lugar impacto y tipo Differences in the quality of life of patients with oropharyngeal dysphagia according to the place of residence: impact on food selection and type of diet

Background: dysphagia is a disabling, uncomfortable symptom with repercussions on daily basic aspects of well-being. The SWAL-QoL test is validated for checking dysphagia's impact on quality of life (QoL). Methods: a descriptive cross-sectional study. Randomized patients from our in-house Nutrition & Dietetics database. Telephone interviews directly with patients or caregivers. SWAL-QoL test, 11 sections: swallowing, eating, symptoms, food selection, communication, fears, mental health, fatigue, and social function. A 1-5 Likert scale was adjusted and final results were linearly transferred to 0-100 (100 being best positive score). Results as follows: 0-49 severe impact (SI), 50-70 moderate impact (MI), and 71-100 mild impact or no impact (DI/NI). Variables: gender, age, days with treatment, residence: Home (H)/nursing home (NH), indication of commercial thickener (CT) by V/V test: nectar (N), honey (H), pudding (P), days with CT, type of diets; pureed (PD), soft diet (SD), mixed(P&S/D), regular (RD), SWAL-QoL sections. Results: a total of 202 patients with a mean age of 85 years (23-103); IQR: 12. Mostly women, 57.9 %. Dwelling: 43.1 % H/56.9 % NH. SWAL-QoL: SI affects 19.3 %, 59.9 % MI and 20.8 % DI/NI. Using less thickener proved a better QoL; SI in pudding 21.1 % vs nectar 15.3 %, p = 0.04. Diets included 66.3 % PD; 3 % SD; MD, 21.3 %, and RD, 9.4 %. At NH 86.1 % of PD vs 40.2 % at H, p < 0.001. Direct impact of diet on QoL: 30.8 % on DI or no impact of grouped diets vs 15.7 % with PD, p = 0.016. Analysing each section by H/NH, significant difference between fears, higher at H, 57.01 +/- 36.41 vs NH, 48.70 +/- 27.03, p < 0.001; worse mental health for NH, 66.44 +/- 34.30 vs H, 47.48 +/- 24.06, p < 0.001; better food selection for H, 75.86 +/- 34.12 vs NH, 68.17 +/- 33.60, p < 0.01. Conclusions: defining QoL contributes to a better understanding of patient needs. More information to confront their fears is helpful to adjust the texture of liquids properly. Increasing adaptations of diets and diversity in food selection are needed especially in those living in NH.