Sofie Noë1, Ann Goeleven2, Hilde Brouwers3, Tom Meurrens4, Alexander De Cock5,6, Daphne Kos5,7, Kris Vanhaecht8,9. 1. Speech and Language Department (SN), Melsbroek, Belgium. 2. Department of ENT-Head and Neck Surgery (AG), University Hospitals Leuven, Leuven, Belgium. 3. Nursing Department (HB), Melsbroek, Belgium. 4. Rehabilitation Center (TM), Melsbroek, Belgium. 5. National MS Center Melsbroek (AD, DK), Melsbroek, Belgium. 6. Neurology, Center of Neuroscience, Vrije Universiteit Brussel, Brussels, Belgium (AD). 7. Department of Rehabilitation Sciences (DK), Katholieke Universiteit Leuven, Leuven, Belgium. 8. Department of Quality Management (KV), University Hospitals Leuven, Leuven, Belgium. 9. Department of Public Health and Primary Care, Leuven Institute for Healthcare Policy (KV), Katholieke Universiteit Leuven, Leuven, Belgium.
Abstract
BACKGROUND: Dysphagia is common in persons with multiple sclerosis (MS). Speech and language therapists give dysphagia recommendations to persons with MS and caregivers. Nonadherence to these recommendations can increase the risk of aspiration. We investigated current compliance with dysphagia recommendations among caregivers and kitchen staff and assessed improvement in compliance by increasing knowledge through tailored training. METHODS: An observational cohort study was conducted over 4 weeks during which the compliance of the caregivers and kitchen staff in a rehabilitation center was monitored. A questionnaire was used to assess reasons for noncompliance. A 2-hour training session was provided for all caregivers and kitchen staff to improve their knowledge and skills. The compliance rate was observed again 1 and 6 months after the training. Compliance was defined by whether recommendations were followed. RESULTS: Results showed a significant improvement after training for overall compliance by caregivers (from 58% to >81%, P < .001). This improvement was still observed 6 months later (80%). After training, significant differences were found in compliance with the following recommendations (P ≤ .001): consistency of soup, consistency of liquids, food preparation, alertness, speed, amount, posture, and supervision. Recommendation for utensils did not improve (P = .44). Compliance with diet modifications made by the kitchen staff improved significantly (from 74% to >86%, P = .002), and even more during follow-up (to >95%, P = .009). CONCLUSIONS: Dysphagia training tailored to the needs of caregivers to improve knowledge significantly improves compliance with dysphagia recommendations and the quality of care.
BACKGROUND: Dysphagia is common in persons with multiple sclerosis (MS). Speech and language therapists give dysphagia recommendations to persons with MS and caregivers. Nonadherence to these recommendations can increase the risk of aspiration. We investigated current compliance with dysphagia recommendations among caregivers and kitchen staff and assessed improvement in compliance by increasing knowledge through tailored training. METHODS: An observational cohort study was conducted over 4 weeks during which the compliance of the caregivers and kitchen staff in a rehabilitation center was monitored. A questionnaire was used to assess reasons for noncompliance. A 2-hour training session was provided for all caregivers and kitchen staff to improve their knowledge and skills. The compliance rate was observed again 1 and 6 months after the training. Compliance was defined by whether recommendations were followed. RESULTS: Results showed a significant improvement after training for overall compliance by caregivers (from 58% to >81%, P < .001). This improvement was still observed 6 months later (80%). After training, significant differences were found in compliance with the following recommendations (P ≤ .001): consistency of soup, consistency of liquids, food preparation, alertness, speed, amount, posture, and supervision. Recommendation for utensils did not improve (P = .44). Compliance with diet modifications made by the kitchen staff improved significantly (from 74% to >86%, P = .002), and even more during follow-up (to >95%, P = .009). CONCLUSIONS: Dysphagia training tailored to the needs of caregivers to improve knowledge significantly improves compliance with dysphagia recommendations and the quality of care.
Authors: P Clavé; M de Kraa; V Arreola; M Girvent; R Farré; E Palomera; M Serra-Prat Journal: Aliment Pharmacol Ther Date: 2006-11-01 Impact factor: 8.171