Understanding the Predictors of Swallowing-Related Quality of Life

Research Objectives To identify the independent predictors of swallowing-related quality of life (QOL) in stroke survivors. Give that a large proportion of stroke survivors suffer from swallowing difficulties (dysphagia), which negatively impact survival and QOL, it is important pinpoint modifiable factors contributing to reduced quality of life in order to improve treatment outcomes and the overall health of the patient. Design Cross-sectional online survey. Setting General community. Participants A volunteer sample of 31 adult stroke survivors with dysphagia (mean age 62 years; 23 males) and their spouses (mean age 57 years; 7 male). Survivors were >3 months post-stroke and living with their spouse who was providing some degree of caregiving. Interventions Not applicable. Main Outcome Measures Backward regression analysis methods were employed.Dependent variable: dysphagia-related quality of life (SWAL-QOL)Independent variables: age; employment status; receiving dysphagia treatment; number of medical conditions; diet restrictiveness (based on consumption of texture modified food and drink); stroke impact (Stroke Impact Scale; SIS); relationship with spouse; spousal age; spousal employment status; spousal burden; spousal depression. Results Number of survivor medical conditions, degree of diet restrictiveness, SIS emotional subscale score, and spousal employment status significantly predicted dysphagia-related QOL, F(3, 21) = 16.423, p < .001, accounting for 75.4% of the variation in SWAL-QOL scores with an adjusted R2 of 70.1%. The model suggested that stroke survivors with more medical conditions and/or a caregiver who worked outside of the home had worse dysphagia-related QOL, and those with fewer feelings of sadness, burden, nervousness, etc. and/or a less restrictive diet had better dysphagia-related QOL. Conclusions Factors related to dysphagia-related QOL are multifactorial and include both survivor and spousal variables. Results support the interrelatedness of overall patient health, patient mental health, and family support, particularly for individuals coping with dysphagia-related dietary restrictions. These data highlight the need for speech-language pathologists and other members of the rehabilitation team to consider patient disability and needs more holistically in order to maximize perceived treatment outcomes. Author(s) Disclosures Nothing to disclose.