Discussion
The results showed a positive impact of the booklet utilization in the
patient’s knowledge about their disease. In previous studies, patients
more informed about their diseases showed higher ability to comply with
clinical manifestations and more efficient in avoiding
difficulties23,24. Patients using the booklet report
to have more information on preparing meals and seat at the table
safely. Moreover, they are supplied with information they can consult as
many times as needed, and we may anticipate that they will be more
prepared to prevent and deal with clinical complications after
discharge,
These patients could additionally be readier to follow the
recommendations given by the professionals to ensure efficacy and safety
in swallowing24. They declare to rely on the
professional’s ability to reassure them when needed.
Studies have shown that patients with more knowledge adhere more
frequently to therapy and patient adherence to treatment recommendations
is an important issue for healthcare providers. Neurological dysphagia
requires complex and specific interventions, with altered daily patterns
of behaviour3,4,24, which may be difficult to follow
and undermine patient’s compliance. Patients and their caregivers have
reported feelings of concern, fear, and anxiety in dealing with
dysphagia25. These feelings can be explained by
demanding tasks related with diet management, including changes in food
consistency, body positioning and the use of specialized equipment. Lack
of information and follow-up may provoke feelings of incompetence and
over-responsibility to both patients and those who support them at
home25.
The role of communication between patients and health professionals in
clinical outcomes and satisfaction with care has been confirmed in the
literature26,27. Patients submitted to the routine
procedures presented decreased satisfaction at the second evaluation.
This may be related with the difficulties in delivering information,
without written support, when professionals are professionally
overloaded or unprepared. On the other hand, patient’s anxiety may
interfere with their ability to recall and understand information
adequately delivered27.
This study has several limitations. A limitation is the small number of
patients included, although they presented similar type and severity of
dysphagia. Also, the short follow up period thus not permit to infer the
impact of the intervention after discharge. A re-evaluation in ongoing,
associated with the monitoring of hospital admissions and complications
of the patients surveyed.
The use of written information in hospitalized patients has shown to be
a resource that allows to improve the subjective sensation of happiness
in patients with neurological dysphagia, a debilitating and distressing
disorder.