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- Communication strategies for adults in palliative care: the speech-language therapists’ perspectivePublication . Dias, Cátia; Rodrigues, Inês Tello; Gonçalves, Hernâni; Duarte, IvoneBackground Communication disorders are a challenge that many patients in palliative care (PC) may encounter. This intervention area is emerging for the speech-language therapist (SLT), the professional who works in preventing, assessing, diagnosing, and treating human communication disorders. This study aims to identify and classify the communication strategies considered most important by SLTs for use in PC and evaluate whether there are any differences in perception regarding the importance of strategies between SLTs with and without PC experience. Methods This cross-sectional quantitative study was conducted using a survey, which employed a well-structured, self-completion questionnaire previously validated by a panel of experts with over six years of PC experience. Results The strategies rated as most important within each group were the following: (i) adjust the patient’s position and minimise environmental noise; (ii) establish eye contact and adjust the pace of speech; (iii) adjust the language level and raise one topic at a time; (iv) use images of the patient’s interests and their personal objects; (v) use orality and multimodal form; (vi) use simplified language and structured pauses; and (vii) use tables with images and books with pictures. Conclusions Verbal and non-verbal strategies were rated as highly important. There was no evidence of differences in perception in terms of importance between the SLTs with or without experience in PC, but more studies are needed to support this aspect. The patient’s communication ability is one of the cornerstones of PC quality. Through their actions, speech-language professionals could empower the patient with strategies so that they can autonomously and self-determinedly express their experiences and most significant needs.
- Dysphagia in Alzheimer’s disease: a systematic reviewPublication . Mira, Ana; Gonçalves, Rita; Rodrigues, Inês TelloDysphagia is described as a highly relevant comorbidity of Alzheimer’s disease (AD). However, there is a scarcity of studies aiming at the characteristics and progression of dysphagia. Objective: The objective of this study was to identify the specific characteristics, progression, and prevalence of dysphagia in AD. Methods: Publications were searched in the PubMed (MEDLINE), EBSCO, ScienceDirect, and BASE databases. Critical appraisal and evidence-level analysis were conducted using the Joanna Briggs Institute and Effective Public Health Practice Project’s (EPHPP) tools. Results: A total of 26 studies were reviewed. Symptoms begin in the early stage of AD, as oral phase impairments, and progress to pharyngeal symptoms and swallowing apraxia in the later stages of AD. Dysphagia progresses, as AD, along a continuum, with severity depending on individual variability. There were no studies found on prevalence. Conclusions: Dysphagia is a complex and important comorbidity in AD that impacts the quality of life. No recent publications on prevalence may imply that is not being coded as a potential cause for pneumonia deaths in AD.
- Exercícios profiláticos de deglutição em pessoas com cancro de cabeça e pescoço: revisão sistemáticaPublication . Goulart, Veronica; Ribeiro, Sara; Rodrigues, Inês TelloIntrodução: As alterações de deglutição são comuns após tratamento para cancro de cabeça e pescoço. Os exercícios para a recuperação das funções da deglutição são importantes, mas a sua utilização de forma profilática ainda é pouco estudada. Objetivo: Analisar a utilização de exercícios profiláticos para a deglutição em pessoas com cancro de cabeça e pescoço submetidas a tratamento (neo)adjuvante com radioterapia e/ou quimioterapia. Métodos: Revisão sistemática da literatura cuja seleção dos estudos decorreu em outubro de 2022 envolvendo pesquisas nas bases de dados PubMed central, LILACS, Scielo, CINAHL Complete, Cochrane Collection Plus, Nursing & Allied Health Collection e Medic Latina. A análise do nível de evidência foi realizada através da escala “Quality Assessment Tool for Quantitative Studies”. Resultados: Identificaram-se 1.401 estudos e selecionados apenas oito para análise e extração de dados. Conclusão: A utilização de exercícios profiláticos parece ter algum benefício nas funções da deglutição, mas os resultados não são consistentes. Sugerem-se novas investigações para estudar os seus potenciais benefícios de forma mais específica (i.e. tipo exercício versus tratamento).
- Action verbal fluency in Parkinson’s patientsPublication . Tello Rodrigues, Inês; Ferreira, Joaquim; Coelho, Miguel; Rosa, Mário; Castro-Caldas, AlexandreWe compared the performance of 31 non-demented Parkinson´s disease (PD) patients to 61 healthy controls in an action verbal fluency task. Semantic and phonemic fluencies, cognitive impairment and behavioural dysfunction were also assessed. The mean disease duration of PD was 9.8 years (standard deviation (SD) = 6.13). There were no age (U = 899.5, p = 0.616), gender(chi-square = 0.00, p = 1.00) or literacy (U = 956, p = 0.96) differences between the two groups. A significant difference was observed between the two groups in the action verbal fluency task (U = 406.5, p < 0.01) that was not found in the other fluency tasks. The education level was the only biographical variable that influenced the action (verb) fluency outcomes, irrespective of disease duration. Our findings suggest a correlation between the disease mechanisms in PD and a specific verb deficit, support the validity of the action (verb) fluency as an executive function measure and suggest that this task provides unique information not captured with traditional executive function tasks.
- Feeding problems in children with autism spectrum disorders: a systematic reviewPublication . Pinto Silva, Rita; Costa, Ana Margarida Nunes; Rodrigues, Inês TelloFeeding problems are often associated with Autism Spectrum Disorders. However, many terms are used to describe these problems with a lack of consensus between authors. This systematic review critically examines the available scientific literature on the most commonly described characteristics of feeding disorders among children with Autism Spectrum Disorders. The literature was evaluated according to PRISMA standards by searching electronic databases (e.g., MEDLINE, EBSCO) with reference lists from January 2009 to January 2019. English language studies were included. Abstract and full-text article reviews were conducted by two independent authors with sequential data extraction. The systematic search and the subsequent analysis of the results revealed 45 articles eligible for full review. Detailed information regarding the methods and results was extracted from the original articles, and the quality of the included studies was appraised. The most commonly described feeding problem was food selectivity followed by mealtime behaviour problems. We also found some frequently associated issues like sensory sensitivity as well as anthropometric deviations and nutritional deficits that can negatively impact health. Oral motor impairment was a less commonly studied phenomenon. Most of the reviewed studies were considered to have a ‘moderate’ level of evidence. Although current evidence suggests that feeding problems are often associated with autism, more research is needed to understand the reliability and validity between and within existing feeding definitions and measures, as well as into the prevalence of oral sensory-motor related deficits.
- Research practices of the speech- language pathologist in Portugal: needs, barriers and facilitatorsPublication . Mendes, Ana; Moreira, Miriam; Guerreiro, David; Nascimento, David; Tello Rodrigues, Inês; Aguiar, VaniaIntrodução: A necessidade e o interesse na investigação pelos Terapeutas da Fala (TFs) tem sido crescente. Objetivos: (i) caracterizar o nível de autonomia atual dos TFs em Portugal em investigação científica; (ii) caracterizar o nível de autonomia desejado dos TFs em Portugal em investigação científica; (iii) caracterizar as necessidades de formação assim como identificar as barreiras e facilitadores de práticas de investigação dos TFs em Portugal. Métodos: 86 TFs preencheram um questionário validado por um painel de peritos. A recolha de dados incidiu sobre: (i) nível de autonomia atual e desejado para a prática de investigação; (ii) barreiras e facilitadores inerentes à prática da investigação. Resultados: Os níveis de autonomia foram significativamente inferiores aos níveis desejados (p<0,001). A autonomia atual para a tarefa de criação de uma ideia de investigação foi significativamente inferior quando comparada com as tarefas de definição de metodologia (p<0,05), análise de dados (p<0,001), processamento de dados (p<0,001) e síntese de resultados (p<0,001). Não houve diferenças de autonomia entre a tarefa de comunicação em conferências e a tarefa de criação de uma ideia de investigação (p<0,05). A maioria reportou a necessidade de formação adicional para conseguir integrar a investigação na sua prática clínica. A principal barreira para a realização de investigação foi a ausência de tempo (64,5%). O principal facilitador foi o tempo disponível (27,7%). Conclusão: Os TFs possuem o desejo de maior autonomia no processo de investigação. A identificação de barreiras e facilitadores encontrados poderão permitir uma resposta mais adequada às capacidades e necessidades dos TFs.
- The effect of speech and language therapy in adults with temporomandibular disorder: a systematic reviewPublication . Rodrigues, Sara Martins; Vieira, Helena Isabel; Rodrigues, Inês TelloTemporomandibular disorder (TMD) is considered the second most common musculoskeletal pathology. The purpose of this review is to systematically assess the role of speech and language therapy (SLT) in adults with TMD. A search was conducted in the PubMed-Central, ScienceDirect, Scielo, and Academic Search Complete (via EBSCOHost) databases. The research was independently carried out by two researchers, considering primary studies without any time limit. The articles were assessed independently for screening, selection, and duplication of results. Evidence analysis was performed using the “Quality Assessment Tool for Quantitative Studies” scale. A total of 99 articles were extracted for full reading, but only 10 were integrated into the final sample. Most of the included articles (n=8) were classified with a “weak” level of evidence. Agreement between observers on which studies to include was very high. The results of the studies associate the primary intervention of SLT with myofunctional therapy. The most widely described intervention strategies are thermotherapy, relaxation, massage therapy, myotherapy, and functional training of oral functions, although their methodology and application details are not fully specified in the literature. The use of laser and electrostimulation in SLT is starting to be explored as a prior approach to intervention, but its effectiveness is not yet firmly established. The team intervention is described as fundamental for a successful TMD intervention. The role of SLT in TMD is beginning to be described and valued, however, the criteria for choosing best practices and their effects are not yet fully described and verified in the literature.
- “To talk or not to talk”- an rTMS study about naming during stimulationPublication . Tello Rodrigues, Inês; Castelo-Branco, M; Castro-Caldas, Alexandre
- Fundamentos e aplicabilidade clínica da estimulação magnética transcraniana na reabilitação das afasias:Publication . Tello Rodrigues, InêsA recuperação após um Acidente Vascular Cerebral (AVC) é baseada nos mecanismos de plasticidade neuronal e na forma como o sistema nervoso central se reorganiza para compensar a perda das áreas afetadas. Neste contexto específico, as técnicas de neuromodulação, onde se enquadra a Estimulação Magnética Transcraniana (EMT), têm tido avanços promissores e suscitado grande interesse por parte da comunidade científica pelo seu potencial terapêutico, especialmente nas sequelas pós-AVC. A EMT resulta da produção de campos magnéticos modulados, induzindo a produção de correntes eléctricas no córtex cerebral, modificando a excitabilidade intra-cortical e ativando ou inibindo estruturas corticais e subcorticais distantes ao longo de conexões específicas. Neste sentido, a EMT pode promover os mecanismos de neuroplasticidade e está associada à recuperação funcional de pacientes que sofreram AVC´s. Pretende-se, com este artigo, apresentar uma atualização da literatura sobre este tema de forma a evidenciar as diferentes aplicações clínicas desta técnica especificamente na reabilitação de pessoas com afasia após AVC.
- Communication of mechanically ventilated patients in intensive care unitsPublication . Martinho, Carina; Tello Rodrigues, InêsObjective: The aim of this study was to translate and culturally and linguistically adapt the Ease of Communication Scale and to assess the level of communication difficulties for patients undergoing mechanical ventilation with orotracheal intubation, relating these difficulties to clinical and sociodemographic variables. Methods: This study had three stages: (1) cultural and linguistic adaptation of the Ease of Communication Scale; (2) preliminary assessment of its psychometric properties; and (3) observational, descriptive-correlational and cross-sectional study, conducted from March to August 2015, based on the Ease of Communication Scale - after extubation answers and clinical and sociodemographic variables of 31 adult patients who were extubated, clinically stable and admitted to five Portuguese intensive care units. Results: Expert analysis showed high agreement on content (100%) and relevance (75%). The pretest scores showed a high acceptability regarding the completion of the instrument and its usefulness. The Ease of Communication Scale showed excellent internal consistency (0.951 Cronbach’s alpha). The factor analysis explained approximately 81% of the total variance with two scale components. On average, the patients considered the communication experiences during intubation to be “quite hard” (2.99). No significant correlation was observed between the communication difficulties reported and the studied sociodemographic and clinical variables, except for the clinical variable “number of hours after extubation” (p < 0.05). Conclusion: This study translated and adapted the first assessment instrument of communication difficulties for mechanically ventilated patients in intensive care units into European Portuguese. The preliminary scale validation suggested high reliability. Patients undergoing mechanical ventilation reported that communication during intubation was “quite hard”, and these communication difficulties apparently existed regardless of the presence of other clinical and/or sociodemographic variables.