{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T06:02:38Z","timestamp":1785218558793,"version":"3.55.0"},"reference-count":41,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the DANISH OCCUPATIONAL ASSOCIATION"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Objective: Dysphagia is common among elderly patients after hip fracture surgery and can lead to aspiration pneumonia, malnutrition, and delayed rehabilitation. This study aims to present current clinical practice patterns of assessment and intervention for dysphagia in this patient group. Methods: The study was conducted through a two-round online questionnaire targeting Danish occupational therapists with expertise in dysphagia post hip fracture. Results: A total of 71 therapists participated in round one, and 44 (62%) completed round two. Triggers for assessment included coughing, recurrent pneumonia, voice changes, altered eating habits, unplanned weight loss, functional decline, and comorbidities; age was rarely used. Frequently used assessment tools were Facio-Oral Tract Therapy (57.1%), the Minimal Eating Observation Form\u2014Version II (40%) and the Volume\u2013Viscosity Swallow Test (41.4%). Key interventions included texture modification, posture correction, patient education, oral hygiene optimization, compensatory strategies, and dysphagia training; oral screens and electrical stimulation were less common. Conclusions: This study provides a descriptive overview of current dysphagia assessment triggers, tools, and interventions used for elderly hip fracture patients in Denmark. The findings highlight clinical practice patterns that can inform future research on patient outcomes and the effectiveness of specific interventions in this population.<\/jats:p>","DOI":"10.3390\/diseases13080253","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T13:20:09Z","timestamp":1754659209000},"page":"253","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical Practice Patterns of Assessment and Interventions for Elderly Patients with a Hip Fracture Who Are at Risk of Dysphagia\u2014A Survey"],"prefix":"10.3390","volume":"13","author":[{"given":"Stine M\u00f8lgaard","family":"Kristoffersen","sequence":"first","affiliation":[{"name":"Department of Physiotherapy and Occupational Therapy, Horsens Regional Hospital, 8700 Horsens, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Signe","family":"Westmark","sequence":"additional","affiliation":[{"name":"Center for Clinical Research, North Denmark Regional Hospital, 9800 Hjoerring, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5656-402X","authenticated-orcid":false,"given":"Dorte","family":"Melgaard","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark"},{"name":"EMRUn, Department of Acute Medicine and Trauma Care, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.2147\/CIA.S107750","article-title":"European Society for Swallowing Disorders\u2014European Union Geriatric Medicine Society white paper: Oropharyngeal dysphagia as a geriatric syndrome","volume":"11","author":"Baijens","year":"2016","journal-title":"Clin. Interv. Aging"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1080\/00365521.2022.2151850","article-title":"Defining dysphagia\u2014A modified multi-professional Danish Delphi study","volume":"58","author":"Nielsen","year":"2022","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_3","unstructured":"World Health Organiszation (2016). International Statistical Classification of Deseases and Related Health Problems (ICD), World Health Organiszation."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s00455-016-9765-z","article-title":"The Prevalence of Oropharyngeal Dysphagia in Danish Patients Hospitalised with Community-Acquired Pneumonia","volume":"32","author":"Melgaard","year":"2016","journal-title":"Dysphagia"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Melgaard, D., Rodrigo-Domingo, M., and M\u00f8rch, M.M. (2018). The Prevalence of Oropharyngeal Dysphagia in Acute Geriatric Patients. Geriatrics, 3.","DOI":"10.3390\/geriatrics3020015"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"eAO4189","DOI":"10.1590\/s1679-45082018ao4189","article-title":"The importance of dysphagia screening and nutritional assessment in hospitalized patients","volume":"16","author":"Andrade","year":"2018","journal-title":"Einstein"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.clnesp.2025.03.041","article-title":"Impact of post-hospitalization dysphagia on dependence in activities of daily living at discharge in older adults with hip fracture: A nationwide inpatient database study","volume":"67","author":"Tamura","year":"2025","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/j.1365-277X.2006.00692.x","article-title":"Vulnerable patients with a fractured neck of femur: Nutritional status and support in hospital","volume":"19","author":"Nematy","year":"2006","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1302\/0301-620X.103B1.BJJ-2020-0991.R1","article-title":"Poor nutritional status correlates with mortality and worse postoperative outcomes in patients with femoral neck fractures","volume":"103-B","author":"Jayatilaka","year":"2021","journal-title":"Bone Jt. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1302\/0301-620X.94B5.28933","article-title":"Causes and predictors of early re-admission after surgery for a fracture of the hip","volume":"94-B","author":"Khan","year":"2012","journal-title":"J. Bone Jt. Surg. Br. Vol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1016\/j.injury.2018.04.015","article-title":"Epidemiology and social costs of hip fracture","volume":"49","author":"Veronese","year":"2018","journal-title":"Injury"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.1007\/s00590-024-03918-6","article-title":"Dysphagia is associated with increased mortality risk after hip fracture surgery","volume":"34","author":"Boyapati","year":"2024","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1111\/ajr.12512","article-title":"Swallowing disorders in an older fractured hip population","volume":"27","author":"Beric","year":"2019","journal-title":"Aust. J. Rural Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1416","DOI":"10.1093\/ageing\/afab032","article-title":"Oropharyngeal dysphagia in older patients with hip fracture","volume":"50","year":"2021","journal-title":"Age Ageing"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Madsen, G., Kristoffersen, S.M., Westergaard, M.R., Gj\u00f8dvad, V., Jessen, M.M., and Melgaard, D. (2020). Prevalence of Swallowing and Eating Difficulties in an Elderly Postoperative Hip Fracture Population\u2014A Multi-Center-Based Pilot Study. Geriatrics, 5.","DOI":"10.3390\/geriatrics5030052"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Byun, S.E., Kwon, K.B., Kim, S.H., and Lim, S.J. (2019). The prevalence, risk factors and prognostic implications of dysphagia in elderly patients undergoing hip fracture surgery in Korea. BMC Geriatr., 19.","DOI":"10.1186\/s12877-019-1382-x"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1093\/ageing\/aft081","article-title":"Oropharyngeal dysphagia in an elderly post-operative hip fracture population","volume":"42","author":"Miller","year":"2013","journal-title":"Age Ageing"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"E93","DOI":"10.3928\/01477447-20151222-07","article-title":"Identifying the Risk of Swallowing-Related Pulmonary Complications in Older Patients with Hip Fracture","volume":"39","author":"Meals","year":"2016","journal-title":"Orthopedics"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1093\/ageing\/aft037","article-title":"Oropharyngeal dysphagia in an elderly post-operative hip fracture population: A prospective cohort study","volume":"42","author":"Love","year":"2013","journal-title":"Age Ageing"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1111\/1460-6984.13015","article-title":"Supporting safe swallowing of care home residents with dysphagia: How does the care delivered compare with guidance from speech and language therapists?","volume":"59","author":"Griffin","year":"2024","journal-title":"Int. J. Lang. Commun. Disord."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Tsai, K.-T., Guo, T.-G., Wu, W.-T., Lee, R.-P., Yao, T.-K., Chen, I.-H., Wang, J.-H., and Yeh, K.-T. (2025). Postoperative mortality following hip fracture surgery in older adults: A single-center retrospective study in the context of Taiwan\u2019s transition to an aged society. Sci. Rep., 15.","DOI":"10.1038\/s41598-025-06181-9"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1080\/03007995.2024.2380007","article-title":"Nutritional care in older adults: Are we doing everything? An expert opinion review","volume":"40","author":"Ravasco","year":"2024","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014A metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J. Biomed. Inform."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Harris, P.A., Taylor, R., Minor, B.L., Elliott, V., Fernandez, M., O\u2019Neal, L., McLeod, L., Delacqua, G., Delacqua, F., and Kirby, J. (2019). The REDCap Consortium: Building an International Community of Software Platform Partners. J. Biomed. Inform., 95.","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"ref_25","unstructured":"DePoy, E., and Gitlin, L.N. (2011). Introduction to Research\u2014Understanding and Applying Multiple Strategies, Elsevier Mosby."},{"key":"ref_26","first-page":"5","article-title":"A technique for the measurement of attitudes","volume":"22","author":"Likert","year":"1932","journal-title":"Arch. Psychol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Keeney, S., Hasson, F., and McKenna, H.P. (2011). The Delphi Technique in Nursing and Health Research, Wiley-Blackwell.","DOI":"10.1002\/9781444392029"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.clnu.2014.04.014","article-title":"Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital","volume":"34","author":"Monteis","year":"2015","journal-title":"Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1159\/000339986","article-title":"Pathophysiology, relevance and natural history of oropharyngeal dysphagia among older people","volume":"Volume 72","author":"Rofes","year":"2012","journal-title":"Stepping Stones to Living Well with Dysphagia"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Aoki, S., Hosomi, N., Hirayama, J., Nakamori, M., Yoshikawa, M., Nezu, T., Kubo, S., Nagano, Y., Nagao, A., and Yamane, N. (2016). The Multidisciplinary Swallowing Team Approach Decreases Pneumonia Onset in Acute Stroke Patients. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0154608"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1097\/NOR.0000000000000743","article-title":"A Swallowing Screening Test Enhances a Better Recognition of Patients with a Hip Fracture at Risk for Oropharyngeal Dysphagia","volume":"40","author":"Wijnen","year":"2021","journal-title":"Orthop. Nurs."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1891\/JNM-D-18-00084","article-title":"The Minimal Eating Observation Form\u2013II Danish Version: Psychometric and Metrological Aspects","volume":"28","author":"Westergren","year":"2020","journal-title":"J. Nurs. Meas."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Riera, S.A., Marin, S., Serra-Prat, M., Tomsen, N., Arreola, V., Ortega, O., Walshe, M., and Clav\u00e9, P. (2021). A Systematic and a Scoping Review on the Psychometrics and Clinical Utility of the Volume-Viscosity Swallow Test (V-VST) in the Clinical Screening and Assessment of Oropharyngeal Dysphagia. Foods, 10.","DOI":"10.3390\/foods10081900"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s00455-021-10283-7","article-title":"White Paper by the European Society for Swallowing Disorders: Screening and Non-instrumental Assessment for Dysphagia in Adults","volume":"37","author":"Speyer","year":"2022","journal-title":"Dysphagia"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1007\/s00455-016-9696-8","article-title":"Effect of Bolus Viscosity on the Safety and Efficacy of Swallowing and the Kinematics of the Swallow Response in Patients with Oropharyngeal Dysphagia: White Paper by the European Society for Swallowing Disorders (ESSD)","volume":"31","author":"Newman","year":"2016","journal-title":"Dysphagia"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jpainsymman.2014.04.014","article-title":"Pretreatment information on dysphagia: Exploring the views of head and neck cancer patients","volume":"49","author":"Brockbank","year":"2015","journal-title":"J. Pain Symptom Manag."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1226","DOI":"10.1111\/j.1532-5415.2009.02311.x","article-title":"Pilot testing of intervention protocols to prevent pneumonia in nursing home residents","volume":"57","author":"Quagliarello","year":"2009","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/j.1741-2358.2012.00637.x","article-title":"Oral health care and aspiration pneumonia in frail older people: A systematic literature review","volume":"30","author":"Vanobbergen","year":"2013","journal-title":"Gerodontology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e007889","DOI":"10.1136\/bmjopen-2015-007889","article-title":"Effect of daily application of a 0.05% chlorhexidine solution on the incidence of (aspiration) pneumonia in care home residents: Design of a multicentre cluster randomised controlled clinical trial","volume":"5","author":"Hollaar","year":"2015","journal-title":"BMJ Open"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1046\/j.0309-2402.2003.02830.x","article-title":"Efficacy of swallowing training for residents following stroke","volume":"44","author":"Lin","year":"2003","journal-title":"J. Adv. Nurs."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1046\/j.1365-2648.2000.t01-1-01567.x","article-title":"Research guidelines for the Delphi survey technique","volume":"32","author":"Hasson","year":"2000","journal-title":"J. Adv. Nurs."}],"container-title":["Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-9721\/13\/8\/253\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:26:34Z","timestamp":1760034394000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-9721\/13\/8\/253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,8]]},"references-count":41,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["diseases13080253"],"URL":"https:\/\/doi.org\/10.3390\/diseases13080253","relation":{},"ISSN":["2079-9721"],"issn-type":[{"value":"2079-9721","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,8]]}}}