Speech and language therapists’ belief systems and decision making in dysphagia management with dementia patients.
Cardiff Metropolitan University
MetadataShow full item record
Background: There is an ongoing debate regarding the most appropriate feeding options for dementia patients with dysphagia due to the presence of conflicting evidence, decisions being made on behalf of those who lack capacity and a lack of guidelines. Research in the field of Percutaneous Endescopic Gastrostomy (PEG) in dementia has focused on outcomes and the ethical issues surrounding decisions. There has been some exploration into health professionals’ knowledge, beliefs and practices regarding the use of PEG which revealed conflicting results. Speech and language therpaists (SLTs) form part of the multi-disciplinary team (MDT) involved in feeding management decisions. Aims: To explore SLTs’ belief systems and decision making in dysphagia management with dementia patients. It aims to explain aspects of how SLTs construct their views and knowledge on issues surrounding artificial nutrition and hydration (ANH) and how this influences clinical decisions. Methods and Procedures: Data collection consisted of face to face semi-structured interviews with five SLTs. Interview questions focused on factors which influenced their decisions, discrepancies in viewpoints and the influence of team dynamics and service culture. A Grounded Theory approach was used for data collection and analysis. Themes which emerged from the data were grouped together into core categories. Outcomes and Results: Data analysis revealed seven core categories relating to SLTs’ beliefs: (1) Multiple SLT roles (2) Communication (3) Treating everyone as an individual (4) Decision making process (5) Type of SLT power and control (6) The role of the system and internal values in SLTs’ decisions (7) Acknowledging the significance of time course and disease progression. These core categories were organised into two broad areas of interests: ‘outsiderness’ (core categories 1-3) and ‘decision making’ (core categories 4-7). Conclusions and Implications: The findings revealed that considering patients holistically with an emphasis on quality of life (QOL) was central to SLTs’ belief systems. These beliefs often resulted in SLTs being ‘outsiders’ to other medical professionals. It was identified that SLTs lacked the power to make ANH decisions however their beliefs guided their desire to influence and persuade others in order to get the most appropriate decisions for patients. It appeared that participants had to balance the degree to which they stayed true to their beliefs in sensitivity to patients’ needs with avoiding conflicting with medical professionals to such an extent to make discussions confusing for families. The findings support the need to explore further the nature of this ‘mediatory role’ of SLTs so that they can be better equipped to fulfil it. Research into different health professionals understanding of each others’ role would be useful in addressing the ‘outsiderness’ of SLTs’ beliefs and could lead to improved collaboration between teams and more appropriate decisions for patients.
B.Sc. (Hons) Speech and Language Therapy
Showing items related by title, author, subject and abstract.
Associations between staff sex/gender identity and their perceptions of patients’ attachment style in a medium secure unit Crompton, Katherine (Cardiff Metropolitan University, 2013)Background - The major premise in medium secure services is attachment theory (Adshead, 2007, 2008; Bagshaw, Lewis & Watt, 2012; Fonagy et al, 2000; Pfafflin & Adshead, 2004, van IJzendoorn et al, 1997). Assumptions are ...
Davies, Catrin, Lisa (University of Wales Institute Cardiff, 2011-03-15)There is adequate research within the field of obesity; however there is little research on how women of specific ages react to the obese. Additionally there is limited research on how much women of specific ages understand ...
Davies, Catrin Lisa (University of Wales, 2011)There is adequate research within the field of obesity; however there is little research on how women of specific ages react to the obese. Additionally there is limited research on how much women of specific ages understand ...