Factors affecting dysphagia management and compliance with recommendations in non-metropolitan healthcare settings.

It is acknowledged that a team approach to management of stroke is essential to improving patient outcomes. For the speech-language pathologist (SLP), communication and swallowing are key concerns in stroke rehabilitation. However, little is known about how services are provided following stroke in non-metropolitan areas. This paper presents findings from a study investigating issues related to the provision of dysphagia services in non-metropolitan New South Wales (NSW) and Victoria. The theme 'You've got to have an impact' was one of the major themes identified from analysis of data gathered via semi-structured interviews with eight SLPs. Participants in this study highlighted compliance with recommendations as a point of breakdown in the care of the patient with dysphagia. Underlying compliance were issues related to team functioning that could hold the key to improving outcomes. These findings have implications for non-metropolitan SLPs' ability to participate within a stroke team, for the way care for patients with dysphagia is conceptualized, and for improvement of compliance with SLP recommendations.