(32):4335. https://doi.org/10.3748/wjg.v18.i32.4335.

    Article  PubMed  PubMed Central  Google Scholar 

  5. White GN, O’Rourke F, Ong BS, Cordato DJ, Chan DK. Dysphagia: causes, assessment, treatment, and management. Geriatrics. 2008;63(5):15–20.

    PubMed  Google Scholar 

  6. Schindler A, Ginocchio D, Ruoppolo G. What we don’t know about dysphagia complications? Rev Laryngol Otol Rhinol. 2008;129(2):75–8.

    CAS  Google Scholar 

  7. Rofes L, Arreola V, Almirall J, Cabré M, Campins L, García-Peris P, et al. Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterol Res Prac. 2011. https://doi.org/10.1155/2011/818979.

    Article  Google Scholar 

  8. Chen P-H, Golub JS, Hapner ER, Johns MM. Prevalence of perceived dysphagia and quality-of-life impairment in a geriatric population. Dysphagia. 2009;24(1):1–6. https://doi.org/10.1007/s00455-008-9156-1.

    Article  PubMed  Google Scholar 

  9. Eslick GD, Talley N. Dysphagia: epidemiology, risk factors and impact on quality of life–a population based study. Aliment Pharmacol Ther. 2008;27(10):971–9. https://doi.org/10.1111/j.1365-2036.2008.03664.x.

    Article  CAS  PubMed  Google Scholar 

  10. Barikroo A, Hosseini Z, Ansari Z. The prevalence of oropharyngeal dysphagia among nursing home residents in Isfahan. J Res Rehabilit Sci. 2012;7(2):155–61.

    Google Scholar 

  11. Poorjavad M, Derakhshandeh F, Etemadifar M, Soleymani B, Minagar A, Maghzi A-H. Oropharyngeal dysphagia in multiple sclerosis. Mult Scler J. 2010;16(3):362–5. https://doi.org/10.1007/s00455-008-9156-1.

    Article  Google Scholar 

  12. Guan X-L, Wang H, Huang H-S, Meng L. Prevalence of dysphagia in multiple sclerosis: a systematic review and meta-analysis. Neurol Sci. 2015;36(5):671–81. https://doi.org/10.1007/s10072-015-2067-7.

    Article  PubMed  Google Scholar 

  13. Bakhtiyari J, Sarraf P, Nakhostin-Ansari N, Tafakhori A, Logemann J, Faghihzadeh S, et al. Effects of early intervention of swallowing therapy on recovery from dysphagia following stroke. Iran J Neurol. 2015;14(3):119.

    PubMed  PubMed Central  Google Scholar 

  14. Farpour S, Farpour HR. Acute phase of stroke and dysphagia: A cross-sectional study in Shiraz, Iran. An International Peer Reviewed Open Access Journal For Rapid Publication. 2017:328.

  15. Speyer R, Baijens L, Heijnen M, Zwijnenberg I. Effects of therapy in oropharyngeal dysphagia by speech and language therapists: a systematic review. Dysphagia. 2010;25(1):40–65. https://doi.org/10.1007/s00455-009-9239-7.

    Article  PubMed  Google Scholar 

  16. Association AS-L-H. Scope of practice in speech-language pathology. Rockville: Association AS-L-H; 2016.

    Google Scholar 

  17. Do Canada. Defining the role of the dietitian in dysphagia assessment and management. Can J Diet Pract Res. 2015;76(2):100. https://doi.org/10.3148/cjdpr-2015-013.

    Article  Google Scholar 

  18. Macleod M, O’Shea S. The dietitian’s role in diagnosis and treatment of dysphagia. Med Radiol Diagn Imaging. 2017. https://doi.org/10.1007/174_2017_124.

    Article  Google Scholar 

  19. Ortega O, Sakwinska O, Combremont S, Berger B, Sauser J, Parra C, et al. High prevalence of colonization of oral cavity by respiratory pathogens in frail older patients with oropharyngeal dysphagia. Neurogastroenterol Motil. 2015;27(12):1804–16. https://doi.org/10.1111/nmo.12690.

    Article  CAS  PubMed  Google Scholar 

  20. Pace CC, McCullough GH. The association between oral microorgansims and aspiration pneumonia in the institutionalized elderly: review and recommendations. Dysphagia. 2010;25(4):307–22. https://doi.org/10.1007/s00455-010-9298-9.

    Article  PubMed  Google Scholar 

  21. Poisson P, Laffond T, Campos S, Dupuis V, Bourdel-Marchasson I. Relationships between oral health, dysphagia and undernutrition in hospitalised elderly patients. Gerodontology. 2016;33(2):161–8. https://doi.org/10.1111/ger.12123.

    Article  PubMed  Google Scholar 

  22. Ortega O, Parra C, Zarcero S, Nart J, Sakwinska O, Clavé P. Oral health in older patients with oropharyngeal dysphagia. Age Ageing. 2014;43(1):132–7. https://doi.org/10.1093/ageing/aft164.

    Article  PubMed  Google Scholar 

  23. Speyer R. Oropharyngeal dysphagia. Otolaryngol Clin N Am. 2013;46(6):989–1008. https://doi.org/10.1016/j.otc.2013.08.004.

    Article  Google Scholar 

  24. Clavé P, Arreola V, Romea M, Medina L, Palomera E, Serra-Prat M. Accuracy of the volume-viscosity swallow test for clinical screening of oropharyngeal dysphagia and aspiration. Clin Nutr. 2008;27(6):806–15. https://doi.org/10.1016/j.clnu.2008.06.011.

    Article  PubMed  Google Scholar 

  25. Kamal RM, Ward E, Cornwell P. Dysphagia training for speech-language pathologists: implications for clinical practice. Int J Speech Lang Pathol. 2012;14(6):569–76. https://doi.org/10.3109/17549507.2012.713394.

    Article  PubMed  Google Scholar 

  26. Dolce MC, Haber J, Shelley D. Oral health nursing education and practice program. Nurs Res Pract. 2012;2012:149673. https://doi.org/10.1155/2012/149673.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This study was funded by Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran (Grant No. 13502).

Author information

Authors and Affiliations

  1. Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Sima Farpour

  2. Department of Physical Medicine and Rehabilitation, Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, 7187719446, Iran

    Hamid Reza Farpour

  3. Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust, London, UK

    David Smithard

  4. Bone and Joint Diseases Research Center, Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Bahareh Kardeh

  5. Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran

    Fatemeh Ghazaei

  6. Department of Physical Medicine and Rehabilitation, Mashhad University of Medical Sciences, Mashhad, Iran

    Mohsen Zafarghasempour

Authors
  1. Sima Farpour
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hamid Reza Farpour
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. David Smithard
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bahareh Kardeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fatemeh Ghazaei
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mohsen Zafarghasempour
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hamid Reza Farpour.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Farpour, S., Farpour, H.R., Smithard, D. et al. Dysphagia Management in Iran: Knowledge, Attitude and Practice of Healthcare Providers. Dysphagia 34, 105–111 (2019). https://doi.org/10.1007/s00455-018-9919-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-018-9919-2

Keywords

Search

Navigation