Feasibility and acceptability of a dysphagia screening intervention for hospitalised older patients - a process evaluation.

Abstract

<h4>Purpose</h4>To assess: (1) reach (patients screened for dysphagia), (2) dose (patients receiving 4 Questionnaire Test (4QT), 30 ml water swallow test, and if positive, dysphagia specialist referral), (3) acceptability of the dysphagia screening intervention among stakeholders, and (4) adaptations made or planned.<h4>Materials and methods</h4>A process evaluation using a mixed methods approach was conducted at an orthopaedic surgery department in Denmark. Patients aged ≥65 years admitted with hip fracture were dysphagia screened. Data from electronic health records, semi-structured interviews with health professionals, management, and patients, and a logbook were analysed.<h4>Results</h4>The screening procedure was performed by a multidisciplinary group of health professionals in 141 patients, achieving 94% reach and 92% completion of the 4QT and 30 ml water swallow tests, and near the success criterion for dysphagia specialist referrals (89%). The screening intervention was accepted by the participants, with positive feedback and no serious unexpected consequences. Three adaptations were made immediately, and four were planned.<h4>Conclusions</h4>The dysphagia screening intervention is feasible and acceptable, providing a strong basis for further research on diagnostic performance and broader clinical implementation. Enabling early identification and management of dysphagia may reduce disability, support effective rehabilitation, and improve outcomes.