Establishment of a post stroke dysphagia rehabilitation service in a lower middle income nation.

• Main Author: Abu Hassan, Salmah Anim
• Format: Conference or Workshop Item
• Language: English; English; English
• Published: 2021
• Subjects: RZ Other systems of medicine
• Online Access: http://irep.iium.edu.my/95952/19/95952_%20Establishment%20of%20a%20post%20stroke%20dysphagia%20rehabilitation%20service%20in%20a%20lower%20middle%20income%20nation.pdf; http://irep.iium.edu.my/95952/20/95952_%20Establishment%20of%20a%20post%20stroke%20dysphagia%20rehabilitation%20service%20in%20a%20lower%20middle%20income%20nation_slides.pdf; http://irep.iium.edu.my/95952/21/95952_%20Establishment%20of%20a%20post%20stroke%20dysphagia%20rehabilitation%20service%20in%20a%20lower%20middle%20income%20nation_WDS2021.pdf; http://irep.iium.edu.my/95952/
• Institution: Universiti Islam Antarabangsa Malaysia

[Background and aims] From a preliminary six-month survey carried out amongst stroke patients in our center, dysphagia is a common complication affecting 57% of survivors and puts them at higher risk of morbidity and increased mortality. To date, there is no uniform approach for early post stroke dysphagia evaluation and management at our centre. Hereby, we describe our efforts in setting up a structured service for dysphagia rehabilitation in the acute hospital setting led by the rehabilitation physician. [Methods] The formation of a multidisciplinary team was tailored according to the limited human resources at our centre. Echoing the scenario throughout the country, scarcity of speech-language therapists (SLT) required delegation of responsibilities to the rehabilitation medicine team. Other key collaborators included nurses, visiting speech language therapists,otorhinolaryngologists, dentists and also dieticians. We seek to establish a post stroke dysphagia evaluation and rehabilitation protocol that may be applicable in establishments with similar resources. [Results] The multidisciplinary collaboration allowed a holistic approach in patient management ranging from good oral hygiene practice to routes of adjunctive enteral nutrition for patients who needed time for transition to full oral feeding. The involvement of a diverse group of healthcare professionals also allowed a wider dissemination of post stroke-dysphagia awareness amongst other clinicians. [Conclusions] In conclusion, countries with limited resources need to make necessary investments and pool resources to form a structured dysphagia rehabilitation team in the acute hospital setting to improve patient outcome.