Factors influencing eating ability of old in-patients in a rehabilitation hospital in Japan.
Factors influencing eating ability of old in-patients in a rehabilitation hospital in Japan.
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DOI：
10.1111/j.1741-2358.2003.00024.x
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发表时间：
2003-07-01
期刊：
影响因子：
2
通讯作者：
Kumakura, Isami
中科院分区：
文献类型：
--
作者：
Ono, Takahiro;Hori, Kazuhiro;Kumakura, Isami
目的：本研究旨在确定影响康复医院老年住院患者进食能力的因素。设计：横断面调查。地点：采用多学科方法对日本香川县桥本医院康复病房的46名住院患者进行调查。主要观察指标：年龄、性别、牙列状态、唇、颊和舌的肌肉活动、咬合力、每分钟唾液流量（SFR）、咀嚼软糖的能力、吞咽能力、膳食质地，行走独立性（功能独立性测量= 100）和沟通能力。结果：调查项目与咀嚼能力关系的双变量分析（卡方检验）发现，更好的咀嚼能力的软糖与年龄有关（<85岁）、性别（男性）、牙列状态（齿状）、SFR（高）、唇活动度（好）、咬合力（高）、吞咽能力（好）和交流活动度（高）。在这些项目中，SFR（p = 0.001），性别（p = 0.004），沟通能力（p = 0.005）和年龄（p = 0.012）被发现对咀嚼能力有影响（logistic回归分析）。另一方面，年龄（<85岁）、性别（男性）、SFR（高）、唇活动度（好）、颊活动度（好）、咬合力（高）、咀嚼能力（好）和吞咽能力（好）与正常膳食质地有关。在回归分析中，只有两个项目，嘴唇的活动（p = 0.003）和吞咽能力（p = 0.024）出现的膳食质地的因素。结论：咀嚼能力的软糖是由认知功能的影响，并排除了膳食状态的因素。这些结果表明，使用测试食物进行评估是有局限性的，因此，牙科医生应观察住院患者的饮食行为。此外，在饮食能力的恢复中，口腔医生应注意唇的活动和吞咽能力，以及牙列和修复体。由于SFR是影响咀嚼能力的最重要因素，这强调了护理由多种药物副作用引起的口干的必要性。
OBJECTIVES: This study was designed to determine the factors influencing eating ability of old in-patients in a rehabilitation hospital.DESIGN: Cross-sectional investigation.SETTING: Forty-six in-patients in the rehabilitation ward of Hashimoto Hospital in Kagawa Prefecture in Japan were investigated using a multidisciplinary approach.MAIN OUTCOME MEASURES: Age, gender, state of dentition, muscle activity of lip, cheek and tongue, biting force, salivary flow rate per a minute (SFR), masticatory ability for gummy jelly, swallowing ability, texture of meal, independency of walking (Functional Independence Measure = FIM) and ability to communicate.RESULTS: Bivariate analysis for the relationship between surveyed items and masticatory ability (chi-square test) identified that better masticatory ability for gummy jelly was associated with age (< 85years), gender (male),state of dentition (dentate), SFR (high), activity of lip (good), biting force (high), swallowing ability (good) and activity of communication (high). Among these items, SFR (p = 0.001), gender (p = 0.004), ability to communicate (p = 0.005) and age (p = 0.012) were found having an influence on the masticatory ability (logistic regression analysis). On the other hand, age (< 85years), gender (male), SFR (high), activity of lip (good), activity of cheek (good), biting force (high), masticatory ability (good) and swallowing ability (good) had a relationship with normal texture of meal. In regression analysis, only two items, activity of lip (p = 0.003) and swallowing ability (p = 0.024) emerged as factors on texture of meal.CONCLUSIONS: Masticatory ability for gummy jelly was influenced by cognitive function and was excluded from the factors on the state of meal. These results suggested the limitation of evaluation using test food, so dentists should observe eating behaviour of in-patients. In addition, dentists should pay attention to the activity of the lip and swallowing ability as well as dentition and prostheses in the rehabilitation of eating ability. As SFR was the most significant factor on masticatory ability, this emphasizes the necessity of care for dry mouth caused by side effects of multi-medication.