Efficacy of a Low-cost Multidisciplinary Team-led Experiential Workshop for Public Health Midwives on Dysphagia Management for Children with Cerebral Palsy

Shyamani Hettiarachchi; Gopi Kitnasamy; Raj Mahendran; Fathima Shamra Nizar; Chamara Bandara; Paramaguru Gowritharan

doi:10.5463/dcid.v29i3.764

Shyamani Hettiarachchi ⁽¹⁾, Gopi Kitnasamy ⁽²⁾, Raj Mahendran ⁽³⁾, Fathima Shamra Nizar ⁽⁴⁾, Chamara Bandara ⁽⁵⁾, Paramaguru Gowritharan ⁽⁶⁾

(1) Department of Disability Studies, Faculty of Medicine, University of Kelaniya, LK; School of Social Work and Social Policy, Trinity College Dublin, The University of Dublin, Ireland,

(2) Cerebral Palsy Lanka Foundation, Sri Lanka,

(3) Cerebral Palsy Lanka Foundation, Sri Lanka,

(4) Cerebral Palsy Lanka Foundation, Sri Lanka,

(5) Cerebral Palsy Lanka Foundation, Sri Lanka,

(6) District General Hospital, Mannar, Sri Lanka

https://doi.org/10.5463/dcid.v29i3.764

Issue
Vol. 29 No. 3 (2018): Autumn 2018

Submitted
September 14, 2020

Published
February 23, 2019

Keywords:

Cerebral palsy, dysphagia, midwives, training

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Abstract

Purpose: Over the past decade there has been a growing focus on offering appropriate training to healthcare professionals and caregivers to support safe feeding practices for children with cerebral palsy. Early and consistent multidisciplinary intervention is required to minimise the risks of aspiration pneumonia. The high incidence of complications from aspiration pneumonia among children with cerebral palsy in Sri Lanka has made it necessary to conduct low-cost multidisciplinary team-led dysphagia awareness workshops for healthcare professionals and caregivers.

Method: A group of 38 Public Health Midwives (PHMs) was offered an experiential workshop by a small multidisciplinary team (MDT). To determine changes in knowledge, a self-administered questionnaire that included a video-based client scenario was administered pre- and post-workshop. The data were analysed statistically using non-parametric within-participant t-tests.

Results: The post-workshop responses to the questionnaire indicated a significant increase in the level of knowledge. This included positive changes in the understanding and knowledge of cerebral palsy (t (37) =-7.44, p=.000), effects of cerebral palsy on eating and drinking skills (t (37) =-3.91, p=.000), positioning (t (37) = -9.85, p=.000), aspiration (t (37) =-3.46, p=.001), food categorisation (t (37), -3.85, p=.000) and client video observation (t (37)-3.91, p=.000) at a p=.05 level of significance. While there was also an increase in the knowledge on general guidelines during mealtimes, this did not reach statistical significance.

Conclusion: The low-cost MDT-led experiential workshop was effective in increasing knowledge of feeding and dysphagia-related issues in cerebral palsy among a group of PHMs. This workshop could serve as a model for training PHMs and Community-Health Workers across the country in order to reach the Sustainable Development Goal of ‘good health and well-being’ for children with cerebral palsy and all children experiencing feeding difficulties. Follow-up workshops and continued professional development courses for midwives on dysphagia care are strongly recommended, in addition to collaborative clinical practice.

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Authors

Shyamani Hettiarachchi

Department of Disability Studies, Faculty of Medicine, University of Kelaniya, LK; School of Social Work and Social Policy, Trinity College Dublin, The University of Dublin

shyamani@kln.ac.lk (Primary Contact)

Gopi Kitnasamy

Cerebral Palsy Lanka Foundation

Raj Mahendran

Cerebral Palsy Lanka Foundation

Fathima Shamra Nizar

Cerebral Palsy Lanka Foundation

Chamara Bandara

Cerebral Palsy Lanka Foundation

Paramaguru Gowritharan

District General Hospital, Mannar

Author Biographies

Shyamani Hettiarachchi, Department of Disability Studies, Faculty of Medicine, University of Kelaniya, LK; School of Social Work and Social Policy, Trinity College Dublin, The University of Dublin

Shyamani Hettiarachchi is a Speech & Language Therapist, and Senior Lecturer at the Department of Disability Studies at the Faculty of Medicine, University of Kelaniya, Sri Lanka. She graduated from the University of Kelaniya and completed her postgraduate studies at University College London, Oxford University and City University and trained as a Dramatherapist at the University of Roehampton. She is currently a Visiting Research Fellow at the School of Social Work and Social Policy, Trinity College Dublin, The University of Dublin. Her special research interests include phonological disorders, dysphagia, and the intersectionality between culture, gender and disability.

Gopi Kitnasamy, Cerebral Palsy Lanka Foundation

Gopi is a Bobath-trained Physiotherapist. He is the Founder/Director of Cerebral Palsy Lanka Foundation. His research interests include dysphagia and quality of life.

Raj Mahendran, Cerebral Palsy Lanka Foundation

Raj is a Bobath-trained physiotherapist. He is a member of Cerebral Palsy Lanka Foundation and works at the National Centre for Children with Cerebral Palsy and Other Developmental Disorders. His research interests include collaborative research and clinical work.

Fathima Shamra Nizar, Cerebral Palsy Lanka Foundation

Shamra is a speech and language therapist. She works in communication and dysphagia.

Chamara Bandara, Cerebral Palsy Lanka Foundation

Chamara is a speech and language therapist. His clinical work includes communication therapy and dysphagia in children.

Paramaguru Gowritharan, District General Hospital, Mannar

Gowritharan is a speech and language therapist. He works in the Northern Province of Sri Lanka and is interested in research on inclusive education, quality of life and dysphagia.

1.

Hettiarachchi S, Kitnasamy G, Mahendran R, Nizar FS, Bandara C, Gowritharan P. Efficacy of a Low-cost Multidisciplinary Team-led Experiential Workshop for Public Health Midwives on Dysphagia Management for Children with Cerebral Palsy. DCIDJ [Internet]. 2019 Feb. 23 [cited 2024 Dec. 22];29(3):67-92. Available from: https://dcidj.uog.edu.et/index.php/up-j-dcbrid/article/view/305

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