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Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study
Background: Due to a lack of prospective research in South Africa's Speech-Language Therapy (SLT) private healthcare sector, this prospective cohort study investigated associations between speech, language, and swallowing conditions (i.e. dysarthria, apraxia of speech, aphasia, dysphagia), risk fact...
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| Format: | Thesis |
| Language: | English |
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Division of Communication Sciences and Disorders
2023
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| _version_ | 1867613262630092801 |
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| access_status_str | Open Access |
| author | Kaylor, Stephanie Anne |
| author2 | Singh, Shajila |
| author_browse | Kaylor, Stephanie Anne Singh, Shajila |
| author_facet | Singh, Shajila Kaylor, Stephanie Anne |
| author_sort | Kaylor, Stephanie Anne |
| collection | Thesis |
| description | Background: Due to a lack of prospective research in South Africa's Speech-Language Therapy (SLT) private healthcare sector, this prospective cohort study investigated associations between speech, language, and swallowing conditions (i.e. dysarthria, apraxia of speech, aphasia, dysphagia), risk factors, and outcomes post-stroke (i.e. length of hospital stay, degree of physical disability according to the Modified Rankin Scale [mRS], functional level of oral intake according to the Functional Oral Intake Scale [FOIS], dehydration, weight loss, aspiration pneumonia, mortality). Methods: Adults with a new incident of stroke without pre-existing speech, language or swallowing difficulties (N=68) were recruited. Convenience sampling was used to select participants. A prospective design was used to determine the incidence of speech, language, and swallowing conditions poststroke and association with outcomes from admission to discharge. Results: Co-occurring speech, language, and swallowing conditions frequently occurred post-stroke (88%). Participants who were referred to SLT greater than 24 hours post-admission (52.94%) stayed in hospital for a median of three days longer than those who were referred within 24 hours (p=.042). Dysphagia was significantly associated with moderate to severe physical disability. Dysphagia with aspiration was significantly associated with poor functional level of oral intake (i.e. altered consistency diets and enteral nutrition), at admission and at discharge (p<. 01). Dysphagia had a higher likelihood of mortality (OR=2.86) (p=.319). At discharge, aspiration pneumonia was significantly associated with severe physical disability (p< .01, r=0.70). Risk factors; poor oral hygiene (p=1.00), low level of consciousness (p=1.00), dependent for oral intake (p=.040), and enteral nutrition (p=.257); were not associated with aspiration pneumonia. Conclusion: In South Africa's private sector, cooccurring speech, language, and swallowing conditions commonly occurred post-stroke, and dysphagia was strongly associated with physical disability and poor functional level of oral intake. Length of hospital stay was increased by delayed SLT referrals. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/37539 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:21.255Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Division of Communication Sciences and Disorders |
| publisherStr | Division of Communication Sciences and Disorders |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/37539 Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study Kaylor, Stephanie Anne Singh, Shajila stroke acute care prospective cohort South Africa private sector speech therapy dysphagia outcomes Background: Due to a lack of prospective research in South Africa's Speech-Language Therapy (SLT) private healthcare sector, this prospective cohort study investigated associations between speech, language, and swallowing conditions (i.e. dysarthria, apraxia of speech, aphasia, dysphagia), risk factors, and outcomes post-stroke (i.e. length of hospital stay, degree of physical disability according to the Modified Rankin Scale [mRS], functional level of oral intake according to the Functional Oral Intake Scale [FOIS], dehydration, weight loss, aspiration pneumonia, mortality). Methods: Adults with a new incident of stroke without pre-existing speech, language or swallowing difficulties (N=68) were recruited. Convenience sampling was used to select participants. A prospective design was used to determine the incidence of speech, language, and swallowing conditions poststroke and association with outcomes from admission to discharge. Results: Co-occurring speech, language, and swallowing conditions frequently occurred post-stroke (88%). Participants who were referred to SLT greater than 24 hours post-admission (52.94%) stayed in hospital for a median of three days longer than those who were referred within 24 hours (p=.042). Dysphagia was significantly associated with moderate to severe physical disability. Dysphagia with aspiration was significantly associated with poor functional level of oral intake (i.e. altered consistency diets and enteral nutrition), at admission and at discharge (p<. 01). Dysphagia had a higher likelihood of mortality (OR=2.86) (p=.319). At discharge, aspiration pneumonia was significantly associated with severe physical disability (p< .01, r=0.70). Risk factors; poor oral hygiene (p=1.00), low level of consciousness (p=1.00), dependent for oral intake (p=.040), and enteral nutrition (p=.257); were not associated with aspiration pneumonia. Conclusion: In South Africa's private sector, cooccurring speech, language, and swallowing conditions commonly occurred post-stroke, and dysphagia was strongly associated with physical disability and poor functional level of oral intake. Length of hospital stay was increased by delayed SLT referrals. 2023-03-29T06:55:00Z 2023-03-29T06:55:00Z 2022 2023-03-15T07:46:37Z Master Thesis Masters MSc http://hdl.handle.net/11427/37539 eng application/pdf Division of Communication Sciences and Disorders Faculty of Health Sciences |
| spellingShingle | stroke acute care prospective cohort South Africa private sector speech therapy dysphagia outcomes Kaylor, Stephanie Anne Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study |
| thesis_degree_str | Master's |
| title | Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study |
| title_full | Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study |
| title_fullStr | Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study |
| title_full_unstemmed | Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study |
| title_short | Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study |
| title_sort | clinical outcomes associated with speech language and swallowing difficulties post stroke a prospective cohort study |
| topic | stroke acute care prospective cohort South Africa private sector speech therapy dysphagia outcomes |
| url | http://hdl.handle.net/11427/37539 |
| work_keys_str_mv | AT kaylorstephanieanne clinicaloutcomesassociatedwithspeechlanguageandswallowingdifficultiespoststrokeaprospectivecohortstudy |