Speech and Hearing Sciences ETDs

Publication Date

Summer 6-30-2017

Abstract

INTRODUCTION: Eating is a function of daily life and is the centerpiece of family gatherings, business meetings, and holiday/religious traditions. Dysphagia (difficulty swallowing), can abolish the pleasure of mealtimes, which can negatively impact quality of life (QOL) and result in stigma. These variables may be influenced by cultural perceptions and/or acculturation, which is a measure of the impact that one cultural group has on another. The purpose of this investigation was to: a) identify the relationship between level of acculturation and QOL and stigma for Hispanics, b) measure the relationship between dysphagia severity and QOL and stigma, and c) explore the QOL experiences for Hispanics with dysphagia.

METHODS: This study was divided into two phases. In Phase I, seven participants completed the SWAL-QOL, Neuro-QoL stigma subtest, and the Acculturation Rating Scale for Mexican Americans- II. SWAL-QOL was divided into three clusters; Cluster 1 represented mental health, Cluster 2 encompassed swallow symptoms, and Cluster 3 was fatigue. In Phase II, three individuals from Phase I with varying levels of acculturation, as measured by the ARMSA-II, participated in two semi- structured interviews designed to explore their QOL experiences.

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RESULTS: Level of acculturation was weakly correlated with quality of life for Cluster 1 and 3, and moderately correlated with Cluster 2. That is, reporting of swallow symptoms increased as level of acculturation increased. A strong correlation was observed between acculturation level and stigma. Increased dysphagia severity resulted in decreased quality of life for Cluster 2. Oddly, as dysphagia severity increased, reports of fatigue decreased. A weak relationship was observed between dysphagia severity and stigma.

Quality of life experiences as identified from the ethnographic interview in Phase II were classified into emotional experiences and swallow safety. Emotional experiences included: stigma, distrust, fear, frustration, religion, coping, and impact. Swallow safety was comprised of: symptoms, treatment, triggers, and compensatory strategies.

CONCLUSION: Acculturation did not align well with measures of mental health or fatigue. Yet, there were noted relationships between level of acculturation and symptom reporting, as well as patient perception of stigma. Overall, disease severity correlated with swallow related QOL, but not with levels of perceived stigma.

First Committee Member (Chair)

Phyllis M. Palmer, Ph.D., CCC-SLP

Second Committee Member

Barbara L. Rodríguez, Ph.D., CCC-SLP

Third Committee Member

Jessica D. Richardson, Ph.D., CCC-SLP

Document Type

Thesis

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