Deglutologist Practices and Perceptions of the Penetration-Aspiration Scale: A Survey Study.
Deglutologist Practices and Perceptions of the Penetration-Aspiration Scale: A Survey Study.
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食欲专家的实践和对渗透-渴望量表的看法：一项调查研究。
DOI：
10.1007/s00455-023-10637-3
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发表时间：
2024
期刊：
影响因子：
2.6
通讯作者：
Rogus-Pulia,Nicole
中科院分区：
文献类型：
--
作者：
Burdick,Ryan;Peña-Chávez,Rodolfo;Namasivayam-MacDonald,Ashwini;Rogus-Pulia,Nicole
成功的吞咽困难管理需要准确，简洁的诊断和吞咽安全损伤的表征。然而，渗透-抽吸量表（PAS）仍然是唯一专门用于评估气道保护的工具。为了最好地支持努力，以促进该领域的吞咽安全性的理解，这是至关重要的，以了解目前的临床医生的实践模式，看法和准确性有关的PAS。制定了一项46项调查，并分发给国际上的糖尿病学家，检查：（1）人口统计学;（2）量表实践;（3）吞咽安全优先级;（4）量表感知;和（5）准确性。前四个部分包括问卷。在可选的第五部分中，要求受访者对通过视频荧光透视收集的5个吞咽视频进行评分，之前由两名经过培训的评分员进行PAS评分。总共分析了335份答复。大多数受访者自我报告的考绩制度的培训（84%）; 90%的未经培训的受访者接受培训。受访者报告说，“总是”（40%）或“经常”（29%）使用考绩制度，考绩制度在评估中具有“很大”的权重（40%）。报告的PAS应用是异质性的，最常见的方法是“每种独特表现的单一最差评分”（45%）。大多数受访者（64%）优先考虑PAS未捕获的参数。未经培训的受访者对PAS评级的信心明显高于受过培训的受访者（X2= 7.47; p = 0.006）。在提供的1460个PAS评级中，与经过培训的实验室成员的评级相比，其中364个准确（25%）。这项调查的结果反映了PAS的普遍使用，吞咽安全性评估的需求未得到满足，尽管总体上信心很高，但准确性较低，以及与信心不一致的异质性培训。这强调了需要在PAS的临床应用中进行额外的培训，以及开发新的指标来优化吞咽安全性的评估。
Successful dysphagia management requires accurate, succinct diagnosis and characterization of swallowing safety impairments. However, the Penetration-Aspiration Scale (PAS) remains the only available tool developed exclusively for assessment of airway protection. To best support efforts to advance the field’s understanding of swallowing safety, it is crucial to understand current clinician practice patterns, perceptions, and accuracy regarding the PAS. A 46-item survey was developed and distributed to deglutologists internationally examining: (1) Demographics; (2) Scale Practices; (3) Swallowing Safety Priorities; (4) Scale Perceptions; and (5) Accuracy. The first four sections consisted of questionnaires. In the optional fifth section, respondents were asked to score five videos of swallows collected via videofluoroscopy and previously PAS-scored by two trained raters. In total, 335 responses were analyzed. The majority of respondents self-reported PAS training (84%); 90% of untrained respondents were receptive to training. Respondents reported using the PAS “always” (40%) or “frequently” (29%), and that the PAS carries “a great deal of” weight in assessment (40%). Reported application of the PAS was heterogeneous, with the most common approach being “single worst score per unique presentation” (45%). Most respondents (64%) prioritized a parameter not captured by the PAS. Untrained respondents were significantly more confident with PAS ratings than trained respondents (X2= 7.47; p = 0.006). Of 1460 PAS ratings provided, 364 of them were accurate (25%) when compared to ratings by trained lab members. Results of this survey reflect ubiquitous use of the PAS, unmet needs for assessment of swallowing safety, low accuracy despite generally high confidence, and heterogenous training that does not correspond to confidence. This emphasizes the need for additional training in clinical application of the PAS as well as development of novel metrics to optimize assessments of swallowing safety.