Nurses’ management of stroke-related oropharyngeal dysphagia in a rural province of South Africa

Abstract

Background: Early identification of stroke-related oropharyngeal dysphagia (OPD) using screening by nurses can prevent adverse patient outcomes in lower-middle-income countries (LMICs). Nurses are essential in the OPD management team and should ideally be able to screen and prioritise dysphagia management in stroke patients. Objective: The aim of this study was to describe nurses’ identification and management practices of patients with OPD following a stroke in a rural province of South Africa. Qualified nurses from various healthcare levels in a rural province of South Africa were invited to complete a previously published hard copy survey on signs, symptoms, complications, and management of stroke-related OPD. A sample of 130 participants were included. The majority of participants (n=66; 50.8%) had ten or more years of experience. Results: The mean scores of correct responses for each section were: 8.7/13 (66.7%) for signs and symptoms, 4.7/10 (47.3%) for complications and 3.8/7 (54.2%) for management practices. There were no significant differences between groups for the signs and symptoms section and the complications section. Secondary healthcare nurses demonstrated significantly better knowledge than primary (p=0.022) and tertiary (p=0.010) level nurses regarding management of OPD. Overall, secondary level nurses had significantly higher scores than the other levels. Conclusions: Moderate knowledge of identification and management of stroke-related OPD among nurses across all health care levels was evident. Interdisciplinary collaboration between nurses and speech-language therapists can improve team members’ continued professional development and refining of skills in decision-making regarding stroke-related OPD in LMICs.