A proposal for a team approach in dysphagia rehabilitation

～ From our experiences of dysphagia treatment ～

Abstract

In dysphagia rehabilitation，we know it is best that various professional medical staff people，such as doctors，nurses，dietitians，physical therapists，occupational therapists，speech therapists and so on，take part in a dysphagia team and stay in contact with each other for patient care．However，this is not easy，and each staff member may not realize his or her own part．In our hospital the otolaryngologists and speech therapists began a rehabilitation approach to dysphagic patients from 1997．In our past experience of dysphagia treatment，we encountered some problems．Therefore，we felt the need for a team approach in dysphagia rehabilitation and considered how to organize it．

Looking back at six cases of swallowing disorder treated by otolaryngologists， we discussed who requested swallowing training， who was the examiner， who was the evaluator，and whether or not videofluoroscopic examination of swallowing（VF）or videoendoscopic examination of swallowing（VE）was carried out．From a different point of view，otolaryngologists and speech therapists discussed the problems．As a result，we came to the conclusion that doctors in attendance should have been the leaders in patients’ rehabilitation．

Even if we need a professional/dysphagia team，there is not always one at hand in every medical facility．For better dysphagia treatment， the attending surgeons or physicians must deepen their understanding and bear the burden as leaders．As the first step in organizing a team，we propose the circulation of dysphagia rehabilitation among the attending doctors and other medical staff people by making frequent contact with them during dysphagic patient care．