Dysphagia Quality Of Life Research Articles

Development of Symptom Specific Dysphagia Quality of Life Questionnairein Tamil.

Swallowing intricately involves sensorimotor systems, pivotal for integrating upper digestive and respiratory functions. Dysphagia, challenging swallowing, often precipitates anxiety and depression, deeply affecting the quality of life (QOL). Understanding patient-centric symptoms is vital for assessing dysphagia's QOL impact. This study aimed at developing and validating the Symptom Specific Dysphagia Quality of Life Questionnaire in Tamil (SSDQOL-T). SSDQOL-T was developed in Tamil and underwent rigorous content validation. This questionnaire was administered to 120 normal individuals and 32 dysphagia patients, assessing various swallowing difficulties and their QOL impact. Results indicate SSDQOL-T's good internal consistency (Cronbach's α = 0.78). Significant differences in swallowing ability and QOL were noted across age groups, with older adults experiencing heightened symptoms. A high significance in mean score was obtained between healthy adults and dysphagia across all sub-domains with a 'p-value' of 0.0005. Symptoms that were found to have high significance were cough/gag reflex, regurgitation, odynophagia, globus sensation, heartburn and tiredness when compared between mechanical and degenerative dysphagia group. Strong correlations were found between SSDQOL-T scores and the Dysphagia Handicap Index in Tamil (r = 0.89). The SSDQOL-T questionnaire provides a robust tool for evaluating dysphagia-related QOL in the Tamil-speaking population. Its validation underscores its clinical relevance and utility for understanding the multidimensional impact of dysphagia. This study emphasizes the importance of culturally sensitive assessment tools in comprehensively evaluating dysphagia's QOL implications.

Quality of life in dysphagia and functional performance of cancer patients in palliative care.

To correlate the functional performance and impact of dysphagia on the quality of life of cancer patients in palliative care. This cross-sectional, quantitative study was conducted at the outpatient clinic and oncology ward of a university hospital. Inclusion criteria required patients to respond positively to the question: "Do you have difficulty or problems swallowing?". Patients were excluded if they had been diagnosed with head and neck cancer, were unable to answer questionnaires due to actively dying status, were in a state of drowsiness, experienced extreme pain and systemic instability, or if data collection instruments were incomplete. Two instruments were used in their Brazilian Portuguese versions: the Palliative Performance Scale (PPS) and the M. D. Anderson Dysphagia Inventory (MDADI). The variables were analyzed using descriptive and inferential statistics, with Pearson's correlation used at a 5% significance level. The sample consisted of 39 participants, with an average age of 65.3 years, of whom 24 (61.5%) were women. The most frequent neoplasm sites were the pancreas and stomach. The results of the PPS indicated that the average patient had reduced ambulation and inability to work, but maintained independence in self-care, with a complete level of swallowing and consciousness. The MDADI showed an average degree of limitation. Outpatients exhibited a moderate correlation between the MDADI result and the level of functionality according to the PPS. Cancer patients at the palliative care outpatient clinic demonstrated a correlation between functional performance and the impact of dysphagia on quality of life.

Treatment of supraglottic squamous cell carcinoma with advanced technologies: observational prospective evaluation of oncological outcomes, functional outcomes, quality of life and cost-effectiveness (SUPRA-QoL)

BackgroundOver the past decade, therapeutic options in head and neck supraglottic squamous cell carcinoma have constantly evolved. The classical total laryngectomy has been partially replaced by alternative organ- and function-sparing techniques with the same prognosis but less morbidity, such as Radiotherapy, Transoral Laser Microsurgery (TLM) and Trans-Oral Robotic Surgery (TORS). Up to now, a prospective comparison of these innovant techniques has not been conducted.Methods/designWe will conduct an original international multicentric prospective nonrandomized clinical trial to compare the efficacy between these treatments (Arm 1: Radiotherapy ± chemotherapy; Arm 2: TLM and Arm 3: TORS) with 4 classes of outcomes: quality of life (QoL), oncological outcomes, functional outcomes and economic resources. The population will include cT1-T2 /cN0-N1/M0 supraglottic squamous cell carcinoma. The primary outcome is a Clinical Dysphagia QoL evaluation assessed by the MD Anderson Dysphagia questionnaire. Secondary outcomes include others QoL evaluation, oncological and functional measures and cost parameters. The sample size needs to reach 36 patients per arm (total 108).DiscussionIn the current literature, no prospective head-to-head trials are available to compare objectively these different treatments. With the increase of highly efficient treatments and the increase of oncological survival, it is imperative also to develop management strategies that optimize QoL and functional results. We will conduct this innovate prospective trial in order to obtain objective data in these two main issues.Trial registrationNCT05611515 posted on 10/11/2022 (clinicaltrial.fgov).

Qualidade de vida em disfagia e sintomas de ansiedade e depressão pré e pós-tireoidectomia

ABSTRACT Purpose To correlate the dysphagia quality of life and symptoms of anxiety and depression before and after thyroidectomy. Methods Observational, longitudinal, prospective, and experimental study. Twenty patients participated, with a mean age of 54 years, prevalence of females (n=17; 85%) and partial thyroidectomy (n=14; 70%). All subjects underwent laryngeal visual examination and answered the MD Anderson Dysphagia Questionnaire (MDADI) and the Hospital Anxiety and Depression Scale (HADS) in three different moments: preoperatively, immediately postoperatively (maximum one week) and three months after surgery. Results There was a significant difference in dysphagia quality of life for the physical and total domains in the three different moments. Regarding anxiety and depression, a statistically significant difference was observed between the scores in all domains, with a greater difference observed between the preoperative period and after 1 week. Higher values were observed in the preoperative period for mild anxiety traits, being more frequent in relation to depression, with a reduction after 1 week and an increase after three months of surgery. There was no significant correlation between the MDADI and HADS protocols. Conclusion Patients undergoing thyroidectomy self-report better quality of life in dysphagia and reduced anxiety/depression scores after three months of surgery. There was no correlation between anxiety, depression and quality of life in dysphagia at the moments evaluated.

Postoperative morbidity and quality of life between totally laparoscopic total gastrectomy and laparoscopy-assisted total gastrectomy: a propensity-score matched analysis

BackgroundThis study aimed to evaluate the surgical outcome and quality of life (QoL) of totally laparoscopic total gastrectomy (TLTG) compared with laparoscopy-assisted total gastrectomy (LATG) in patients with clinical stage I gastric cancer.MethodsFrom 2012 to 2018, EGC patients who underwent TLTG (n = 223), including the first case with intracorporeal hemi-double stapling, were matched to those who underwent LATG (n = 114) with extracorporeal circular stapling, using 2:1 propensity score matching (PSM). Prospectively collected morbidity was compared between the TLTG and LATG groups in conjunction with the learning curve. The European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaires QLQ-C30, STO22, and OG25 were prospectively surveyed during postoperative 1 year for patient subgroups.ResultsAfter PSM, grade I pulmonary complication rate was lower in the TLTG group (n = 213) than in the LATG group (n = 111) (0.5% vs. 5.4%, P = 0.007). Other complications were not different between the groups. The learning curve of TLTG was overcome at the 26th case in terms of the comprehensive complication index. The TLTG group after learning curve showed lower grade I pulmonary complication rate than the matched LATG group (0.5% vs. 4.7%, P = 0.024). Regarding postoperative QoL, the TLTG group (n = 63) revealed less dysphagia (P = 0.028), pain (P = 0.028), eating restriction (P = 0.006), eating (P = 0.004), odynophagia (P = 0.023) than the LATG group (n = 21). Multivariate analyses for each QoL item demonstrated that TLTG was the only common independent factor for better QoL.ConclusionsTLTG reduced grade I pulmonary complications and provided better QoL in dysphagia, pain, eating, odynophagia than LATG for patients with clinical stage I gastric cancer.

Managing and supporting quality‐of‐life issues in dysphagia: A survey of clinical practice patterns and perspectives in the UK, Ireland and South Africa

There is increasing recognition that dysphagia has significant implications for a person's psychological well-being, social participation and quality of life (QOL). However, a paucity of research exists regarding the clinical management of this area. To inform future research and the development of appropriate and beneficial resources and guidelines, a better understanding of the current practice of speech and language therapists (SLTs) in this area would be useful. This information will highlight current challenges to clinical practice and the ongoing development needs of the profession, which are, as of yet, undocumented. To determine the practices of SLTs when addressing QOL issues in individuals with dysphagia, the beliefs of SLTs regarding the impact of dysphagia on QOL, the current trends in assessing and managing QOL in dysphagia, and if variations in beliefs and practices in this area exist. An anonymous cross-sectional, non-experimental survey study was used. The survey consisted of 18 questions exploring participants' beliefs and opinions regarding dysphagia and QOL, current clinical practice in the area, perceived facilitators and barriers, and education, training and development needs. The survey was created on Survey Monkey and disseminated by e-mail link to SLT professional bodies. Purposive and snowball sampling were used and participants self-selected based on the information provided alongside the e-mail link. Inclusion criteria for the study were a qualification in speech and language therapy, proficiency in the English language, and access to a computer with the internet. A total of 148 SLTs working across the UK, Ireland and South Africa completed the survey. Over 90% of respondents believe that dysphagia has a negative impact on QOL, but only 25% are currently satisfied with the amount of clinical time they can dedicate to this area. Staffing, resources, a lack of best-practice guidelines and disease-specific QOL assessment tools were cited as contributing factors. A number of facilitators and barriers to best practice were also highlighted. Based on these findings, professional development actions for the future are suggested. SLTs believe they have an important role to play in supporting QOL issues in dysphagia. However, it is reported that the area is currently under-developed, under-resourced and under-supported. Increased awareness raising of the role of SLT, alongside the development of best-practice guidelines and disease-specific QOL assessment tools, will enhance the quality of care that can be offered in this area.

A Pilot Study on the Efficacy of Continuous Positive Airway Pressure on the Manifestations of Dysphagia in Patients with Obstructive Sleep Apnea

There is evidence in the literature demonstrating that patients with obstructive sleep apnea (OSA) may present with dysphagia, but few studies have evaluated whether this complaint can be reversed with treatment of OSA. To assess whether findings of dysphagia in patients with OSA can be reversed with the use of continuous positive airway pressure (CPAP) devices. Seventy adult patients (age 18-70years) with moderate or severe OSA were included in the study. All patients underwent fiberoptic endoscopic evaluation of swallowing (FEES) and completed the SWAL-QOL questionnaire on quality of life in dysphagia. Patients with visible abnormalities on FEES were treated with CPAP and reassessed after 3months. The prevalence of dysphagia was 27.3% (18 patients). Premature spillage was the main finding. On comparison of groups with and without dysphagia, the SWAL-QOL score was significantly worse in the dysphagia group in domain 2 (eating duration and eating desire, p = 0.015), with no impact on overall score (p = 0.107). Of the 18 patients with dysphagia, 12 were started on CPAP; 11 exhibited satisfactory adherence and remained in the study. Abnormal FEES findings resolved in 81% (n = 9/11) of patients who started CPAP (p = 0.004), and dysphagia-specific quality of life also improved significantly (overall SWAL-QOL score, p = 0.028). In this sample of patients with OSA, the overall prevalence of dysphagia (as demonstrated by premature spillage on FEES) was 27.3%. Treatment of OSA with CPAP was able to reverse the endoscopic findings of swallowing dysfunction and to improve quality of life as measured by the SWAL-QOL.

Swallowing ability and its impact on dysphagia-specific health-related QOL in oral cavity cancer patients post-treatment.

The purpose of this study was to identify the characteristics of swallowing ability, depression, and dysphagia-specific health-related quality of life (QOL), and the predictors of dysphagia-specific health-related QOL in oral cavity cancer patients post-treatment. A cross-sectional study of 151 oral cavity cancer patients was performed at a medical center. Patients were assessed for swallowing ability, depression, and dysphagia-specific health-related QOL. Multiple stepwise regression was used to identify factors related to dysphagia-specific health-related QOL. Of the 151 patients surveyed, the top swallowing impairments were difficulty swallowing dry foods, difficulty swallowing hard food, and swallowing problems interfering with enjoyment or QOL. Patients with tumors of the tongue had worse functional dysphagia QOL than those with cancers in other locations. Patients with buccal cancer had worse overall dysphagia QOL, functional dysphagia QOL, and physical dysphagia QOL than patients with cancers in other locations. Patients with poor swallowing ability were more likely to have worse global dysphagia QOL. Emotional dysphagia QOL was associated with poor swallowing ability and depression. Poor swallowing ability, higher level of depression, and tumors of the tongue were associated with the worst functional dysphagia QOL. Patients with poor swallowing ability, higher level of depression, and less functional oral intake were more likely to have worse physical dysphagia QOL. Swallowing ability and depression were the most important factors associated with dysphagia-specific health-related QOL. Patient-centered swallowing rehabilitation programs are recommended to help cope with swallowing impairment.

Effects of a swallowing exercise education program on dysphagia-specific health-related quality of life in oral cavity cancer patients post-treatment: a randomized controlled trial.

The purpose of this study was to evaluate the effects of a swallowing exercise education program (SEEP) on swallowing ability, depression, and dysphagia-specific health-related quality of life (QOL) in oral cavity cancer (OCC) patients. This was a prospective, randomized controlled study with two groups using a pre- and post-repeated measures design. A total of 76 participants were randomly assigned to an experimental group (n = 38) and a control group (n = 38). The experimental group participated in a SEEP and the control group received normal care. Patients were assessed at five time points: baseline assessment (T0) and then 1, 2, 3, and 6-months (T1, T2, T3, and T4) after participating in the SEEP or receiving normal care. Patients in the experimental group had significantly greater emotional dysphagia QOL compared to those in the control group. In the experimental group, post-education (T4) depression was better than baseline (T0). For both groups, functional dysphagia QOL and physical dysphagia QOL were greatest at T0, decreased from T1 to T2, and slightly decreased at T3 and T4. There were no differences between the groups and within the groups with respect to dysphagia-specific health-related QOL, global dysphagia QOL, functional dysphagia QOL, and physical dysphagia QOL. The SEEP was effective in improving emotional dysphagia QOL during the initial 6months after treatment of patients with OCC.

SPEECH THERAPY INTERVENTION IN MORBIDLY OBESE UNDERGOING FOBI-CAPELL GASTROPLASTY METHOD.

Background : The rehabilitation of complications related to oral feeding, resulting from gastroplasty is the competence of the speech therapist, to intervene in mastication and swallowing functions, aiming at quality of life. Aim : Check in the postoperative period the efficiency of stimulation, independent judges in readiness for re-introduction of solid food in morbidly obese undergoing gastroplasty. Method : Cross-sectional study of descriptive and quantitative evaluated mastication and quality of life of 70 morbidly obese patients undergoing gastroplasty, and a group of 35 obese suffered speech therapy. Results : In the evaluation of mastication for group 1 (pre and post speech therapy), the results show that, except for the lack of chewing, the other variables, such as food court, type of mastication, mastication rhythm, jaw movements, bolus size, excessive mastication and fluid intake, demonstrate statistical insignificance. In evaluating the quality of life when compared groups 1 and 2, the results from the questionnaire on quality of life in dysphagia (SWAL-QoL - Quality of Life in Swallowing) total and 11 domains assessed in the questionnaire, were statistically significant. With these results, the group 2 presented unfavorable conditions for quality of life . Conclusion : The stimulation protocol, independent judges in readiness for re-introduction of solid food of these patients in the postoperative period, applied in these conditions of the study, was not the distinguishing factor of the rehabilitation process for the observed period.

Prospective Dysphagia Quality of Life Scores and Treatment Outcomes in Oropharyngeal Cancer Patients: Is it Time to Reconsider the Prophylactic Percutaneous Endoscopic Gastrostomy?

Prospective Dysphagia Quality of Life Scores and Treatment Outcomes in Oropharyngeal Cancer Patients: Is it Time to Reconsider the Prophylactic Percutaneous Endoscopic Gastrostomy?

Qualidade de vida em disfagia na doença de Parkinson: uma revisão sistemática

A doença de Parkinson pode causar distúrbios da deglutição em qualquer fase da doença devido às disfunções dos movimentos. Apesar da diversidade de sintomas, normalmente as alterações iniciais na deglutição do parkinsoniano são despercebidas e podem ocasionar prejuízo na qualidade de vida. Contudo, instrumentos que avaliam a qualidade de vida em disfagia na doença de Parkinson não têm sido sistematicamente estudados. Esta revisão sistemática objetivou identificar a utilização do questionário de Qualidade de Vida em Disfagia para avaliação na doença de Parkinson. Foram incluídos artigos com sujeitos de ambos os sexos e com doença de Parkinson idiopática, e excluídos os artigos de avaliação de tratamento e que apresentaram indivíduos com outra forma de parkinsonismo. Após a busca realizada nos portais da Bireme, Pubmed e Banco de Teses da Capes, foram analisados 30 artigos, dos quais dois foram incluídos depois da aplicação da Escala de Jadad modificada. Os dois artigos evidenciaram que o questionário de Qualidade de Vida em Disfagia é um instrumento seguro e relevante para avaliar alterações da deglutição do parkinsoniano nos domínios do instrumento, exceto no sono. Além disso, o questionário pode indicar uma compreensão da qualidade de vida geral. Sendo assim, a utilização do questionário de Qualidade de Vida em Disfagia contribuiu para avaliação da qualidade de vida em disfagia de sujeitos com doença de Parkinson.

Oropharyngeal dysphagia in amyotrophic lateral sclerosis alters quality of life

Dysphagia is one of the most important complications encountered in amyotrophic lateral sclerosis (ALS). Our aim was to determine whether oropharyngeal dysphagia impacted the quality of life (QoL) of patients with ALS. Thirty consecutive patients were recruited (31-82years, 18 men). Swallowing function was evaluated using a standardised videofluoroscopic barium swallow. All the patients completed a specific questionnaire on quality of life in dysphagia (SWAL-QoL) immediately after the videofluoroscopy. The results of dysphagia outcome severity scale separated 14 patients with oropharyngeal dysphagia and 16 with normal swallowing function. There was no difference in the average age, weight and body mass index of the two groups (dysphagic patients: 68±11kg versus non-dysphagic patients: 69±14kg). Most of the dysphagic patients had a bulbar affection based on their Norris scores which determine the importance of cranial nerves illness (20±8), significantly lower than those of the non-dysphagic patients (35±5) (P<0·0001). There was no difference in the neurological peripheral symptoms evaluated by Amyotrophic Lateral Sclerosis Functional Rating Scale scores (dysphagic patients: 26±7 versus non-dysphagic patients: 27±8) (ns). The swallowing quality of life questionnaire revealed that the dysphagic patients had significant burden (P<0·001). They were affected by the necessity to applied a food selection (P<0·01), by the increase in eating duration (P<0·05) and described a decrease in eating desire (P<0·05). They complained of fear regarding the risk of dysphagia (P<0·05). They also described difficulties with oral communication (P<0·001). All of those complained about dysphagia which impacted directly mental health (P<0·05) and social life (P<0·05). In conclusion, oropharyngeal dysphagia is a common symptom accompanying ALS, which alters the patient's QoL, especially social health.

Pretreatment, Preoperative Swallowing Exercises May Improve Dysphagia Quality of Life

Pretreatment, Preoperative Swallowing Exercises May Improve Dysphagia Quality of Life