Dysphagia therapy for head and neck cancer patients undergoing radiotherapy by speech-language pathologists in Malaysia

Abstract

Abstract Purpose This study aimed to identify the current practices and challenges faced by speech-language pathologists (SLPs) in managing dysphagia among head and neck cancer patients undergoing radiotherapy (RT) in Malaysia. Method A sequential, mixed-method study design was utilized in this research. Quantitative data were collected using a survey among 65 SLPs from 34 government hospitals throughout Malaysia. Additionally, 10 SLPs were selected using maximum variation sampling and interviewed for this study. Results The survey showed that only 7.8% of SLPs conducted therapy on all patients before RT. Moreover, the frequency of therapy during and after RT has significant relationships with the variable of time to provide intervention [χ 2 (3, 63) = 13.93, p = 0.004; χ 2 (3, 64) = 12.58, p = 0.007]. This study also revealed varying responses from SLPs regarding the frequency and intensity of performing home therapy programs for patients undergoing RT. Furthermore, SLP practices were divided based on the type of treatments for patients who did not experience dysphagia or mild dysphagia upon the completion of RT. Nevertheless, this study had a high agreement on the type of treatment given to patients who had completed the RT. Qualitative results showed that SLPs faced challenges in terms of a lack of awareness of their role, the establishment of multidisciplinary teams, insufficient SLPs, and inadequate equipment for assessment. Conclusion The study findings indicated a low standard of care in managing dysphagia among head and neck cancer patients undergoing RT and urgently call for improvements toward evidence-based practices.

Keywords

• Dysphagia
• Head and neck cancer
• Swallowing
• Speech-language pathologists