Literature Review - Dehydration and Dysphagia After a Stroke

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Topics: Stroke, Nursing home
Dysphagia and dehydration after a Stroke: A Literature Review

Background. Stroke is a major cause of mortality in the United Kingdom; it is the third biggest killer in the UK (National audit office 2005) around 53,000 people die every year from this long term condition. (Scarborough et al 2009) In people under the age of 75 it is a main cause of premature mortality with 1 in 20 dying because of an acute stroke and the complications that arise. In socially deprived areas a person is 3 times more likely to suffer from a stroke than in the least deprived areas of the UK. Dehydration is preventable but is unfortunately very common; there is a method of early identification that could stop a patient becoming increasingly unwell in a short space of time. What is the best and safest method for the patient when replacing lost fluids? Dysphagia, a person who has problems with swallowing, is another common concern with people who have suffered a stroke. Most issues resolve themselves within a few weeks after the stoke, but for an unfortunate few problems persist and more complications arise in up to 19% of patients (Rowat 2011) including dehydration, nutritional problems because of a poor dietary intake and depression perhaps due to embarrassment of the effects of the stroke
Search Terms. The keywords used in this literature review were, ‘stroke’, ‘dehydration’, ‘nursing’ ‘dysphagia’ and ‘literature review’. The keywords were used in a variety of ways to see as many different articles of interest. The databases used were Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Scorpus and Google Scholar. The search has included worldwide journals and papers with the date limitations of 2001 to 2012 to ensure that all evidence and information is current. Only those articles published in English and available through the University of Dundee library were considered for inclusion.
Findings. Morris (2008) states a stroke has a far greater effect on a



References: CAMPBELL, N., 2012. Dehydration: best practice in the care home. Nursing and residential care. 14 (1) pp 21-25. CAMPBELL-TAYLOR, I., 2008 CARE QUALITY COMMISSION. 2011. Dignity and nutrition for older people: review of compliance. CQC. London. CICHERO, J A Y et al., 2009. Triaging dysphagia: nurse screening for dysphagia in an acute hospital. Journal of clinical nursing. 18 (11) p 1469. CLAROS, E and COLLINS, M., 2011. The face of dehydration. Nursing. 41 (8) pp26-31. DENNIS, M., 2000. Nutrition after a stroke. British Medical Bulletin. 56 (2) pp 466-475. DENNIS, M et al ., 2006. FOOD: A multicentre randomised trial evaluating feeding policies in patients admitted to hospital with a recent stroke. Health technology assessment. 10 (2). FORSTER, A., 2011. Oropharyngeal dysphagia in older adults : A review. European geriatric medicine. 2 (6) pp356-362. HEALTH SERVICE OMBUDSMAN. 2011. Care and compassion? Report of the health service ombudsman on the ten investigations into the NHS care of older people. Health Service Ombudsman. London. LI-CHAN, L et al., 2002 MARTINO, R et al., 2005. Dysphagia after stroke. Incidence, diagnosis and pulmonary complications. Stroke. 36 (12) pp2756-2763. McNICOLL- WHITEMAN, R et al., 2008. Dysphagia screening tools: A review June 2008. The dysphagia screening tool working group. Heart and stroke foundation: Ontario. MORRIS, H., 2008. Dysphagia: Implications of stroke on swallowing. Nurse and residential care. 10 (8) pp 378-381. NAZARKO, L. 2010. Recognising and managing dysphagia. 12 (3) pp133-137. NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE. 2008. Stroke: Diagnosis and initial management of acute stroke and transient ischaemic attack (TIA). Nice guideline 68. London. O’NEILL, PA., 2000. Swallowing and prevention of complications. British medical bulletin. 56 (2) pp 457-465. PERRY, L., 2001 PERRY, L., 2001. Screening swallowing function of patients with acute stroke. Part two: detailed evaluation of the tool used by nurses. Journal of clinical nursing. 10 (4) pp 474-481. PERRY, L and LOVE, CP., 2001. Screening for dysphagia and aspiration in acute stroke: a systematic review. Dysphagia. 16 (1) pp 7-18. ROWAT, A et al., 2011 ROWAT, A et al., 2011. Apilot study to access if urine specific gravity and urine colour charts are useful indicators of dehydration in stroke patients. Journal of advanced nursing. 67 (9) pp 1976-1983. ROWAT, A et al., 2012. Dehydration in hospital-admitted stroke patients. Detection, Frequency and Association. http://stroke.ahajournals.org/content/43/3/857 accessed 28/05/12. SCALES SCARBOROUGH, P et al., 2009. Stroke Statistics. British Heart Foundation Statistics Database. http://www.heartstats.org accessed 31/05/12. SLESAK,G et al., 2003. Comparison of subcutaneous and intravenous rehydration in geriatric patients: A randomised trial. Journal of the American geriatrics society. 51 (2) pp 155-160. SCHROCK, JW et al ., 2012 WESTERGREN, A., 2006. Detection of eating difficulties after stroke: a systematic review. International nursing review. 53 pp 143-149.

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