IN FOCUS: Explore the future of profession - 2022
Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/25599
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Item Translation and adaptation of a dysarthria assessment tool to be used in the Sri Lankan clinical context(University of Kelaniya, Sri Lanka, 2022) Perera, W.M.K.; Rathnayake, S.P.Background: Dysarthria is one of the commonest communication disorders that arise due to neuromuscular damage. Diagnosing dysarthria requires careful assessments. In the absence of a formal dysarthria assessment tool in the Sri Lankan (SL) clinical context, the translated and adapted Sinhala Language Newcastle Dysarthria Assessment Tool (SLN-DAT) was validated using a normative sample. Methods: This research study was conducted in three phases related to 3 objectives using a mixed methodology: (I) Identification of the relevant tool amongst FDA, DP and N-DAT to be adapted and translated to the SL context using views of 20 Speech and Language Therapists (SLTs) and 20 undergraduate final year students; (II) Initial translation and adaptation of assessment tool into Sinhala language based on WHO tool translation guidelines; (III) Face, content and concurrent validity of the tool using 10 subject experts and 50 normative samples of five age ranges (20-40,40–60,60–70,70–80 and 80+). Internal consistency and intra-rater agreement for the tool tasks were analysed by the subject specialists and concurrent validity were assessed comparing the scores of Dysarthria Profile (DP) and SLN-DAT tool. Data was analyzed using SPSS (Statistical Package for Social Sciences) statistical software and the thematic analysis was used for the qualitative part of the study. Results: N-DAT was selected as the most voted (SLTs=58% & students=55%), and relevant dysarthria assessment tool to be translated and adapted to the SL context. At the end of phase II, the assessment tool contained all related sections of the original N-DAT in Sinhala, which was adapted to suite to SL context. Overall, the SLN-DAT has the same conceptual meaning, semantics, idiomatic and score equivalences as the original version, yet SLT-DAT had one additional section related to ICF model. Statistical analysis showed higher agreement among graders (missing data 0%), including high internal consistency for tool items (Cronbach’s α = 0.8) including the new sections. Performance of the normative sample exhibited a predicted variation among age and tool performance with negative correlation for articulation r = -.32 (p<0.05), respiration r = -.70 (p<0.01), phonation voice r = -.33 (p<0.05), phonation pitch r = -.40 (p<0.01) and DDK rates r = -.33 (p<0.01). The concurrent validity of the SLN-DAT was very high for all subsystems. Each subsystem had higher ICC values ranging between r = 1.0 – 0.7 (p<0.01). Conclusion: The translated, adapted and validated formal dysarthria assessment tool; Sinhala Language Newcastle Dysarthria Assessment Tool (SLN-DAT) had higher face validity, higher internal consistently with items and satisfactory concurrent validity. Therefore, the SLN-DAT could be recommended to the SL context after it was validated among the dysarthria population, which will enable to identify dysarthria reliability in the Sri Lankan clinical context.Item Communicative effectiveness and speech intelligibility among ageing adult population in the Kandy District(University of Kelaniya, Sri Lanka, 2022) Madapathage, M.T.; Rathnayake, S.P.Background: With typical ageing, specific communication skills change due to the physical changes and cognitive changes, which is one of the most common problems among ageing adults. The communicative changes consist of speech, hearing, language, and voice difficulties that directly influence the effects of functional communication. The result of the present study will help identify how communication and speech skills change and can be used as norms to differentiate age-related vs disease-related defects in assessment and intervention. Objectives: The aim of this study is to describe the communicative effectiveness and speech intelligibility among Sinhala speakers of ageing adult individuals 60 years or above in age in the Sri Lankan (SL) context. Methods: The research study was based on quantitative methods with a descriptive cross-sectional study design via a web-based platform. The study population was 78 ageing adults representing each age category of 60-69, 70-79, and 80≥ years and recruited using the purposive sampling method. Data collection was done based on an interviewer-administered questionnaire with rating scales and self-administered questionnaires. Data analysis was done based on the frequency distribution of study sample and other relevant statistical analysis was using the SPSS free version. Results: There were less communication and speech intelligibility difficulties shown at the age of 60-69 years compared to other age groups. However, at the age of 70-79 years and 80≥ years, there were more declines in the communication and speech intelligibility difficulties. At the age of 60-69 years, 70-79 years, and 80≥ years, the self-reported questionnaire communicative difficulties were highest when compared to clinician reported questionnaire results. In the speech intelligibility, self-reported difficulties were highest when compared to clinician reported difficulties at the age of 60-69 years and 70-79 years, but at the age of 80≥ years, clinician reported speech intelligibility difficulties were more when compared to the self-reported questionnaire results.Conclusion: This present study examined the communicative effectiveness and speech intelligibility among all three age groups (60-69 years, 70-79 years, and 80≥years). There was communicative and speech intelligibility decline observed with ageing. These norms could be used in language assessments to increase the validity of the diagnosis. The present study could become a foundation for future research on ageing and communication in the SL context.Item Effectiveness of an educational workshop for improving ICU nurses` knowledge on managing dysphagia in patients with tracheostomy at government hospitals in Sri Lanka(University of Kelaniya, Sri Lanka, 2022) Karunarathna, W.K.L.; Perera, K.D.R.D.; Rathnayake, S.P.Background: Adult patients with tracheostomy are a medically complex population. Tracheostomy insertion is a common procedure seen in Intensive Care Unit (ICU} settings to manage many critical patients by means of an artificial airway. But the tracheostomy indication is associated with several complications. Therefore, dysphagia is one of the main complications that tracheostomy leads to, where 11% to 93% of patients following tracheostomy have been identified with dysphagia in various studies. The management of dysphagia is a multidisciplinary team approach, and the nurses are one of the health professionals in this team. Therefore, the nurses` knowledge of the management process of dysphagia is important to improve the Quality of Life (QoL) of patients with tracheostomy. Objective/s: The objectives of this study were to describe nurses` knowledge regarding dysphagia management in patients with tracheostomy before and after conducting an educational workshop and to describe the nurses’ perspectives on the effectiveness of the educational workshop. Methods: The pre-post interventional study design compared nurses' knowledge differences after attending an educational workshop on dysphagia management in tracheostomy patients. There were sixty participants (n = 60) included, and they were selected by purposive sampling and the snowballing technique. The data was gathered through an online survey. The educational workshop was planned based on the outcomes of the needs assessment and the nurses` knowledge assessed by providing pre and post-test questionnaires. Paired-sample t-tests were used to identify whether there is a significant improvement in the nurses` knowledge after the educational workshop. Results: The findings showed that the designed online workshop significantly improved nurses’ knowledge of managing dysphagia in tracheostomy patients t (59) =-25.755, p =.000. Further, the perceived effectiveness of the workshop, as reported by nurses, indicated that the workshop is highly effective and helpful in improving their knowledge regarding dysphagia management in patients with tracheostomy. Conclusion/s: The results of the present study showed that the nurses had moderate knowledge regarding dysphagia management in patients with tracheostomy before conducting the educational workshop. However, after conducting the educational workshop, the mean scores of nurses increased to the high knowledge level. Therefore, the study concludes that the educational workshop undertaken is an effective method to improve nurses' knowledge on the management of dysphagia in patients with tracheostomy.