Browsing by Author "Giray, E"

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    Pediatric dysphagia overview: best practice recommendation study by multidisciplinary experts
    Umay, E; Eyigor, S; Giray, E; Saygi, EK; Karadag, B; Kocaaslan, ND; Yuksel, D; Demir, AM; Tutar, E; Tikiz, C; Gurcay, E; Unlu, Z; Celik, P; Akyuz, EU; Mengu, G; Bengisu, S; Alicura, S; Unver, N; Yekteusaklari, N; Uz, C; Uytun, MC; Bagcier, F; Tarihci, E; Akaltun, MS; Sucakli, IA; Cankurtaran, D; Aykin, Z; Aydin, R; Nazli, F
    Background Currently, there is no comprehensive and multidisciplinary recommendation study covering all aspects of pediatric dysphagia (PD). This study aimed to generate PD management recommendations with methods that can be used in clinical practice to fill this gap in our country and in the world, from the perspective of experienced multidisciplinary experts. Methods This recommendation paper was generated by a multidisciplinary team, using the seven-step process and a three-round modified Delphi survey via e-mail. First, ten open-ended questions were created, and then detailed recommendations including management, diagnosis, treatment, and follow-up were created with the answers from these questions. Each recommendation item was voted on by the experts as overall consensus (strong recommendation), approaching consensus (weak recommendation) and divergent consensus (not recommended). Results In the 1st Delphi round, a questionnaire of 414 items was prepared based on the experts' responses to ten open-ended questions. In the 2nd Delphi round, 59.2% of these items were accepted as pre-recommendation. In the 3rd Delphi round, 62.6% of 246 items were accepted for inclusion in the proposals. The final version recommendations consisted of 154 items. Conclusions This study includes comprehensive and detailed answers for every problem that could be posed in clinical practice for the management of PD, and recommendations are for all pediatric patients with both oropharyngeal and esophageal dysphagia.
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    The caregiver burden of informal caregivers for stroke patients with and without dysphagia: A multi-center, cross-sectional study in Turkiye
    Giray, E; Eyigör, S; Çalik, Y; Gezer, IA; Sari, A; Umay, E; Akaltun, MS; Tikiz, C; Ünlü, Z; Vural, M; Aydeniz, B; Karahan, AY
    Objectives: The aim of this study was to investigate the caregiver burden (CB) of informal caregivers for stroke survivors with and without dysphagia and to assess the relationship between the CB levels of informal caregivers for stroke survivors with dysphagia, patients' swallowing-related quality of life (QoL), and patients' stroke-specific QoL. Patients and methods: This multi- center, prospective, cross-sectional study included a total of 120 stroke patients (76 males, 44 females; mean age: 61.1 +/- 12.3 years; range, 19 to 86 years) between October 2019 and 2020. Of the patients, 57 had dysphagia and 63 had no dysphagia. The Functional Oral Intake Scale (FOIS) was used to classify the degree of functional dietary limitation caused by each patient's swallowing impairment. Patients and caregivers completed the Eating Assessment Tool (EAT-10), Swallowing Quality of Life (SWQoL) questionnaire, Stroke Impact Scale (SIS), and the Zarit Caregiver Burden Interview (ZBI). Results: The CB levels were higher in those caring for stroke patients with dysphagia than in those caring for stroke patients without dysphagia. Caregiver burden was found to be associated with patients' swallowing-related QoL and stroke-related QoL. Significant predictors of high CB scores (F=2.55, R2=0.59; p= 0.007) were being an employed caregiver (B=17.48, p= 0.003), being a caregiver with high school (B=-19.6, p=0.03), and secondary school (B=-16.28, p=0.02) educational status, being son, daughter (B=30.63, p=0.007) or other relative of the patient (B=20.06, p=0.01), lower FOIS stage (B=-3.14, p=0.011), lower SWQoL (B=0.52, p=0.009) and lower SIS (B=- 0.37, p=0.04) scores. Conclusion: Caregivers of stroke patients with dysphagia suffer from a higher CB than those without dysphagia. In stroke patients with dysphagia, swallowing-related QoL is associated with the QoL levels of stroke patients and the CB levels of their caregivers. Employment status, educational status of caregiver, caregiver's relativity to the patient, FOIS stage, swallowing and stroke related QoL of the patients are factors related to burden levels of caregivers of stroke patients with dysphagia. These results may help health professionals to understand dysphagia as an essential source of CB and consider it, while planning treatments.
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    Best Practice Recommendations for Dysphagia Management in Intensive Care Unit (ICU): A Delphi Study from Multidisciplinary Experts in Turkey
    Umay, E; Eyigor, S; Demirag, K; Karatas, GK; Gundogdu, I; Giray, E; Ates, MP; Kocer, BG; Gurcay, E; Unlu, Z; Bengisu, S; Karaahmet, F; Bagcier, F; Vural, M; Aydeniz, B; Kullukcu, H; Oztekin, F; Alicura, S; Uz, C; Barmak, E; Uzunkulaoglu, A; Adiguzel, E
    There is no study about all aspects of oropharyngoesophageal (OPE) dysphagia from diagnosis to follow-up in a multidisciplinary manner in the world. In order to close this gap, we aimed to create a recommendation study that can be used in clinical practice, addressing all aspects of dysphagia in the ICU in detail with the opinion of experienced multidisciplinary experts. This recommendation paper was generated by a multidisciplinary team, using the seven-step process and a three-modified Delphi round via e-mail. Firstly, 15 open-ended questions were created, and then detailed recommendations including general principles, management, diagnosis, rehabilitation, and follow-up were created with the answers from these questions, Each recommendation item was voted on by the experts as overall consensus (strong recommendation), approaching consensus (weak recommendation), and divergent consensus (not recommended).In the first Delphi round, a questionnaire consisting of 413 items evaluated with a scale of 0-10 was prepared from the opinions and suggestions given to 15 open-ended questions. In the second Delphi round, 55.4% were accepted and revised suggestions were created. At the end of the third Delphi round, the revised suggestion form was approved again and the final proposals containing 133 items were created. This study includes comprehensive and detailed recommendations, including a broad perspective from diagnosis to treatment and follow-up, as detailed as possible, for management of dysphagia in patients with both oropharyngeal- and esophageal-dysphagia in ICU.
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    Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part I: Management, Diagnosis, and Follow-up
    Umay, E; Eyigor, S; Ertekin, C; Unlu, Z; Selcuk, B; Bahat, G; Karahan, AY; Secil, Y; Gurcay, E; Kiylioglu, N; Keles, BY; Giray, E; Tikiz, C; Gezer, IA; Yaliman, A; Sen, EI; Vural, M; Saylam, G; Akaltun, MS; Sari, A; Alicura, S; Karaahmet, F; Inanir, M; Demirhan, A; Aydeniz, B; Bilgilisoy, M; Yuksel, A; Ozcete, ZA; Calik, Y; Alemdaroglu, E; Keskin, D; Sahin, S; Oztekin, MF; Sezgin, B; Karaahmet, O; Bengisu, S; Gokler, TY; Mercimekci, S
    Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome after acute stroke and may become chronic after the acute period and continues to affect all aspects of the patient's life. Patients with stroke may encounter any of the medical branches in the emergency room or outpatient clinic, and as in our country, there may not be specialists specific for dysphagia, such as speech-language pathologists (SLP), in every hospital. This study aimed to raise awareness and create a common opinion of medical specialists for stroke patients with dysphagia. This recommendation paper has been written by a multidisciplinary team and offers 45 recommendations for stroke patients with dysphagia. It was created using the eight-step Delphi round via e-mail. This study is mostly specific to Turkey. However, since it contains detailed recommendations from the perspective of various disciplines associated with stroke, this consensus-based recommendation paper is not only a useful guide to address clinical questions in practice for the clinical management of dysphagia in terms of management, diagnosis, and follow-up, but also includes detailed comments for these topics.
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    Best Practice Recommendations for Geriatric Dysphagia Management with 5 Ws and 1H
    Umay, E; Eyigor, S; Bahat, G; Halil, M; Giray, E; Unsal, P; Unlu, Z; Tikiz, C; Vural, M; Cincin, AT; Bengisu, S; Gurcay, E; Keseroglu, K; Aydeniz, B; Karaca, EC; Karaca, B; Yalcin, A; Ozsurekci, C; Seyidoglu, D; Yilmaz, O; Alicura, S; Tokgoz, S; Selcuk, B; Sen, EI; Karahan, AY; Yaliman, A; Ozkok, S; Ilhan, B; Oytun, MG; Ozturk, ZA; Akin, S; Yavuz, B; Akaltun, MS; Sari, A; Inanir, M; Bilgilisoy, M; Çaliskan, Z; Saylam, G; Ozer, T; Eren, Y; Bicakli, DH; Keskin, D; Ulger, Z; Demirhan, A; Calik, Y; Saka, B; Yigman, ZA; Ozturk, EA
    Background: Dysphagia is a geriatric syndrome. Changes in the whole body that occur with aging also affect swallowing functions and cause presbyphagia. This condition may progress to oropharyngeal and/or esophageal dysphagia in the presence of secondary causes that increase in incidence with aging. However, no study has been published that provides recommendations for use in clinical practice that addresses in detail all aspects of the management of dysphagia in geriatric individuals. This study aimed to answer almost all potential questions and problems in the management of geriatric dysphagia in clinical practice. Methods: A multidisciplinary team created this recommendation guide using the seven-step and three-round modified Delphi method via e-mail. The study included 39 experts from 29 centers in 14 cities. Results: Based on the 5W and 1H method, we developed 216 detailed recommendations for older adults from the perspective of different disciplines dealing with older people. Conclusion: This consensus-based recommendation is a useful guide to address practical clinical questions in the diagnosis, rehabilitation, and follow-up for the management of geriatric dysphagia and also contains detailed commentary on these issues.
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    Best Practice Recommendations for Stroke Patients with Dysphagia: A Delphi-Based Consensus Study of Experts in Turkey-Part II: Rehabilitation
    Umay, E; Eyigor, S; Ertekin, C; Unlu, Z; Selcuk, B; Bahat, G; Karahan, AY; Secil, Y; Gurcay, E; Kiylioglu, N; Keles, BY; Giray, E; Tikiz, C; Gezer, IA; Yaliman, A; Sen, EI; Vural, M; Saylam, G; Akaltun, MS; Sari, A; Alicura, S; Karaahmet, F; Inanir, M; Demirhan, A; Aydeniz, B; Bilgilisoy, M; Yuksel, A; Ozcete, ZA; Calik, Y; Alemdaroglu, E; Keskin, D; Sahin, S; Oztekin, MF; Sezgin, B; Karaahmet, O
    Dysphagia is one of the most common and important complications of stroke. It is an independent marker of poor outcome following acute stroke and it continues to be effective for many years. This consensus-based guideline is not only a good address to clinical questions in practice for the clinical management of dysphagia including management, diagnosis, follow-up, and rehabilitation methods, but also includes detailed algorithms for these topics. The recommendation paper has been written by a multidisciplinary team and offers 117 recommendations for stroke patients with dysphagia. While focusing on management principles, diagnosis, and follow-up in the 1st part (45 items), rehabilitation details were evaluated in the 2nd part (72 items).