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.