Oropharyngeal Dysphagia in Hospitalized Older Adults With Dementia: A Mixed-Methods Study of Care Partners.
Oropharyngeal Dysphagia in Hospitalized Older Adults With Dementia: A Mixed-Methods Study of Care Partners.
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住院老年痴呆症患者的口咽吞咽困难：护理伙伴的混合方法研究。
DOI：
10.1044/2022_ajslp-22-00126
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发表时间：
2023
影响因子：
2.6
通讯作者：
Sinvani,Liron
中科院分区：
文献类型：
--
作者：
Makhnevich,Alex;Marziliano,Allison;Porreca,Kristen;Gromova,Valeria;Diefenbach,MichaelA;Sinvani,Liron
目的口咽吞咽困难(OD)影响近90%的住院痴呆患者。然而，人们对护理伙伴的体验知之甚少。本研究的目的是描述痴呆患者从医院过渡到社区环境中与OD管理相关的护理伙伴的经验。方法采用混合方法，对最近住院的老年痴呆和OD患者的护理伙伴进行电话访谈。访谈包括定量/定性评估：与医疗保健团队的沟通，对吞咽困难饮食的风险/好处的看法，以及信息需求。定量数据采用描述性统计方法。结果受访护理员(N=24)平均年龄63.5岁(SD=14.9)，女性占62.5%，白人占66.7%。近60%的患者患有严重痴呆症，66.7%的患者需要喂养帮助。护理伙伴(n=18)报告中度负担为14.11(SD=10.03)。大多数护理伙伴(83.3%)在住院期间第一次了解到OD。只有29.2%的护理伙伴报告他们与医生讨论过OD。护理伙伴对吞咽困难饮食风险/益处的看法差异很大：33.3%的人认为吞咽困难饮食会促进更愉快的生活。超过一半(54.2%)的护理伙伴表示，没有向他们提供吞咽困难饮食的选择。三分之二(n=16)的护理伙伴不遵守饮食建议；最主要的原因(n=13%)是患者拒绝饮食。虽然83.3%的护理伙伴希望获得有关吞咽困难治疗的额外信息，但只有20.8%的人寻求任何信息。结论我们的研究结果强调，痴呆症患者的护理伙伴面临着与OD相关的沟通和信息差距，这可能会导致负担增加。未来的研究需要解决未得到满足的与OD相关的护理伙伴的需求。
PurposeOropharyngeal dysphagia (OD) affects nearly 90% of hospitalized persons with dementia. Yet, little is known about the care partner experience. The purpose of our study was to describe the experience of care partners related to OD management in patients with dementia as they transition from the hospital to the community setting.MethodUsing a mixed-methods approach, we conducted telephone interviews with care partners of recently hospitalized older adults with dementia and OD. Interviews consisted of quantitative/qualitative assessments: communication with health care team, perception about risks/benefits of dysphagia diet, and informational needs. Descriptive statistics were used for quantitative data. For the qualitative data, transcripts were independently coded by research team and categorized into themes.ResultsOf the care partners interviewed (N= 24), mean age was 63.5 (SD= 14.9), 62.5% were female, and 66.7% were White. Nearly 60% of patients had severe dementia, and 66.7% required feeding assistance. Care partners (n= 18) reported moderate burden of 14.11 (SD= 10.03). Most care partners (83.3%) first learned about OD during hospitalization. Only 29.2% of care partners reported that they discussed OD with a physician. Care partner perception of dysphagia diet risks/benefits ranged widely: 33.3% thought dysphagia diets would promote a more enjoyable existence. Over half (54.2%) of care partners indicated no choice regarding dysphagia diets was presented to them. Two thirds (n= 16) of care partners were nonadherent to diet recommendations; the top reason (n= 13%) was diet refusal by patients. Although 83.3% of care partners wanted additional information regarding dysphagia management, only 20.8% sought any.ConclusionsOur findings highlight that care partners of persons with dementia face significant OD-related communication and informational gaps, which may lead to elevated burden. Future studies are needed to address unmet OD-related care partner needs.
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DOI：
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