The use of effortful swallowing to deal nutritional problem in patient with ischaemic stroke who also experiencing dysphagia

Abstract

Stroke is a leading cause of disability and death, with dysphagia being one of its most frequent complications. Dysphagia can result in decreased nutritional intake and an increased risk of aspiration. Nursing interventions such as Effortful Swallowing can help improve swallowing ability in stroke patients. This case study evaluates the effectiveness of Effortful Swallowing therapy in improving swallowing ability and nutritional status in non-hemorrhagic stroke patients with dysphagia. The case study was conducted on Mrs. I, a 50-year-old woman diagnosed with non-hemorrhagic stroke and dysphagia. The assessment included neurological condition, swallowing ability, and nutritional status. Nursing interventions were carried out over three days and included nutritional management, aspiration prevention, family education, and Effortful Swallowing therapy administered twice daily. Evaluation was performed using the FOIS (Functional Oral Intake Scale). After three days of intervention, improvements were observed in swallowing ability, reduced coughing during meals, and increased food intake. The FOIS score improved from level 3 (minimal oral intake) to level 5 (oral intake with dietary restrictions—soft/thick liquid texture—without requiring additional nutritional support). The patient was able to finish one serving of smooth porridge without coughing or hoarseness. Effortful Swallowing therapy proved effective in improving swallowing function and nutritional status in stroke patients with dysphagia, while also preventing aspiration complications. This intervention can be implemented as an evidence-based nursing practice (EBP) in dysphagia rehabilitation. Active involvement of both family members and nurses is crucial for the success of therapy.

Keywords: Dysphagia, effortful swallowing, nursing care, nutrition, stroke