A-LEVEL OF DYSPHAGIA WITH STROKE
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Table of Contents TOC o “1-3” h z u DECLARATION PAGEREF _Toc55661083 h iABSTRACT PAGEREF _Toc55661084 h iiACKNOWLEDGEMENT PAGEREF _Toc55661085 h iiiLIST OF TABLES PAGEREF _Toc55661086 h viLIST OF FIGURES PAGEREF _Toc55661087 h viiABBREVIATIONS PAGEREF _Toc55661088 h viiiI. CHAPTER ONE PAGEREF _Toc55661089 h 1Introduction. PAGEREF _Toc55661090 h 1Background PAGEREF _Toc55661091 h 3The Problem Statement PAGEREF _Toc55661092 h 7Study Objectives PAGEREF _Toc55661093 h 8Specific Objectives PAGEREF _Toc55661094 h 9Research Questions PAGEREF _Toc55661095 h 9Significance of the Study PAGEREF _Toc55661096 h 10Study Scope PAGEREF _Toc55661097 h 11II. CHAPTER TWO PAGEREF _Toc55661098 h 12LITERATURE REVIEW PAGEREF _Toc55661099 h 12Risk Factors Accompanying Dysphagia in Freshly Extubated Ill Patients. PAGEREF _Toc55661100 h 12Managing Dysphagia in Acute Stroke PAGEREF _Toc55661101 h 14Dysphagia Diagnosis PAGEREF _Toc55661102 h 15Dysphagia Screening. PAGEREF _Toc55661103 h 17Location of Stroke besides Physiologic Deficits PAGEREF _Toc55661104 h 18primary care of dysphagia PAGEREF _Toc55661105 h 20Principles of Ischemic Stroke Management PAGEREF _Toc55661106 h 20Impacts of Nasogastric Tubes in Acute Stroke Patients. PAGEREF _Toc55661107 h 21Dysphagia as an Indicator of Transition to Palliative Care. PAGEREF _Toc55661108 h 22Aspiration Pneumonia and Pneumonia in Care Home Populations PAGEREF _Toc55661109 h 22Tongue Pressure Profile Training (TPPT) PAGEREF _Toc55661110 h 23Dysphagia and Texture-modified Nutrition PAGEREF _Toc55661111 h 24Change in Life Quality in Patients at Home Care Facilities PAGEREF _Toc55661112 h 25Inpatient Rehabilitation PAGEREF _Toc55661113 h 25Impressions of Oropharyngeal Complications on Healthcare Cost PAGEREF _Toc55661114 h 26Medical Performance Trials for Adults with Acute Ischemic Stroke PAGEREF _Toc55661115 h 27III. CHAPTER THREE PAGEREF _Toc55661116 h 29RESEARCH METHODOLOGY PAGEREF _Toc55661117 h 29Introduction PAGEREF _Toc55661118 h 29Site Description PAGEREF _Toc55661119 h 29Research design PAGEREF _Toc55661120 h 29Study Population and Sample PAGEREF _Toc55661121 h 30Targeted Population PAGEREF _Toc55661122 h 30Sampling Techniques PAGEREF _Toc55661123 h 30Sample Size PAGEREF _Toc55661124 h 30Key Informants PAGEREF _Toc55661125 h 31Research Instruments PAGEREF _Toc55661126 h 31Data Collection Methods and Procedures PAGEREF _Toc55661127 h 31Data Assortment Procedures PAGEREF _Toc55661128 h 31Data Analysis Methods PAGEREF _Toc55661129 h 32Ethical Contemplation PAGEREF _Toc55661130 h 32Limitations of the Study PAGEREF _Toc55661131 h 33Problems met throughout the study PAGEREF _Toc55661132 h 33CHAPTER FOUR PAGEREF _Toc55661133 h 35RESULTS AND DISCUSSIONS. PAGEREF _Toc55661134 h 35References PAGEREF _Toc55661135 h 36
LIST OF TABLES
LIST OF FIGURES
ABBREVIATIONS
TIA: Transient Ischemic Attack
UK: United Kingdom
V.F: Video Fluorography
V.E: Video endoscopic Examination
VFSS: Video Fluoroscopy
FEES: Video Endoscopy
NGT: Nasogastric Tube
MCA: Middle Cerebral Artery
TPPT: Tongue Pressure Profile Training
I. CHAPTER ONE
Introduction.
Dysphagia is a health complication allied to the interruption of the bolus flow beginning in the mouth via the pharynx CITATION Sin l 1033 (Singh, et al., 2006). Under the usual condition, swallowing in humans takes a safe food passage through boluses flowing smoothly until they reach the stomach. Nevertheless, disruption due to dysphagia interferes with the food movement and in most cases, some food particles find their way into the air route. Remarkably, some studies indicate that dysphagia in specific does not result in abnormality of the esophagus CITATION Sin l 1033 (Singh, et al., 2006).
Stroke on the other hand is an emergency disorder that occurs when a person experiences a decline in the supply of blood into the brain cellsCITATION Cam19 l 1033 (Campbell, et al., 2019). Stroke has been proved to manifest in three diverse forms. Consequently, any given person may be diagnosed with Transient Ischemic Attack (TIA), complications due to hemorrhagic stroke, otherwise, the patient may be diagnosed with another manifestation of this disease known as ischemic strokeCITATION Die19 l 1033 (Diener, et al., 2019). Furthermore, of the three forms, ischemic stroke adds up to about 87% of all stroke cases. Therefore, this is the utmost popular form of strokeCITATION Die19 l 1033 (Diener, et al., 2019). Stroke has majorly been associations with blood clotting which in turn hinders the flow of blood carrying oxygen to the brain.
Disturbances in swallowing resulting from stroke complications have often exposed the patients to supplementary health problems. Such patients are likely to suffer extended complications such as pneumonia, malnutrition, dehydration, or else suffocation CITATION Osa19 l 1033 (Osawa & Meshina, 2019). Additionally, dysphagia has been found to affect more than 50% of patients who have manifestations of acute strokeCITATION Bal18 l 1033 (Balamurali, et al., 2018). Correspondingly, this research indicates that the initial phases of dysphagia management support the reduction of pulmonary difficulties among stroke patientsCITATION Bal18 l 1033 (Balamurali, et al., 2018).
Dedicated control of dysphagia is vital especially for the total welfare of the elderly. The prominent condition is highly predominant amongst elderly stroke patients. About 50% of all patients suffering from stroke have the greatest probability of showing symptoms of Dysphagia and most of them need extended supervision of their conditionsCITATION Joh14 l 1033 (Johnson, et al., 2014).
Nevertheless, acute management care levels have changed with time. The management heights have shifted by about 47% starting from 1989 to 2009CITATION Hal12 l 1033 (Hall, et al., 2012). Similar projections have been witnessed in the United Kingdom. Further studies reveal that care and management of stroke patients are sandwiched between 3.1 days in patients with fewer complications and 6.8 days of managed care for the life-threatening incidences of DysphagiaCITATION Joh14 l 1033 (Johnson, et al., 2014). Hence, the magnitude and the length of problems limit the scope of the management and care of the patients.
This study concentrated on the specialized stroke and dysphagia care home facility; with the capacity to offer trained care to all patients with related complications. Normally, care home facilities attend to patients with complex health cases. Most of the time, such cases necessitate compensatory approaches while handling the conditionCITATION Joh14 l 1033 (Johnson, et al., 2014). The care service providers in such facilities have a wide-ranging understanding of swallowing therapy as well as the strategies of addressing the patient’s needs.
Background
Patients suffering from Dysphagia conditions have the challenge of drinking fluids safely. A comprehensive research review indicates that patients associated with swallowing impairment, drink fluids that have been thickened. Such