Shaker Exercises, Feeding modification, and Associated-depression Relief as Dysphagia Care Bundle: A quasi-Experimental Study in Elderly Patients

Abstract

Background: Dysphagia is frequently overlooked by elderly individuals who may consider it a normal part of aging. This condition causes psychological distress, such as depression. Therefore, early, multidisciplinary care is essential. Aim of the study: To evaluate the effectiveness of shaker exercises, feeding modification, and associated-depression relief as dysphagia care bundle among elderly patients. Design: Quasi-experimental research design (study/ control) was utilized in the current study. Sample: Purposive sample of 120 elderly patients with dysphagia were collected from the outpatient clinic of the Ear, Nose, and Throat of El-Minia university hospital and randomly divided into the bundle group and the control group which include 60 elderly patients in each. Tools: Three tools and one scale were used for data collection before and after intervention: Eat-10 scale, the 3-ounce Water Swallow Test (3OWST), and Geriatric Depression Scale (Short Form). Results: In the post-intervention phase, the mean scores of Eat-10 scale declined from 16.2±4.8 to 8.3±2.27 among the bundle group with (p-value <0.0001), while it modestly decreased from 15.3±4.6 to 13.4±3.8 among the control group with (p-value=0.2965). The proportion of individuals with normal swallowing in 3-ounce Water Swallow Test were increased among the bundle and control group from 31.7 and 36.7 to 70 % and 38.3%, respectively. The proportion of individuals with moderate to severe depression levels among the participants in the bundle and control groups decreased from 63.3% and 66.7% to 25% and 63.3%, respectively. Conclusion: The study concludes that the intervention protocol was effective in improving dysphagia and its associated depression among the elderly patients. Recommendations: Further researches with larger sample, multiple outcome metrics of timing, and intensity of intervention are needed.