Grant: Project Grant

After a stroke, more than half of people develop difficulty swallowing, called post-stroke dysphagia (PSD). PSD can cause serious problems, including malnutrition and lung infections from food or liquid going into the lungs. For people who need long-term help with swallowing, doctors may switch them from a temporary feeding tube through the nose to a more permanent tube placed directly into the stomach or small intestine (called a GJ-tube). Right now, we don't have clear guidance on who will benefit most from a GJ-tube or when after a stroke it should be inserted. If the tube is placed too early, patients may go through an unnecessary surgery with added discomfort and cost. If it's placed too late, patients may spend more time in hospital, leading to crowding and higher healthcare costs. This study will look at differences in how and when GJ-tubes are used in hospitals across Canada, and will gather the voices of stroke survivors with dysphagia and their caregivers to understand their experiences and perspectives around tube feeding. Aims: 1. Use Canada-wide hospital records to see whether GJ-tube timing varies between hospitals, and how this affects hospital stay length, where patients go after discharge (home vs. care facility), and their recovery. 2. Survey patients with PSD and their caregivers about their experiences with the decision making process and their recommendations on when GJ-tubes should be inserted 3. Interview patients with PSD and their caregivers to gather their detailed perspectives on experiences with GJ-tube insertion and recommendations on improving the process for other patients and families. This study brings together Canadian experts in stroke care, swallowing disorders and research experts in using health records, patient interviews and health policy. The findings will help guide more consistent and patient-centered decisions for GJ-tube use after stroke.