What information do clinicians use in recommending oral versus nonoral feeding in oropharyngeal dysphagic patients?
What information do clinicians use in recommending oral versus nonoral feeding in oropharyngeal dysphagic patients?
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DOI：
10.1007/s00455-008-9152-5
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发表时间：
2008-12
期刊：
影响因子：
2.6
通讯作者：
Veis, Sharon
中科院分区：
文献类型：
--
作者：
Logemann, Jeri A.;Rademaker, Alfred;Pauloski, Barbara Roa;Antinoja, Jodi;Bacon, Mary;Bernstein, Michelle;Gaziano, Joy;Grande, Barbara;Kelchner, Lisa;Kelly, Amy;Klaben, Bernice;Lundy, Donna;Newman, Lisa;Santa, Daphne;Stachowiak, Linda;Stangl-McBreen, Carrie;Atkinson, Cory;Bassani, Heidi;Czapla, Melissa;Farquharson, Julie;Larsen, Kristin;Lewis, Vicki;Logan, Heather;Nitschke, Teri;Veis, Sharon
关键词：
关于临床医生用来推荐口咽吞咽困难患者口服或非口服喂养的信息类型，几乎没有证据。这项研究代表了确定临床医生用于提出这一建议的数据以及临床经验如何影响建议的第一步。23名治疗吞咽困难的临床医生认为，在做出口服还是非口服的决定时，有13个变量是至关重要的。然后临床医生使用这些变量独立推荐口服与非口服喂养或部分口服与非口服喂养的20名匿名患者，这些患者的改良钡吞剂被发送到每个临床医生的录像带中。临床医生还收到了每位患者的13个变量的数据。根据Kappa统计，临床医生对完全口服和非口服推荐的一致意见相当高。在分析临床医生在提出建议时使用的13个标准中，吸痰量是频率最高的标准。建议使用的姿势和手法和临床医生的经验对这些选择的影响也进行了分析。
There is little evidence regarding the type(s) of information clinicians use to make the recommendation for oral or nonoral feeding in patients with oropharyngeal dysphagia. This study represents a first step toward identifying data used by clinicians to make this recommendation and how clinical experience may affect the recommendation. Thirteen variables were considered critical in making the oral vs. nonoral decision by the 23 clinicians working in dysphagia. These variables were then used by the clinicians to independently recommend oral vs. nonoral feeding or partial oral with nonoral feeding for the 20 anonymous patients whose modified barium swallows were sent on a videotape to each clinician. Clinicians also received data on the 13 variables for each patient. Results of clinician agreement on the recommendation of full oral and nonoral only were quite high, as measured by Kappa statistics. In an analysis of which of the 13 criteria clinicians used in making their recommendations, amount of aspiration was the criterion with the highest frequency. Recommendations for use of postures and maneuvers and the effect of clinician experience on these choices were also analyzed.
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DOI：
10.1016/s0003-9993(99)90140-5
发表时间：
1999-03-01
影响因子：
4.3
作者：
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通讯作者：
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