Abstract
Background: Dysphagia has profound effects on individuals, and living with dysphagia is a complex phenomenon that touches essential areas of life. Dysphagia following a brainstem stroke is often more severe and the chances of spontaneous recovery are less likely as compared with dysphagia following a hemispheric stroke. Objective: To explore how two individuals with brainstem stroke experienced severe dysphagia during their inpatient neurorehabilitation and how they experienced their recovery approximately one month following discharge. Methods: An explorative study was conducted to evaluate the first-hand perspective on severe eating difficulties. A qualitative case study was chosen to collect data during two face-to-face semi-structured interviews. Phenomenological perspectives shaped the interview-process and the processing of data. Results: Analysis of the empirical data generated the following main themes regarding experiences of: (i) the mouth and throat; (ii) shared dining; and (iii) recovery and regression related to swallowing-eating-drinking. Conclusion: Participants expressed altered sensations of the mouth and throat, which affected their oral intake and social participation in meals. Good support for managing and adapting their problems of swallowing, eating, and drinking in daily activities is essential. Knowledge and skills of professionals in relation to dysphagia is a significant requirement for recovery progress in settings within the municipality.
Highlights
About 15% of patients in neurorehabilitation are diagnosed with brainstem stroke (BSS) [1]
BSS admitted to neurorehabilitation, and found that patients with BSS experienced a range of reduced functional abilities e.g., hemiparesis, dysarthria and dysphagia, diplopia, and ataxia as a consequence of stroke [1]
The CARE Case Report Guideline [20] was used to increase the accuracy and transparency of the present case report study, which forms one of four sub-studies of a mixed-methods investigation regarding difficulties with swallowing and eating following acquired brain injury (ABI). The first of these studies was a prospective randomised controlled trial (RCT) of the assessment of facial-oral tract therapy versus fibreoptic endoscopic evaluation of swallowing during inpatient neurorehabilitation; we compared the risk of aspiration pneumonia in patients with ABI [21] and the time to initiation of oral intake and recovery of total oral intake prior to discharge [22]
Summary
About 15% of patients in neurorehabilitation are diagnosed with brainstem stroke (BSS) [1].The swallowing centre or the “central pattern generator for swallowing” (CPG) is located in the brainstem [2]. About 15% of patients in neurorehabilitation are diagnosed with brainstem stroke (BSS) [1]. Studies report an incidence of dysphagia in 70–81% of patients with BSS at admission to acute stroke unit [3,4]. 3. The meaning of food and liquid at the time of the interview and immediately after the injury. 5. Are you currently experiencing worries and if so, do they influence your mood in relation to eating and drinking? Objective: To explore how two individuals with brainstem stroke experienced severe dysphagia during their inpatient neurorehabilitation and how they experienced their recovery approximately one month following discharge. Results: Analysis of the empirical data generated the following main themes regarding experiences of: (i) the mouth and throat; (ii) shared dining; and (iii) recovery and regression related to swallowing-eating-drinking
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