Self-perception of swallowing, vocal symptoms, and the possibility of dysphagia occurrence in patients under palliative care

Rodrigues, Sophia Eustáquio; Trevizani, Gabriel; Guimarães, Michelle; Heitmann, Elma

doi:10.1590/2317-1782/e20250208pt

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Original Article • CoDAS 38 (3) • 2026 • https://doi.org/10.1590/2317-1782/e20250208en linkcopy

Self-perception of swallowing, vocal symptoms, and the possibility of dysphagia occurrence in patients under palliative care

Authorship SCIMAGO INSTITUTIONS RANKINGS

Purpose To identify, compare, and correlate self-perception of swallowing, vocal symptoms, and the possibility of dysphagia in patients under Palliative Care (PC).

Methods Observational, cross-sectional, and analytical study, approved by the Research Ethics Committee (nº 6.039.141), with a convenience sample collected between April/2023 and May/2024. Clinical data were obtained from medical records. Included were hospitalized patients in the PC unit, of both sexes, aged over 18 years. Exclusion criteria were lack of clinical conditions and/or willingness to participate. After signing the informed consent form, patients completed the EAT-10, VoiSS, and RaDI-H protocols.

Results A total of 50 patients participated, with a prevalence of males (58%), over 60 years of age (64%), cancer diagnosis (66%), and oral feeding route (74%). Sarcopenia (46%) and dyspnea (52%) were observed. Negative self-perception of swallowing was found in 80% of patients. On the total VoiSS score, 58% scored above the cutoff, with the greatest impact on the limitation domain (44%). Dysphagia was possible in 62% of patients. There was a significant difference between patients with and without sarcopenia regarding self-perception of swallowing, limitation domain, total VoiSS score, and possibility of dysphagia. Significant differences were also found between patients with and without dyspnea reports in all three protocols, except for the emotional domain of the VoiSS. Positive correlations were observed among the protocols.

Conclusion In these PC patients, there was negative self-perception of swallowing, self-reported vocal symptoms, and possibility of dysphagia, with positive correlation among the three protocols. Significant differences were found in self-perception of swallowing, vocal symptoms, and possibility of dysphagia, with greater impact in patients with sarcopenia and dyspnea.

Keywords:
Deglutition; Deglutition Disorders; Voice; Palliative Care; Mass Screening; Speech, Language and Hearing Sciences

Variables	EAT 10	VoiSS Limitation	VoiSS Emotional	VoiSS Physical	VoiSS Total	RaDI-H
Mean (± SD)	10.5 (±10.4)	14.5 (± 12)	1.24 (± 3)	6 (± 5)	21.6 (± 19)	5.44 (± 3.8)
Median	7	12	0	5	19.5	4

Variables		Sarcopenia			Dyspnea
Variables		Yes	No	p-value	Yes	No	p-value
EAT-10		12	8.7	0.005*	15.4	6.2	0.001*
VoiSS	Limitation	19,8	8,6	0.041*	18.6	10.9	0.001*
	Emotional	1.5	0.9	0.765	1.2	1.2	0.233
	Physical	8.4	3.3	0.102	6.9	5	0.001*
	Total	29	12.9	0.044*	26.8	17	0.001*
RaDI-H		7	3.6	0.007*	6.9	4	0.001*

Variables	EAT 10	RaDI-H
RaDI-H	0.664**
VoiSS Limitation	0.492**	0.654**
VoiSS Emotional	0.010**	0.246**
VoiSS Physical	0.653**	0.644**
VoiSS Total	0.556**	0.689**

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[1] Caption: SD = standard deviation; EAT-10 = Eating Assessment Tool; VoiSS = Voice Symptom Scale; RaDI-H = Rastreamento de Disfagia Orofaríngea em Idosos em Ambiente Hospitalar