In the patient’s shoes: The experience of diet modification from the perspectives of speech and language therapy (SLT) students
Cardiff Metropolitan University
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Background: Research into the various factors underlying non-adherence with dysphagia recommendations is limited. Non-adherence is a complex issue that can challenge clinicians managing the condition, as it has been found to result in adverse outcomes. The social and psychological consequences of dysphagia may have a direct impact on patient adherence, as may the consequences of a common management option; diet modifications. Increased understanding and awareness of these psychosocial issues has been previously recommended, yet novel ways of encouraging this amongst students has not yet been explored. Aims: This study aims to explore the experience of diet modification from the perspective of SLT students and to draw out themes regarding non-adherence. This will help to further our understanding on the impact that diet modifications can entail and some of the potential reasons pertaining to non-adherence. It will also help to determine whether patient enactment tasks such as this can increase the understanding and awareness of the patient perspective amongst SLT students. Method & Procedures: This study adopted a mixed-method design. Participants modified their food intake for four days per the national texture descriptor guidelines, recorded their food intake into food diaries, and reported adherence to the guidelines. Quantitative data were gathered via analysis of the food diaries, in which both the adaptations made and the levels of self-reported adherence were evaluated. This allowed for themes to be drawn regarding non-adherence. Qualitative data were gathered via semi-structured interviews that were analysed using interpretative phenomenological analysis. This allowed for data to be gathered on the experience of diet modification. Outcomes & Results: Results indicated that the levels of self-reported adherence to the modifications were quite high amongst all the participants. Despite this finding, there were instances of both intentional and unintentional non-adherence to the modifications, which occurred because of challenges faced during the application of the modifications as well as the impact that they entailed. Several themes were drawn from the data regarding the experience of diet modification and highlighted that diet modifications can place burden on an individual’s social and emotional functioning, as well as on their overall lifestyle. Conclusions & Implications: Findings provide insight into the impact of diet modification on the lives of those recommended them, as well as some of the potential reasons pertaining to non-adherence. Furthermore, the findings demonstrate that enactment of the patient experience can increase the awareness and understanding of the patient perspective amongst SLT students and lead them to identify strategies to assist patients manage some of the practical challenges. This may be of benefit when considering the future training of SLT students in the holistic management of dysphagia.
B.Sc. (Hons) Speech and Language Therapy
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