[Digital support in dysphagia care: Care needs, everyday obstacles, and requirements for a user-centered application - A qualitative study with speech therapists].

BACKGROUND: Dysphagia poses a major challenge due to its clinical, psychosocial and care-related implications. Older adults with underlying neurogenic conditions are particularly vulnerable. However, despite the availability of effective therapeutic approaches, outpatient dysphagia care is often characterized by structural shortcomings such as long therapy waiting times, insufficient frequency of therapy sessions, or a lack of diagnostic equipment due to specialist staff shortages. Digital health applications may offer potential support, yet their use in dysphagia management remains limited. Therefore, this study aimed to explore the perspective of speech and language therapists on the use of digital applications in the care of individuals with neurogenic dysphagia and to identify key requirements, opportunities, and barriers for the development of a practice-oriented, user-centered digital dysphagia application.

METHODS: This study is part of the user-centered research and development project "Dys-Phappgy" funded by the German Federal Ministry of Research, Technology and Space and follows a design-based research approach. A qualitative needs assessment was conducted using semi-structured interviews with 15 speech and language therapists. Data were analyzed using the structured qualitative content analysis according to Kuckartz and Rädiker (2022), combining deductive category development based on the research questions with inductive refinement from the data.

RESULTS: The perceived need for digital support tools is primarily driven by structural challenges, including fragmented information across care sectors, limited access to apparatus-based diagnostic procedures, resource constraints, and insufficient continuity of care. Digital applications are perceived as complementary tools supporting information management, patient education, therapy adherence, and interprofessional collaboration. Nevertheless, acceptance and sustained use largely depend on low implementation costs, clear practical benefits, and seamless integration into existing workflows.

CONCLUSIONS: Digital dysphagia applications can meaningfully support outpatient care if they are developed through participatory processes and aligned with the complex realities of everyday therapeutic practice.