Physicians' opinions regarding the criteria for resuming oral intake after aspiration pneumonia: A questionnaire survey and cluster analysis of hospitals across Japan
Physicians' opinions regarding the criteria for resuming oral intake after aspiration pneumonia: A questionnaire survey and cluster analysis of hospitals across Japan
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DOI：
10.1111/ggi.12792
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发表时间：
2017-05-01
影响因子：
3.3
通讯作者：
Okayama, Masanobu
中科院分区：
文献类型：
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作者：
Kenzaka, Tsuneaki;Kumabe, Ayako;Okayama, Masanobu
目的：调查的项目，考虑由医生作出决定时，对吸入性肺炎患者谁经历了短期fasting.Methods的恢复口服摄入量：我们调查了2490日本医院，内科和呼吸内科。我们将包含24项与吸入性肺炎后恢复口服摄入有关的问卷邮寄给每家医院的部门负责人。Cronbach统计，主成分分析和聚类分析的结果进行了分析：我们收到的答复，从350家医院，89.7%的受访者回答说，他们“非常同意”，“意识水平”是一个有用的标准恢复口服摄入。此外，分别有66%、66%、63.4%、58.5%和51%的受访者回答他们“非常同意”SpO（2）的使用、主治医生的判断、体温、吞咽功能测试结果、精神状态和呼吸频率。在聚类分析中，意识水平、体温、SpO2、呼吸频率、精神状态和主治医师判断力属于第一类。第二个集群包括病人的要求，家庭的要求，医务人员和非医生的医疗保健提供者的意见，和性能status.Conclusions：医生考虑几个标准，在决策过程中关于口服摄入量恢复，这可以被分配到两个集群。未来的研究需要制定普遍和客观的标准。
Aim: To investigate the items that are considered by physicians when making decisions regarding the resumption of oral intake among patients with aspiration pneumonia who have undergone short-term fasting.Methods: We surveyed 2490 Japanese hospitals that had internal medicine and respiratory medicine departments. We mailed questionnaires that contained 24 items related to oral intake resumption after aspiration pneumonia to the head of the department at each hospital. Cronbach statistics, principal component analysis and cluster analysis were used to analyze the results.Results: We received responses from 350 hospitals; 89.7% of the respondents answered that they "Strongly agree" that "level of consciousness" is a useful criterion for resuming oral intake. Furthermore, 66%, 66%, 63.4%, 58.5% and 51% of the respondents answered that they "strongly agree" regarding the use of SpO(2), the discretion of the attending physician, body temperature, swallowing function test results, mental state and respiratory rate, respectively. In the cluster analysis, level of consciousness, body temperature, SpO(2), respiratory rate, mental state and the discretion of the attending physician belonged to the first cluster. The second cluster consisted of the patient's request, the family's request, the opinions of the medical staff and non-physician healthcare providers, and performance status.Conclusions: Physicians consider several criteria during decision-making regarding oral intake resumption, which can be assigned to two clusters. Future studies are required to develop generalizable and objective criteria.