南非言语-语言病理学家吞咽障碍实践模式调查

文献信息

中文摘要

目的： 南非的四重疾病负担导致全生命周期吞咽障碍发生率高，而言语-语言病理学家常在资源有限的环境中提供服务。培训、资源和临床实践的差异凸显了建立全国性吞咽障碍管理概况的必要性。本研究调查了南非言语-语言病理学家的吞咽障碍实践模式和专业需求。
方法： 通过社交媒体向提供吞咽障碍服务的言语-语言病理学家发放电子问卷。采用便利抽样和滚雪球抽样。对124名参与者的回答进行描述性分析，同时对定性数据进行主题分析。
结果： 参与者来自城市（78.8%）和农村（21.2%）环境，分布于公立（38.1%）和私立（47.5%）部门。服务对象主要为患有神经系统疾病的成人，尤其是卒中和颅脑损伤。吞咽障碍评估主要依赖非正式方法，仪器评估的可及性有限，在公立和农村环境中尤为明显。定性研究结果识别出环境限制、培训缺口、指导有限以及对情境相关指南的需求。
结论： 需要制定国家战略，通过加强培训、可及的指导和情境响应性指南来强化吞咽障碍服务提供，以支持在多样环境中实现公平、安全和循证照护。

英文摘要

PURPOSE: South Africa's quadruple burden of disease contributes to high rates of dysphagia across the lifespan, with speech-language pathologists often providing services in resource-limited contexts. Variability in training, resources, and clinical practice highlights the need for a national profile of dysphagia management. This study investigated dysphagia practice patterns and professional needs among South African speech-language pathologists.
METHOD: An electronic survey was distributed via social media to speech-language pathologists providing dysphagia services. Convenience and snowball sampling were used. Responses from 124 participants were analysed descriptively, while qualitative data were analysed thematically.
RESULT: Participants represented urban (78.8%) and rural (21.2%) settings across public (38.1%) and private (47.5%) sectors. Caseloads consisted primarily of adults with neurological conditions, particularly stroke and head injury. Dysphagia assessment relied largely on informal methods, with limited access to instrumental assessments, especially in public and rural contexts. Qualitative findings identified contextual constraints, training gaps, limited mentorship, and a need for contextually relevant guidelines.
CONCLUSION: National strategies are needed to strengthen dysphagia service delivery through enhanced training, accessible mentorship, and contextually responsive guidelines that support equitable, safe, and evidence-informed care across diverse settings.