Determinants of Noncompliance of Speech-Language Pathology Recommendations Among Patients and Caregivers Lack of compliance with speech-language pathology (SLP) recommendations is a complex problem involving nursing staff, non-health care provider (NHP) caregivers, and patients, each having their own reasons for noncompliance. In some cases, SLP recommendations are met with open hostility (Colodny, 2005). Noncompliance with SLP recommendations is a serious and continuing ... Article
Article  |   October 01, 2007
Determinants of Noncompliance of Speech-Language Pathology Recommendations Among Patients and Caregivers
Author Affiliations & Notes
  • Nancy Colodny
    St. John's University, Queens, NY
  • Correspondence: Email(colodnyn@stjohns.edu).
  • Nancy Colodny is an associate professor in the Department of Speech, Communication Sciences and Theatre at St. John’s University in Queens, New York
    Nancy Colodny is an associate professor in the Department of Speech, Communication Sciences and Theatre at St. John’s University in Queens, New York×
Article Information
Speech, Voice & Prosodic Disorders / Swallowing, Dysphagia & Feeding Disorders / Articles
Article   |   October 01, 2007
Determinants of Noncompliance of Speech-Language Pathology Recommendations Among Patients and Caregivers
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), October 2007, Vol. 16, 20-24. doi:10.1044/sasd16.3.20
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), October 2007, Vol. 16, 20-24. doi:10.1044/sasd16.3.20
Lack of compliance with speech-language pathology (SLP) recommendations is a complex problem involving nursing staff, non-health care provider (NHP) caregivers, and patients, each having their own reasons for noncompliance. In some cases, SLP recommendations are met with open hostility (Colodny, 2005). Noncompliance with SLP recommendations is a serious and continuing problem within the profession.
Colodny (2001)  identified three major reasons for nursing staff non-compliance in a skilled nursing facility setting: food preparation and feeding recommendations were perceived as bothersome by the staff, the staff lacked knowledge of appropriate procedures, and the nursing staff disagreed with the recommendations of the SLP. Registered nurses (RNs) tended to follow SLP recommendations less frequently than licensed practical nurses (LPNs) or certified nursing assistants (CNAs). The RNs reported that they regarded feeding patients with dysphagia as demeaning because they thought it should be conducted by health care staff with less training and education. Therefore, although they did not disagree with the SLP recommendations any more than other nursing staffers, they tended to regard feeding patients with recommended compensatory strategies as more onerous and time-consuming than other nursing staffers. They also indicated that they had less knowledge of feeding techniques than LPNs and CNAs. Lack of knowledge may be used as an excuse to avoid feeding patients with dysphagia, so that they can do other required tasks, such as giving patients their medications, which, in the case of patients with dysphagia, can take a considerable amount of time.
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