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  • Uloga logopeda u neurogenoj...
    Pilepić, Lara; Roje Bedeković, Marina

    Logopedija, 09/2021, Letnik: 11, Številka: 1
    Journal Article, Paper

    Neurogene orofaringealne disfagije su vrlo čest simptom i posljedica akutnih i kroničnih neuroloških bolesti, posebice cerebrovaskularnih, ekstrapiramidnih i demijelinizacijskih bolesti. Poremećaj gutanja uzrokuje niz sekundarnih komplikacija - malnutriciju, dehidraciju i aspiracijsku pneumoniju - ali i one suptilnije, često nedovoljno osviještene, psihološke i socijalne posljedice koje dugoročno utječu na kvalitetu života bolesnika. Prepoznavanje i liječenje bolesnika s poremećajem gutanja nerijetko je izazov, zato se cjelokupan postupak odvija u okviru multidisciplinarnog tima. Klinički logoped je sastavni dio multidisciplinarnog tima koji dijagnosticira i liječi poremećaje gutanja, svojim znanjem i kompetencijama utječe na povoljan rezultat liječenja. Logoped, kao član multidisciplinarnog tima, prilagođava konzistenciju hrane koju će uzimati bolesnik s neurogenom disfagijom i omogućuje sigurno hranjenje terapijskim postupcima. Logoped inicijalno provodi testove procjene gutanja, kojima prepoznaje bolesnike s rizičnim čimbenicima za aspiraciju. Ako je kod bolesnika uočen nesiguran obrazac gutanja, provodi se detaljna logopedska dijagnostika kojom se utvrđuje dalji način prehrane, kako bi se bolesniku omogućilo sigurno gutanje. Logoped odabire jednu ili više rehabilitacijskih tehnika koje će primijeniti, ovisno o bolesnikovu općem zdravstvenom stanju, suradljivosti i mogućnosti korištenja naučenim tehnikama nakon otpusta iz bolnice. Ovaj rad daje uvid u načine na koje se logoped brine o bolesnicima s poremećajem gutanja – od primitka do otpusta iz bolnice – i naglašava važnost logopeda u multidisciplinarnom timu, koji se bavi neurogenom disfagijom. Neurogenic oropharyngeal dysphagia is a common symptom and the repercussion of acute and chronic neurological diseases especialy cerebrovascular, extrapyramidal and demyelinating diseases. Swallowing difficulties cause all kinds of secundary complications such as malnutrition, dehydration and pneumonia caused by aspiration. They also affect patient's overall quality of life disturbing its psychological and social well-being. Screening for patients with swallowing difficulties is often a challenge and therefore diagnostics demands working in a multidisciplinary team. Clinical Speech and Language Pathologist (SLP) should be a part of a multidisciplinary team that diagnoses and treats patients with dysphagia. By doing that, SLPs help provide positive treatment outcomes with their specific knowledge and competencies. As members of a multidisciplinary team, SLPs adjust food consistency that patients with neurogenic dysphagia consume and enable safe feeding with therapeutic methods. The role of SLPs is to provide that kind of nutrition. Initialy, SLPs do a brief swallowing screening that singles out patients with risk factors for aspiration. If an unsafe swallowing pattern is recognised, SLPs perform overall diagnostics to determine the way of future food and liquid intake to ensure safe swallowing. Moreover, SLPs choose one or more rehabilitation techniques to use with patients according to their health condition, cooperation and ability to use the technique outside of the hospital. This paper provides a review of ways that Speech and Language Pathologists care for patients with swallowing difficulties from the admission to the hospital till their discharge. Also, it emphasises the importance of SLPs in a multidisciplinary team that deals with patients with neurogenic dysphagia.