Assessment of Patient Perception in Clinical Practice in Mechanical Dysphagia

Introduction: Head and neck cancer treatment is closely associated with functional changes, such as dysphagia, which have a negative impact on quality of life. This study aims to review some concepts inherent to the process of assessment and intervention of the speech therapist, as well as the role of assessing the patient's perception.

Methods: Literature review and retrospective, quantitative and descriptive study, based on a series of five cases, according to inclusion and exclusion criteria. In addition, the sample will be characterized in terms of sociodemographic and clinical variables.

Results: The literature review shows the growing importance of using the patient reported outcome measures in dysphagia. Of the five cases included in this study, most were males aged between 50 and 65 years, and all had undergone radiotherapy. Most of them (60%) had oropharyngeal cancer and performed between 24 and 36 speech therapy sessions. A clinical evaluation of the swallow at initial and final moments was performed. Results show agreement between patient's perception, through SWAL-QOL-PT and dysphagia severity, through FOIS. In general, there is an agreement between the patient's complaints, the SWAL-QOL-PT results, and the clinical evaluation and severity of dysphagia.

Conclusions: A centered person approach in dysphagia management represents a shift paradigm in speech therapy intervention, focused on the person and not only on the physiological findings of the clinical evaluation. This study shows the interception between patient perception and physiological findings; thus, we can increase the effectiveness of intervention results and therapeutic adherence, with real health gains.