Adherence to Dysphagia Treatment Recommendations: A Conceptual Model.

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  • Additional Information
    • Affiliation:
      Department of Communication Sciences and Disorders, University of Wisconsin–Madison.
      Otolaryngology–Head & Neck Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison.
      Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL.
      Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin.
      Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, WI.
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      Purpose: Conceptual models of complex health problems are useful when designing targeted clinical interventions and focused research studies. Understanding and studying patient adherence often involves interplay among many factors that influence whether a patient successfully follows recommendations or completes a therapy program. Functional frameworks serve to arrange these factors visually, increasing interpretability and allowing for empirical testing of relationships among concepts. The purpose of this article is to integrate relevant factors from the literature into a comprehensive framework that describes adherence to dysphagia treatment. Method: Using peer-reviewed, published guidelines regarding conceptual model construction, the authors created a list of potential factors that influence patient adherence to dysphagiarelated treatment recommendations. During model construction, following extensive review of the literature and existing theories that have been applied in other areas of health care, factors were identified and grouped into conceptually similar domains (clusters). Clusters were arranged into larger categories that emerged during model optimization. Ultimately, two models were created: one that illustrates the interrelated factors of patient adherence and another that illustrates a subset of modifiable risk factors that a clinical speech-language pathologist may influence when developing a dysphagia treatment plan. Results: Three general categories from 14 factors emerged based on relationships between factors and aspects of patient care: health factors, individual patient factors, and contextual factors. A second model consisting of modifiable risk factors included access, treatment type, patient perceptions, self-efficacy, health literacy, support factors, and provider bias. Conclusions: This conceptual model allows clinicians and researchers to identify and explore the mechanisms driving adherence. Continual refinements of this model should be made as future studies uncover how the interconnectedness of factors affects adherence in dysphagia management. The models we have presented here are ready for clinical application and should also serve researchers as they generate hypotheses and design targeted research questions.
    • Journal Subset:
      Allied Health; Peer Reviewed; USA
    • ISSN:
      1092-4388
    • MEDLINE Info:
      NLM UID: 9705610
    • Grant Information:
      This work was supported by National Institutes of Health (NIH) Grants 1F31AG059351-01 and1K23AG057805-01A1 and the Clinical and Translational Science Award program, through the National Center for Advancing Translational Sciences Grant UL1TR002373.
    • Publication Date:
      20200624
    • Publication Date:
      20200626
    • DOI:
      http://dx.doi.org/10.1044/2020_JSLHR-19-00270
    • Accession Number:
      143883684
  • Citations
    • ABNT:
      KREKELER, B. N. et al. Adherence to Dysphagia Treatment Recommendations: A Conceptual Model. Journal of Speech, Language & Hearing Research, [s. l.], v. 63, n. 6, p. 1641–1657, 2020. DOI 10.1044/2020_JSLHR-19-00270. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143883684. Acesso em: 15 ago. 2020.
    • AMA:
      Krekeler BN, Vitale K, Yee J, Powell R, Rogus-Pulia N. Adherence to Dysphagia Treatment Recommendations: A Conceptual Model. Journal of Speech, Language & Hearing Research. 2020;63(6):1641-1657. doi:10.1044/2020_JSLHR-19-00270
    • APA:
      Krekeler, B. N., Vitale, K., Yee, J., Powell, R., & Rogus-Pulia, N. (2020). Adherence to Dysphagia Treatment Recommendations: A Conceptual Model. Journal of Speech, Language & Hearing Research, 63(6), 1641–1657. https://doi.org/10.1044/2020_JSLHR-19-00270
    • Chicago/Turabian: Author-Date:
      Krekeler, Brittany N., Kailey Vitale, Joanne Yee, Ryan Powell, and Nicole Rogus-Pulia. 2020. “Adherence to Dysphagia Treatment Recommendations: A Conceptual Model.” Journal of Speech, Language & Hearing Research 63 (6): 1641–57. doi:10.1044/2020_JSLHR-19-00270.
    • Harvard:
      Krekeler, B. N. et al. (2020) ‘Adherence to Dysphagia Treatment Recommendations: A Conceptual Model’, Journal of Speech, Language & Hearing Research, 63(6), pp. 1641–1657. doi: 10.1044/2020_JSLHR-19-00270.
    • Harvard: Australian:
      Krekeler, BN, Vitale, K, Yee, J, Powell, R & Rogus-Pulia, N 2020, ‘Adherence to Dysphagia Treatment Recommendations: A Conceptual Model’, Journal of Speech, Language & Hearing Research, vol. 63, no. 6, pp. 1641–1657, viewed 15 August 2020, .
    • MLA:
      Krekeler, Brittany N., et al. “Adherence to Dysphagia Treatment Recommendations: A Conceptual Model.” Journal of Speech, Language & Hearing Research, vol. 63, no. 6, June 2020, pp. 1641–1657. EBSCOhost, doi:10.1044/2020_JSLHR-19-00270.
    • Chicago/Turabian: Humanities:
      Krekeler, Brittany N., Kailey Vitale, Joanne Yee, Ryan Powell, and Nicole Rogus-Pulia. “Adherence to Dysphagia Treatment Recommendations: A Conceptual Model.” Journal of Speech, Language & Hearing Research 63, no. 6 (June 2020): 1641–57. doi:10.1044/2020_JSLHR-19-00270.
    • Vancouver/ICMJE:
      Krekeler BN, Vitale K, Yee J, Powell R, Rogus-Pulia N. Adherence to Dysphagia Treatment Recommendations: A Conceptual Model. Journal of Speech, Language & Hearing Research [Internet]. 2020 Jun [cited 2020 Aug 15];63(6):1641–57. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143883684