Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Oral feeding difficulties among children with cerebral palsy, aged between birth to 5 years: special challenges faced by primary caregivers during the COVID- 19 pandemic(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2021) Serasinghe, C.S.D.; Hettiarachchi, S.Introduction: The COVID-19 pandemic has affected health service delivery, globally. Cerebral Palsy (CP) can be defined as a group of disorders affecting movements of limbs, muscles, hearing, vision and posture. Feeding and swallowing difficulties or oropharyngeal dysphagia commonly occurs in children with cerebral palsy. Use of telecommunication technologies are able to support long distance clinical health care. Objectives: To describe the perceived positive and negative experiences/ suggestions for getting speech and language therapy support of primary caregivers in managing oral feeding difficulties in children with cerebral palsy aged between birth to 5 years at a clinical setting during the COVID- 19 pandemic in Sri Lanka. Method: A qualitative study using a phenomenological approach in one clinical setting in the Western Province of Sri Lanka. Using a purposive sampling method, data was collected through semi structured tele- interview sessions by interviewing 12 participants. The qualitative data were analysed using thematic analysis. Results: Several themes emerged from the data as a result of qualitative analysis: challenges in accessing food, challenges in accessing medication, special challenges due to COVID-19 and transition of service delivery model. There are problems in accessing telehealth because of poor connectivity, technical issues and also the lack of awareness about the appointment. The knowledge about technology poorer than the other economically advanced countries. Conclusion: Parents across the country have different levels of access to technology and telehealth may not be accessible to all. However, the alternative methods of consultation by using a smart phone (Zoom, WhatsApp, Imo) are safer than the face-to-face consultations during the pandemic.Item Efficacy of a low-cost multidisciplinary team-led experiential workshop for public health midwives on dysphagia management for children with cerebral palsy(VU e-Publishing, Netherlands, 2018) Hettiarachchi, S.; Kitnasamy, G.; Mahendran, R.; Nizar, F. S.; Bandara, C.; Gowritharan, P.PURPOSE: Over the past decade there has been a growing focus on offering appropriate training to healthcare professionals and caregivers to support safe feeding practices for children with cerebral palsy. Early and consistent multidisciplinary intervention is required to minimise the risks of aspiration pneumonia. The high incidence of complications from aspiration pneumonia among children with cerebral palsy in Sri Lanka has made it necessary to conduct low-cost multidisciplinary team-led dysphagia awareness workshops for healthcare professionals and caregivers.METHOD: A group of 38 Public Health Midwives (PHMs) was offered an experiential workshop by a small multidisciplinary team (MDT). To determine changes in knowledge, a self-administered questionnaire that included a video-based client scenario was administered pre- and post-workshop. The data were analysed statistically using non-parametric within-participant t-tests.RESULTS: The post-workshop responses to the questionnaire indicated a significant increase in the level of knowledge. This included positive changes in the understanding and knowledge of cerebral palsy (t (37) =-7.44, p=.000), effects of cerebral palsy on eating and drinking skills (t (37) =-3.91, p=.000), positioning (t (37) = -9.85, p=.000), aspiration (t (37) =-3.46, p=.001), food categorisation (t (37), -3.85, p=.000) and client video observation (t (37)-3.91, p=.000) at a p=.05 level of significance. While there was also an increase in the knowledge on general guidelines during mealtimes, this did not reach statistical significance.CONCLUSION: The low-cost MDT-led experiential workshop was effective in increasing knowledge of feeding and dysphagia-related issues in cerebral palsy among a group of PHMs. This workshop could serve as a model for training PHMs and Community-Health Workers across the country in order to reach the Sustainable Development Goal of ‘good health and well-being’ for children with cerebral palsy and all children experiencing feeding difficulties. Follow-up workshops and continued professional development courses for midwives on dysphagia care are strongly recommended, in addition to collaborative clinical practice