TY - JOUR
T1 - Alterations and preservations
T2 - Practices and perspectives of speech-language pathologists regarding the intervention of thickened liquids for swallowing problems
AU - McCurtin, Arlene
AU - Byrne, Hannah
AU - Collins, Lindsey
AU - McInerney, Michelle
AU - Lazenby-Paterson, Tracy
AU - Leslie, Paula
AU - O’Keeffe, Shaun
AU - O’Toole, Claire
AU - Smithc, Alison
N1 - Publisher Copyright:
© 2023 The Authors.
PY - 2024/1
Y1 - 2024/1
N2 - Purpose: The intervention of thickened liquids (TL) is commonly used to reduce aspiration in people with dysphagia. Speech-language pathologists (SLPs) have traditionally believed it is an effective intervention. Recent articles highlight limited evidence, poor acceptance, and a variety of unintended consequences. This study explores if current debates have been reflected in SLP practices and perspectives. Method: An e-survey was developed. Participants were recruited via professional associations in Australia, New Zealand, Ireland, the United Kingdom, and the United States. Descriptive and inferential statistics were used to explore the data. Principal component analysis was used to summarize SLP practices and perspectives. Results: The 370 respondents represented mainly experienced, confident, hospital-based clinicians. While 20% of respondents frequently recommend TL, 61% believe it to be a burdensome treatment. “Best treatment” and “It works” beliefs continue to underpin decision making. Those who recommend TL most often are most influenced by penetration, coughing, and their own clinical expe-rience. They are more likely to believe TL is evidence based and effective, reduces aspiration, and improves hydration. Person-centeredness is important among all respondents, although significant numbers would implement TL against patient wishes. Improvements in aspiration status and quality of life rank highly as reasons to discontinue TL. Conclusions: The results of this study suggest that fewer respondents are reg-ularly using TL. Divergent groups are evident with those frequently employing and believing in the efficacy of TL and those who do not. While current debates are influencing practice, there clearly remains a significant number of SLPs con-tinuing to recommend TL. This study’s findings highlight both alterations and preservations in the discipline’s approach to TL and calls for SLPs to reframe our thinking regarding this intervention as well as consider alternative options in this treatment space.
AB - Purpose: The intervention of thickened liquids (TL) is commonly used to reduce aspiration in people with dysphagia. Speech-language pathologists (SLPs) have traditionally believed it is an effective intervention. Recent articles highlight limited evidence, poor acceptance, and a variety of unintended consequences. This study explores if current debates have been reflected in SLP practices and perspectives. Method: An e-survey was developed. Participants were recruited via professional associations in Australia, New Zealand, Ireland, the United Kingdom, and the United States. Descriptive and inferential statistics were used to explore the data. Principal component analysis was used to summarize SLP practices and perspectives. Results: The 370 respondents represented mainly experienced, confident, hospital-based clinicians. While 20% of respondents frequently recommend TL, 61% believe it to be a burdensome treatment. “Best treatment” and “It works” beliefs continue to underpin decision making. Those who recommend TL most often are most influenced by penetration, coughing, and their own clinical expe-rience. They are more likely to believe TL is evidence based and effective, reduces aspiration, and improves hydration. Person-centeredness is important among all respondents, although significant numbers would implement TL against patient wishes. Improvements in aspiration status and quality of life rank highly as reasons to discontinue TL. Conclusions: The results of this study suggest that fewer respondents are reg-ularly using TL. Divergent groups are evident with those frequently employing and believing in the efficacy of TL and those who do not. While current debates are influencing practice, there clearly remains a significant number of SLPs con-tinuing to recommend TL. This study’s findings highlight both alterations and preservations in the discipline’s approach to TL and calls for SLPs to reframe our thinking regarding this intervention as well as consider alternative options in this treatment space.
UR - http://www.scopus.com/inward/record.url?scp=85181760762&partnerID=8YFLogxK
U2 - 10.1044/2023_AJSLP-23-00226
DO - 10.1044/2023_AJSLP-23-00226
M3 - Article
C2 - 37889208
AN - SCOPUS:85181760762
SN - 1058-0360
VL - 33
SP - 117
EP - 134
JO - American Journal of Speech-Language Pathology
JF - American Journal of Speech-Language Pathology
IS - 1
ER -