Exploring the Factors Affecting Speech and Language Pathologists’ Decision to Transition from Oral to Non-Oral Feeding in Patients with Dysphagia: A Qualitative Study

Abstract

Aim: Speech and language pathologists (SLP) make decisions regarding the use of alternative feeding methods when oral feeding presents a vital risk for the dysphagia patients or when the patient’s food intake is deficient. This decision affects the lives of patients from physiological, psychological, and social aspects. The decision mechanisms of SLPs involve the medical status of the patient and evaluation results. This study aims to explore factors influencing the decision of SLPs to transition from oral to non-oral feeding. Material and Methods: Our study was conducted with a phenomenological design. Nine SLPs who had experience working with dysphagia patients participated in semi-structured interviews. Data were coded on the MAXQDA program using a thematic analysis approach. Results: Six main themes were constructed. In addition to the medical status of the patients, participants described giving importance to the reactions of patients and relatives, the moment of explaining their decision to the patient, interactions with other professionals, work environments, experiences and educational backgrounds, and the assessments and therapies patients underwent. Conclusion: The decision mechanisms of SLPs regarding feeding are not only affected by the physiological condition of the patient, but also by factors regarding patient relatives, the SLP’s personal approaches, communication with other professionals, the assessment process, and therapy implementation. Non-oral feeding decisions are also linked to their clinical experience and educational backgrounds. It is recommended that SLPs think multi-dimensionally about feeding transitions and give critical importance to their decision processes.