Intervenções do terapeuta da fala em pessoas com perturbação da deglutição em cuidados paliativos
: uma revisão sistemática da literatura

Translated title of the thesis: Speech therapist interventions in people with swallowing disorder in palliative care: a systematic review
  • Maria Gomes Calção Medeiro (Student)

Student thesis: Master's Thesis

Abstract

Introduction: Speech Therapy is essential in Palliative Care (PC), especially in supporting individuals with swallowing disorders, which compromise quality of life and food safety. The intervention of the Speech Therapist is vital to optimize swallowing and promote well-being, and should be tailored to individual needs, balancing safety, comfort, and respect for personal and family preferences. Objective: Analyze the relationship between Speech Therapist interventions in individuals with swallowing disorders in PC concerning swallowing safety and efficacy, as well as quality of life. Methodology: A systematic literature review was conducted, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA-P) guidelines. The search was carried out in the SCOPUS, MEDLINE, CINAHL, SCIELO (via EBSCOHost), and LILACS databases, as well as gray literature (WorldCat and OpenGrey), without date restrictions. Studies were included with participants of all ages who had swallowing disorders in PC, encompassing interventions by Speech Therapists. The review considered works published in English, Spanish, and Portuguese. Secondary studies, such as reviews and editorials, were excluded. The identification of studies and data extraction were conducted independently by two researchers, using Rayyan® software to manage the screening and selection of studies. The data were organized into tables detailing the search strategy, access to studies, and compliance with inclusion criteria. The methodological quality of the studies was assessed using tools recommended by the Joanna Briggs Institute (JBI) and the levels of evidence defined by the Oxford Centre for Evidence-Based Medicine (OCEBM). Results: Five studies were included (i.e., one case study, one series of case studies, one prevalence study, and two cross-sectional studies), which underwent a full reading and critical assessment of methodological quality. Interventions identified included adjustments to the consistency and volume of food, postural and airway clearance maneuvers, sensory techniques, and comfort feeding, aimed at promoting safer swallowing and preserving quality of life. The personalization of interventions according to individual needs is emphasized. The analysis of the included studies revealed notable variability in both levels of evidence and the methodological assessments conducted. Conclusions: The literature reinforces the role of the Speech Therapist's intervention in PC with individuals who have swallowing disorders. Despite the heterogeneity of the studies, most indicate benefits in swallowing safety and quality of life. The review emphasizes the need for careful assessments and shared decision-making, aligned with individuals' wishes. The lack of standardized guidelines and the variability in clinical practices indicate the need for future studies to standardize evidence-based practices.
Date of Award4 Dec 2024
Original languagePortuguese
Awarding Institution
  • Universidade Católica Portuguesa
SupervisorInês Tello Rodrigues (Supervisor)

Keywords

  • Speech therapy
  • Swallowing
  • Swallowing disorders
  • Palliative care
  • End-of-life palliative care

Designation

  • Mestrado em Cuidados Paliativos

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