Nursing assessment of dysphagia among patients with stroke.

The aims of this study were to investigate the frequency of dysphagia among patients with acute stroke and compare non-dysphagic and dysphagic stroke patients regarding demographic aspects, performance in activities of daily living and type of neurological deficiency and to test a bedside screening tool to identify patients with dysphagia. The frequency of dysphagia was found to be 27%, or 40% if those patients who were unconscious, terminally ill or had a previous history of dysphagia were included. Overall stroke severity seemed to be an indicator for dysphagia, i.e. being significantly more drowsy, more dependent in activities of daily living, suffering more often from dysarthria, expressive dysphasia, taking antidepressive medication, staying significantly longer in hospital and being discharged to a higher level of formal care than non-dysphagic patients. The screening method proved to be useful, in that it detected 77% of those with dysphagia using a review of medical charts and continuous observations as a method to check the reliability of the bedside method. It is concluded that most patients with dysphagia can be identified through systematic interviews, observations and test swallows. These have to be repeated and included in nursing care assessment. Overall stroke severity is an indicator of dysphagia.