Dysphagic Independent Feeders’ Justifications for Noncompliance With Recommendations by a Speech-Language Pathologist The purpose of this study was to examine the various ways in which independent-feeding patients with dysphagia justified their noncompliance with swallowing recommendations suggested by a speech-language pathologist (SLP). Sixty-three independent-feeding dysphagia patients between the ages of 65 and 100 years who had been identified by the SLP or staff ... Research Article
Research Article  |   February 01, 2005
Dysphagic Independent Feeders’ Justifications for Noncompliance With Recommendations by a Speech-Language Pathologist
 
Author Affiliations & Notes
  • Nancy Colodny
    St. John’s University, Jamaica, NY
  • Contact author: Nancy Colodny, Department of Speech, Communication Sciences, and Theater, Graduate School of Arts and Sciences, St. John’s Hall 344, St. John’s University, 8000 Utopia Turnpike, Jamaica, NY 11439. E-mail: colodnyn@stjohns.edu
Article Information
Swallowing, Dysphagia & Feeding Disorders / Research Articles
Research Article   |   February 01, 2005
Dysphagic Independent Feeders’ Justifications for Noncompliance With Recommendations by a Speech-Language Pathologist
American Journal of Speech-Language Pathology, February 2005, Vol. 14, 61-70. doi:10.1044/1058-0360(2005/008)
History: Received November 18, 2003 , Revised July 5, 2004 , Accepted January 28, 2005
 
American Journal of Speech-Language Pathology, February 2005, Vol. 14, 61-70. doi:10.1044/1058-0360(2005/008)
History: Received November 18, 2003; Revised July 5, 2004; Accepted January 28, 2005
Web of Science® Times Cited: 40

The purpose of this study was to examine the various ways in which independent-feeding patients with dysphagia justified their noncompliance with swallowing recommendations suggested by a speech-language pathologist (SLP). Sixty-three independent-feeding dysphagia patients between the ages of 65 and 100 years who had been identified by the SLP or staff as noncompliant with SLP recommendations were interviewed about their reasons for noncompliance. Reasons were classified into 8 categories: (a) denial of a swallowing problem, (b) dissatisfaction with the preparations such as thickened liquids or pureed foods, (c) assuming a calculated risk for noncompliant behaviors, (d) rationalizing their noncompliance in the face of contradictory evidence, (e) minimization of the severity of their problem, (f) verbal accommodation while maintaining noncompliance, (g) projection of blame toward the SLP, and (h) deflection of noncompliance by referring to an external authority. Reasons for noncompliance were discussed in light of theory and research on denial, coping mechanisms, and the social-cognitive transition model. Implications were drawn for SLP practice in dealing with noncompliant independent-feeding patients with dysphagia.

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