Abstract
BackgroundEarly identification of stroke-related oropharyngeal dysphagia (OPD) using screening by nurses can prevent adverse patient outcomes in lower middle-income countries. Nurses are essential in the OPD management team and should ideally be able to screen and prioritise dysphagia management in stroke patients.ObjectiveThe aim of this research was to describe nurses’ practices related to identification and management of patients with stroke-related OPD.MethodsQualified nurses from various healthcare levels in the Eastern Cape, South Africa were invited to complete a previously published hard copy survey on the signs and symptoms, complications and management of stroke-related OPD. A sample of 130 participants completed the survey.ResultsThe mean scores of correct responses for each section were: 8.7/13 (66.7%) for signs and symptoms, 4.7/10 (47.3%) for complications and 3.8/7 (54.2%) for management practices. Statistically, there were no differences between the levels of healthcare for the signs and symptoms section and the complications section. Regarding management of OPD, secondary-level (S) nurses demonstrated significantly better knowledge than primary-level (P) and tertiary-level (T) nurses (S–P: p = 0.022; S–T: p = 0.010). Secondary-level nurses also scored significantly higher across all three sections (S–P: p = 0.044; S–T: p = 0.025) than those at the other levels.ConclusionsThe study found that nurses across all levels of healthcare had only moderate knowledge regarding identification and management of stroke-related OPD. Interdisciplinary collaboration between nurses and speech–language therapists may improve nurses’ knowledge in identification and management of stroke-related OPD in lower middle-income settings such as South Africa.
Highlights
In rural South Africa, strokes result in approximately 30 000 deaths yearly and are the largest cause of disability in the country (Maredza, Bertram, Gómez-Olivé, & Tollman, 2016)
Despite regularly managing stroke patients, this study revealed that only half of the participants had received previous training on stroke, and only 26.9% of the participants had received training on stroke-related oropharyngeal dysphagia (OPD)
Research shows that OPD occurs in up to 80% of persons who have suffered a stroke (Takizawa et al, 2016), the nurses in this study, who are vital in the management of OPD, had received minimal training
Summary
In rural South Africa, strokes result in approximately 30 000 deaths yearly and are the largest cause of disability in the country (Maredza, Bertram, Gómez-Olivé, & Tollman, 2016). Stroke is one of the leading causes of oropharyngeal dysphagia (OPD) (Behera et al, 2018; Joundi et al, 2017). Identification of OPD using screening allows for prompt initiation of management plans, which may improve patient outcomes (Sherman et al, 2018). The importance of accurate early identification of stroke-related OPD by nurses is evident, as this may guide its initial management, such as placing a patient nil per os until http://www.sajcd.org.za. Identification of stroke-related oropharyngeal dysphagia (OPD) using screening by nurses can prevent adverse patient outcomes in lower middle-income countries. Nurses are essential in the OPD management team and should ideally be able to screen and prioritise dysphagia management in stroke patients
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