JCPSLP Vol 23, Issue 1 2021

completing case history, oromotor, and clinical swallow assessment, interpretation of assessment results, provision of recommendations) demonstrated a statistically significant improvement in self-rated confidence and ability in administering the specific task. Anxiety Students’ self-reported anxiety about working with adults with dysphagia was evaluated on a scale from 0 to 4 where 0 represented not anxious and 4 indicated extremely anxious. Significant decreases ( p = 0.001) from pre-group participation (1.58; SD 0.77) to post group participation (0.74; SD 0.67) were found. Interest Students reported their level of interest in working with adults with dysphagia following graduation on a scale from 0 to 4 where 0 represented not interested and 4 indicated extremely interested. Students reported interest in working with adults with dysphagia following graduation did not significantly change ( p = 0.149) from pre group (2.84; SD 0.34) to post group (3.00; SD 0.36). There was a 15% increase in overall scores by students when comparing pre and post total scores, demonstrating significant improvement in student’s overall reported confidence and knowledge working with adults with dysphagia. Discussion Group intervention for participants with dysphagia The purpose of the study was to evaluate client satisfaction of the DAT group-based student-led model. Results indicated high client satisfaction with the student-led group intervention with clients reporting “agree” or “strongly agree” across all satisfaction questions. This included satisfaction with the individualised assessment and recommendations within a group context, as well as high satisfaction with professionalism of staff, timing of group and appropriate group education. This demonstrates that all clients were highly satisfied with the service they received within the group setting. Minimal change was found for well-being scores related to anxiety of swallowing condition and impacts that swallowing difficulties have on everyday well-being following the group. These results remained in the neutral “neither agree nor disagree” rating. It is known that people with chronic dysphagia experience depression, anxiety, frustration and embarrassment as a result of their dysphagia (Howells et al., 2019). Therefore, services are needed to assist people with dysphagia through the personal adjustments and emotional impacts of living with dysphagia (Nund et al., 2014). It has been highlighted in the literature that the focus for SLP community intervention differs from acute or hospital-based services which remain impairment based, with little focus on the psychological aspect that impact clients (Howells et al., 2019). Unfortunately, how to address this issue remains unclear in the literature (Howells et al., 2019; Nund et al., 2014). Unlike traditional dysphagia models of care, the DAT provided a degree of social support for clients through the opportunity to interact with peers experiencing similar swallowing difficulties. Lack of change in the pre and post group scores indicated that attendance at the group did not exacerbate feelings of anxiety or burden of dysphagia which was a positive outcome. However, it is important

patient awareness and knowledge of when to contact their speech-language pathologist for swallowing concerns (Pre 0.47, SD 0.62; Post 0.94, SD 1.03). All other parameters measured showed no significant change, including patient’s preference for individualised verses group setting. See Table 2 for further details. As shown in Table 3, all additional satisfaction questions revealed a median response of 5 (IQR varying from 0.0–1.0) on the Likert rating scale, indicating high satisfaction of the student-led group service delivery model.

Table 3 Participants with dysphagia (n = 20) mean satisfaction outcomes

Questionnaire statements

Mean (SD)

Median (IQR)

1. I received recommendations regarding my swallowing 2. I found the education provided was easy to understand 3. I feel I received a thorough assessment within the group environment 4. The students and staff catered for my individual needs within the group setting 5. The time length of the group was appropriate 6. The students and staff were professional and attentive to my needs within the group

4.60 (0.60)

5.0 (1.0)

4.70 (0.47)

5.0 (1.0)

4.75 (0.44)

5.0 (0.75)

4.80 (0.41)

5.0 (0.0)

4.70 (0.47)

5.0 (1.0)

4.75 (0.44)

5.0 (0.75)

Responses were obtained on an ordinal scale from 1 to 5 where 1 = strongly disagree and 5 = strongly agree

Seven additional comments were provided by participants in the post survey free form response section. Of these comments, four were positive feedback relating to how the group ran (i.e. “Felt the sessions was very beneficial particularly as a group because more feedback was able to be given”); one related to feedback regarding materials used (i.e., “Carry a tin of thickener powder because some patients may be in between levels of thickness. Gluten free options—didn’t accommodate for it, also couldn’t have fruit because of IBS”). Another comment was related to the discrepancy between specialist recommendations (i.e., “Conflicting recommendations from other health care professionals—gastro vs SLP”) and one more was a preference to attend the community health centre for appointments due to the ease of access in Twenty-eight SLP students were recruited for the study. Four were excluded from the analyses due to incomplete questionnaire completion, leaving 24 students included in the study. Confidence Analysis of the student questionnaires revealed statistically significant improvements observed in 15 out of 20 knowledge- and confidence-related questions (see Table 4). All questions relating to delivery of clinical skills (i.e., comparison to the hospital. Student participants

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JCPSLP Volume 23, Number 1 2021

Journal of Clinical Practice in Speech-Language Pathology