Abstract
To the Editor, We are pleased to report on the development and progress of the trans-disciplinary field of Deglutology in Japan as the Japanese Society of Dysphagia Rehabilitation (JSDR) commemorates its 20th year of establishment. The JSDR includes a broad range of disciplines in order to integrate diverse knowledge and expertise and pave the way for the emerging field of Deglutition. The percentage of individuals aged over 65 years reached 25.0 % of the Japanese population in 2013 [1]. With this rapid increase in the elderly, a substantially greater demand for dysphagia rehabilitation comes up. As the progression of dysphagia diminishes both the function of swallowing and the enjoyment of eating, the objective of dysphagia rehabilitation should therefore address both the recovery of swallowing function and the restoration of pleasure while eating. Dysphagia rehabilitation is performed for a wide range of disease stages, from acute medical care to terminal support. Although a team approach is essential for effective rehabilitation, treatment can be challenging because support strategies vary considerably over time and require numerous approaches and caregivers. We normally divide the team approach in dysphagia rehabilitation into three categories according to the relationships among participating disciplines as follows: (1) the multi-disciplinary approach, where disciplines treat patients independently and have little communication with each other, (2) the inter-disciplinary approach, where related disciplines exchange information at team conferences to reach a consensus on treatment, thus promoting inter-disciplinary cooperation, and (3) the trans-disciplinary approach, where participating disciplines complement the scope of others to more efficiently integrate a team approach. The trans-disciplinary approach is particularly suitable for dysphagia rehabilitation because the size and composition of a support team may change significantly over time; complementing the scopes of associated disciplines without establishing a rigid inter-disciplinary border enables seamless care over a wider range of individuals, symptom stages, and circumstances. The JSDR was founded in 1995 under the concept of a trans-disciplinary approach for dysphagia rehabilitation. As the society now celebrates 20 years of progress and innovation, its membership has grown to more than 11,000 medical professionals (11,653 as of August 30, 2014) and involves numerous disciplines (Fig. 1) in line with the original JSDR trans-disciplinary tenets. Recently, the 20th annual conference of the JSDR held in Tokyo in September 2014 featured an international symposium that included 12 E. Saitoh Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan e-mail: esaitoh@fujita-hu.ac.jp
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