| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 2.17 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Introdução: A Terapia da Fala é fundamental nos Cuidados Paliativos (CP), especialmente no apoio a indivíduos com perturbações da deglutição, que comprometem a qualidade de vida e a segurança alimentar. A intervenção do Terapeuta da Fala é vital para otimizar a deglutição e promover o bem-estar, devendo ser adaptada às necessidades individuais, equilibrando a segurança, o conforto e o respeito pelas preferências pessoais e familiares. Objetivo: Analisar a relação entre as intervenções do Terapeuta da Fala em pessoas com perturbação da deglutição em CP relativamente à segurança e eficácia da deglutição, assim como, à qualidade de vida. Metodologia: Conduziu-se uma revisão sistemática da literatura, baseada nas diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA-P). A pesquisa foi realizada nas bases de dados SCOPUS, MEDLINE, CINAHL, SCIELO (via EBSCOHost) e LILACS, além de literatura cinzenta (WorldCat e OpenGrey), sem restrição de datas. Foram incluídos estudos com participantes de todas as idades que apresentavam perturbação da deglutição em CP, abrangendo intervenções do Terapeuta da Fala. A revisão considerou trabalhos publicados em inglês, espanhol e português. Estudos secundários, como revisões e editoriais foram excluídos. A identificação dos estudos e a extração de dados foram realizadas de forma independente por dois investigadores, utilizando o software Rayyan® para gerir a triagem e seleção dos estudos. Os dados foram organizados em tabelas, detalhando a estratégia de pesquisa, acesso aos estudos e conformidade com os critérios de inclusão. A qualidade metodológica dos estudos foi avaliada através dos instrumentos preconizados pelo Joanna Briggs Institute (JBI) e pelos níveis de evidência definidos pelo Oxford Centre for Evidence-Based Medicine (OCEBM). Resultados: Foram incluídos cinco estudos (i.e. um estudos de caso, uma série de estudos de caso, um estudo de prevalência e dois transversais), que passaram por uma leitura integral e avaliação crítica da qualidade metodológica. Foram identificadas intervenções como adaptação da consistência e volume dos alimentos, manobras posturais e de limpeza da via aérea, técnicas sensoriais e alimentação de conforto com o objectivo de promover uma deglutição mais segura e preservar a qualidade de vida. É reforçada a personalização das intervenções de acordo com as necessidades individuais. A análise dos estudos incluídos revelou uma variabilidade notável tanto nos níveis de evidência como nas avaliações metodológicas realizadas. Conclusões: A literatura reforça o papel da intervenção do Terapeuta da Fala em CP com pessoas com perturbação da deglutição. Apesar da heterogeneidade dos estudos, a maioria indica benefícios na segurança da deglutição e na qualidade de vida. A revisão enfatiza a necessidade de avaliações cuidadosas e a tomada de decisão compartilhada, alinhadas aos desejos das pessoas. A falta de diretrizes padronizadas e a variabilidade nas práticas clínicas indicam a necessidade de estudos futuros para padronizar práticas baseadas em evidência.
Introduction: Speech Therapy is essential in Palliative Care (PC), especially in supporting individuals with swallowing disorders, which compromise quality of life and food safety. The intervention of the Speech Therapist is vital to optimize swallowing and promote well-being, and should be tailored to individual needs, balancing safety, comfort, and respect for personal and family preferences. Objective: Analyze the relationship between Speech Therapist interventions in individuals with swallowing disorders in PC concerning swallowing safety and efficacy, as well as quality of life. Methodology: A systematic literature review was conducted, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA-P) guidelines. The search was carried out in the SCOPUS, MEDLINE, CINAHL, SCIELO (via EBSCOHost), and LILACS databases, as well as gray literature (WorldCat and OpenGrey), without date restrictions. Studies were included with participants of all ages who had swallowing disorders in PC, encompassing interventions by Speech Therapists. The review considered works published in English, Spanish, and Portuguese. Secondary studies, such as reviews and editorials, were excluded. The identification of studies and data extraction were conducted independently by two researchers, using Rayyan® software to manage the screening and selection of studies. The data were organized into tables detailing the search strategy, access to studies, and compliance with inclusion criteria. The methodological quality of the studies was assessed using tools recommended by the Joanna Briggs Institute (JBI) and the levels of evidence defined by the Oxford Centre for Evidence-Based Medicine (OCEBM). Results: Five studies were included (i.e., one case study, one series of case studies, one prevalence study, and two cross-sectional studies), which underwent a full reading and critical assessment of methodological quality. Interventions identified included adjustments to the consistency and volume of food, postural and airway clearance maneuvers, sensory techniques, and comfort feeding, aimed at promoting safer swallowing and preserving quality of life. The personalization of interventions according to individual needs is emphasized. The analysis of the included studies revealed notable variability in both levels of evidence and the methodological assessments conducted. Conclusions: The literature reinforces the role of the Speech Therapist's intervention in PC with individuals who have swallowing disorders. Despite the heterogeneity of the studies, most indicate benefits in swallowing safety and quality of life. The review emphasizes the need for careful assessments and shared decision-making, aligned with individuals' wishes. The lack of standardized guidelines and the variability in clinical practices indicate the need for future studies to standardize evidence-based practices.
Introduction: Speech Therapy is essential in Palliative Care (PC), especially in supporting individuals with swallowing disorders, which compromise quality of life and food safety. The intervention of the Speech Therapist is vital to optimize swallowing and promote well-being, and should be tailored to individual needs, balancing safety, comfort, and respect for personal and family preferences. Objective: Analyze the relationship between Speech Therapist interventions in individuals with swallowing disorders in PC concerning swallowing safety and efficacy, as well as quality of life. Methodology: A systematic literature review was conducted, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA-P) guidelines. The search was carried out in the SCOPUS, MEDLINE, CINAHL, SCIELO (via EBSCOHost), and LILACS databases, as well as gray literature (WorldCat and OpenGrey), without date restrictions. Studies were included with participants of all ages who had swallowing disorders in PC, encompassing interventions by Speech Therapists. The review considered works published in English, Spanish, and Portuguese. Secondary studies, such as reviews and editorials, were excluded. The identification of studies and data extraction were conducted independently by two researchers, using Rayyan® software to manage the screening and selection of studies. The data were organized into tables detailing the search strategy, access to studies, and compliance with inclusion criteria. The methodological quality of the studies was assessed using tools recommended by the Joanna Briggs Institute (JBI) and the levels of evidence defined by the Oxford Centre for Evidence-Based Medicine (OCEBM). Results: Five studies were included (i.e., one case study, one series of case studies, one prevalence study, and two cross-sectional studies), which underwent a full reading and critical assessment of methodological quality. Interventions identified included adjustments to the consistency and volume of food, postural and airway clearance maneuvers, sensory techniques, and comfort feeding, aimed at promoting safer swallowing and preserving quality of life. The personalization of interventions according to individual needs is emphasized. The analysis of the included studies revealed notable variability in both levels of evidence and the methodological assessments conducted. Conclusions: The literature reinforces the role of the Speech Therapist's intervention in PC with individuals who have swallowing disorders. Despite the heterogeneity of the studies, most indicate benefits in swallowing safety and quality of life. The review emphasizes the need for careful assessments and shared decision-making, aligned with individuals' wishes. The lack of standardized guidelines and the variability in clinical practices indicate the need for future studies to standardize evidence-based practices.
Description
Keywords
Fonoaudiologia Deglutição Transtornos da deglutição Cuidados paliativos Cuidados paliativos na terminalidade da vida Speech therapy Swallowing Swallowing disorders Palliative care End-of-life palliative care