IN FOUCS: Building Collaborative Partnerships - 2023

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    Determining the proportion of dysphagia in post-stroke patients admitted to a teaching hospital in Sri Lanka.
    (University of Kelaniya, Sri Lanka, 2023) Fonseka, O.D.S.; Dharmarathne, N.I.
    BACKGROUND: Post-stroke dysphagia (PSD) is one of leading cause to increase the number of deaths in stroke patients in worldwide. By today, early identification and detection of post-stroke dysphagia is increased due to its severity. Sri Lanka is low-middle income country (LMIC) and currently there is no study about proportion of post-stroke dysphagia in Sri Lanka. Dysphagia is one of severe complications following stroke. And also, PSD can lead to even death. OBJECTIVE/S: The purposes of the study are to evaluate the proportion of patients with PSD admitted to North Colombo Teaching Hospital, Sri Lanka and to determine the association between communication impairments and post-stroke dysphagia. This is novice research question to Sri Lankan context. METHODS: This analytical cross-sectional study recruited seventeen (n=17) adults age ranging from 18 and above male and female who were consecutively admitted to stroke unit with the diagnosis if ischemic or hemorrhagic stroke during acute period of stroke. Stroke was confirmed by either CT or MRI. Patients who were admitted between 29th of November to 23rd of December 2022 were recruited. GUSS, EAT- 10 were administered to evaluate swallowing. Communication was evaluated when SLT record were not available. Period prevalence was measured to evaluate proportion of post-stroke dysphagia. Chi-square test, Mann-Whitney U test, and Kruskal-Wallis one way ANOVA were used to discover the association between dysphagia and communication impairment and other relevant variables. RESULTS: The proportion of dysphagia following stroke in a teaching hospital in Sri Lanka is 70.58%. Twelve (n=12) were presented with PSD. Mean age was 62.06 (SD=8.86) years. Majority of the sample was male (76.5%). The proportion of dysphagia in ischemic stroke is 52.94%. Association between PSD and communication impairment portrayed statistically significant association (x2 (1) = 5.4 , p=.020). Dysarthria is more prominent communication impairment of the sample (n=14). Overall, 88% of patients having communication impairment. Association between dysarthria and dysphagia (p=.707). CONCLUSION/S: Proportion of post-stroke dysphagia is in critical level and it significantly associates with communication impairments. In order to improve outcomes and minimize post-stroke period complications, immediate evaluation or detection of dysphagia is significant.
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    Experiences and expectations of adults who stutter attending speech and language therapy for stuttering in Sri Lanka.
    (University of Kelaniya, Sri Lanka, 2023) Ampemohotti, A.M.N.L.; Nonis, D.
    BACKGROUND: Over the years, the role of adults who stutter in stuttering treatment has evolved from being a passive recipient to an ‘expert’ partner in the collaborative therapeutic process. Therefore, understanding the client’s experiences and expectations regarding stuttering treatment has been recognized as an integral element of an effective therapeutic process. Although several global studies have explored the experiences and expectations of adults who stutter in relation to stuttering treatment, it is an uncharted area related to speech and language therapy in the Sri Lankan context. OBJECTIVE/S: The study explored experiences and expectations of adults who stutter attending speech and language therapy in Sri Lanka. METHODS: This study used a generic qualitative approach. Online semi-structured interviews were conducted with 12 adults who stutter who were attending or had attended speech and language therapy within the past two years at a state university clinic in Sri Lanka. All interviews were conducted in Sinhala language via Zoom. The interviews were audio recorded, transcribed verbatim, translated into English language, and analyzed using a thematic analysis. RESULTS: Four themes emerged from the data: 1) limited awareness of stuttering and its management, 2) impact of stuttering on adults who stutter, 3) experiences of coping with stuttering before attending therapy, and 4) perceptions towards successful management of stuttering. Most of the participants’ experiences before successful management depicted narratives of negative emotions and reactions followed by a lifestyle dominated by avoidance and restriction. The majority of the participants’ expectation of therapy was to improve fluency. Many participants reported that their expectations for therapy were met and that therapy made a positive difference in their lives. Furthermore, the participantsm indicated multiple personal, therapeutic, and social factors that contribute to achieving successful outcomes from therapy. CONCLUSION/S: The current study emphasizes the importance of individualized therapy, designed by considering all the unique perceptions and needs of individuals related to their quality of life to improve the likelihood of successful therapeutic outcomes. The study reveals that being absolutely fluent is not a necessary criterion for the successful management of stuttering. In addition, the findings highlight the need to promote awareness of stuttering and its management and the profession of speech and language therapy among the Sri Lankan public.