An Evaluation of Sialorrhoea Management Practices in Residential Older Adult Care Settings

Varley, Li Ping (2020) An Evaluation of Sialorrhoea Management Practices in Residential Older Adult Care Settings. Masters thesis, Waterford Institute of Technology.

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Abstract

Background: Sialorrhoea (drooling) is the unintentional loss of saliva from the mouth; it is a common and upsetting problem amongst people with certain neurological disorders. It can lead to complications, especially infection, dehydration and fatigue. Saliva can also collect at the back of the throat which causes coughing and may lead to a higher risk of aspiration. In addition, complications from sialorrhoea may cause psychological complications, such as embarrassment, social isolation and feelings of rejection. All these consequences of sialorrhoea can subsequently impact on quality of life. However, there is limited research available in relation to the optimal management of sialorrhoea and subsequently there is no consensus on best practice. Aim: Therefore, the aim of this study was to evaluate practices in the management of sialorrhoea in older adult residential care settings and to, consequently, make recommendations for sialorrhoea management so as to improve quality of life and enhance the person-centred care approach to sialorrhoea management Methods: The study adopted a two phase mixed methods design involving a cross-sectional, descriptive correlational survey and an exploratory, descriptive qualitative design. Sixteen older adult residential care settings in the South East region of Ireland were used as the study sites. A purposive sampling method was used to recruit participants in both study phases. The first phase of this study involved two concurrent strands, one strand involved a survey of older adults experiencing sialorrhoea to identify the impact of sialorrhoea regarding their care needs and their views on sialorrhoea management. The parallel strand involved focus group interviews with the multidisciplinary healthcare team involved with the care of older adults with sialorrhoea to explore and identify current sialorrhoea management practices. The second phase of this study involved one to one in-depth interviews with caregivers (nurses or healthcare assistants) in care of older adults to further explore and confirm findings from the first phase of this study, and to identify changes required to current care and management of sialorrhoea. Findings: Phase 1 questionnaire survey findings revealed that sialorrhoea has quite a significant impact on older adults’ quality of life, relationships were identified between quality of life and impact of sialorrhoea. However, both phase 1 and phase 2 findings also revealed a lack of awareness and knowledge of the underlying issues and management strategies for sialorrhoea in these older adults’ residential care settings. These findings indicate the need for more structured care provision complying with the person-centred care approach. Findings identified that first line healthcare professionals strive to provide care to older adults suffering from sialorrhoea with the utmost empathy and compassion. However, findings demonstrated that first line healthcare professionals face challenges due to a lack of guidelines and, training and education provision. Conclusion: An understructured care provision plan, and the lack of estalished coordination of care among the multidisciplinary healthcare members indicated a deficit in a person-centred care approach to sialorrhoea management within the Irish context. Therefore study findings recommend that current practices would benefit from a structured systematic care protocol regarding sialorrhoea, so as the person-centred care approach could be augmented by such protocols. These include systematic assessment of sialorrhoea, wider multidisciplinary engagement and networking, and continuous professional development training and education programmes focusing on non-invasive management techniques. In order to improve care for older adults with sialorrhoea in residential care setting, policy makers, stakeholders and researchers should work together to further develop national evidence based guidelines to direct the management of sialorrhoea, specifically to develop protocols for nurses to follow in everyday care of the older adults.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Sialorrhoea Management Practices, Residential Older Adult Care
Departments or Groups: *NONE OF THESE*
Divisions: School of Health Sciences > Department of Nursing
Depositing User: Derek Langford
Date Deposited: 22 Sep 2020 11:00
Last Modified: 22 Sep 2020 11:00
URI: http://repository.wit.ie/id/eprint/3453

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