Knowledge, attitudes and practices about swallowing disorders in hemiplegic patients among nurses of Bobo-Dioulasso urban primary health care centers in Burkina Faso

Introduction. - Swallowing disorders are common in primary care patients, and quality of care from admission strongly influences the nutritional status of patients and overall prognosis. Neurological diseases are the main causes of swallowing disorders, which affect one third of patients with hemiplegia. In Burkina Faso (BF), nurses of primary health care centers (PHCC) are usually the first to assess and manage these patients, but there are no data related to their swallowing disorders management. This purpose aimed to assess knowledge, attitudes and practices about swallowing disorders in hemiplegic patients, among nurses of PHCC in Bobo-Dioulasso, where tertiary health centre receives the highest number of hemiplegic patients in BF. Methods. - A cross-sectional survey, performed among nurses of Bobo-Dioulasso urban PHCC from 2014 August 1st to September 15th, administrated a standardized questionnaire to screen their knowledge, attitudes and practices about swallowing disorders in hemiplegic patient. Results. - Of 125 surveyed nurses (83.3% of the targeted workers), 82.4% had prior received a hemiplegic patient. The role of brain in occurrence of hemiplegia and swallowing disorders was known by 56.8% of nurses, 42.3% knew that swallowing disorders can cause aspiration, 36.0% knew a rescue technique in case of aspiration. They correctly assessed impact of swallowing disorders on nutritional status in 39.2% of cases. On this matter, their knowledge was better when they were more recently out of training school. Respectively 65.6 and 1.6% of nurses knew the postural conditions benefit, and influence of food features on ability to swallow. Among the 103 nurses who have prior received a hemiplegic, 68.0% believed being able to detect a swallowing disorder by clinical interview, and 30.1% did not give patient advice. In multivariate analysis, detecting swallowing disorder was associated with a good knowledge of the value of voice troubles (OR=3.5; IC95 = 1.4-8.1; P=0.005). Conclusion. - Few nurses were warned of connection between swallowing disordeits and hemiplegia, classic issues and complications related to swallowing disorders. They had variable practices, mostly lion in conformity with the good strategies for swallowing disorders screening and management. In order to improve hemiplegic patients care, neurological and nutritional training should be accompanied by specific training on swallowing disorders, emphasizing on screening and simple management. (C) 2015 Elsevier Masson SAS. All rights reserved.