Development of Dysphagia Nursing System for the Elderly Living at Home

居家老人吞咽困难护理系统的开发

• 批准号: 15592291
• 负责人: KAMAKURA Yayoi
• 金额: $ 2.24万
• 依托单位: Aichi Prefectural College of Nursing & Health
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2003
• 资助国家: 日本
• 起止时间: 2003 至 2004
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15592291/
• 关键词: Community-residing elderly; Dysphagia; Respiration pattern; Deglutition apnea; Biofeedback; Supraglottic swallow; Nursing

The purpose of this study was to establish dysphagia screening systems for elderly people living at home and to investigate the effectiveness of a self-controlled swallow training program. This study was approved by the ethical committee of the Aichi Prefectural College of Nursing & Health.As the first screening test, A questionnaire survey was performed using modified dysphagia risk self-assessment scale. The voluntary participants were 759 elderly people.As the second screening test, the repetitive saliva swallowing test, modified water swallowing test and food test were examined for 71 elderly people living at home who understood the purpose of this study and expressed their consent. Simultaneously, the surface electromyograms (EMGs) of the suprahyoid muscles and respirograms during swallowing were measured and recorded. Videofluorography was conducted as the gold standard. The results were as follows.Cronbach's α and test-retest correlation of the modified dysphagia risk assessment … More scale was 0.90 and 0.62 respectively, for overall scores. Cronbach's α of each factor was 0.70〜0.88. The validity and reliability were increased compared to before the improvement. When the cut-off point on the scale of the first and all second screening tests were put at 6 points, the sensitivity was 0.619 and the specificity was 0.569.The dysphagia risk family-assessment scale was investigated. Cronbach's α and test-retest correlation of the family-assessment scale were 0.89 and 0.78, respectively, for overall scores. The consistent rate and correlation coefficient between the self-assessment scale and family- assessment scale were 0.85〜0.952 and 0.60〜0.79, respectively.These results showed that screening by the modified dysphagia risk self-assessment scale or the family-assessment scale and second screening test will detect elderly people with dysphagiaThen, the frequency of repetitive swallowing increased and the safe respiratory pattern decreased in elderly 70 years and over.Supraglottic swallow training was conducted on four young persons and one elderly. After inhaling deeply, a sound was generated to trigger the swallowing at the appropriate time in the respiratory cycle. The effectiveness of the training was suggested based on the fact that the numbers of successful supraglottic swallows increased in two young persons and one elderly person. Less

本研究旨在建立居家老人吞咽困难筛检系统，并探讨自我控制吞咽训练计划的有效性。本研究经爱知县立护理保健大学伦理委员会批准，作为第一次筛选试验，采用改良吞咽困难危险自评量表进行问卷调查。自愿参与者为759名老年人，作为第二次筛查试验，对71名了解本研究目的并表示同意的居家老年人进行了重复唾液吞咽试验、改良饮水吞咽试验和食物试验。同时，测量并记录吞咽过程中舌骨上肌的表面肌电图（EMG）和呼吸图。以视频荧光造影作为金标准。结果如下：改良吞咽困难危险度评定的Cronbach α和重测相关性 ...更多信息 量表总分分别为0.90和0.62。各因子的Cronbach’s α为0.70 ± 0.88。与改进前相比，量表的信度和效度均有所提高。当初筛和复筛的临界值均为6分时，其敏感性为0.619，特异性为0.569。家庭评价量表总分的Cronbach’s α和重测相关系数分别为0.89和0.78。自评量表与家庭评定量表的一致率和相关系数分别为0.85 ± 0.952和0.60 ± 0.79。结果表明，用改良吞咽困难危险自评量表或家庭评定量表进行筛查，并进行复筛试验，可检出老年吞咽困难患者。70岁以上老年人重复吞咽频率增加，安全呼吸模式降低。在深吸气后，在呼吸周期的适当时间产生声音以触发吞咽。根据两名年轻人和一名老年人成功的声门上吞咽次数增加这一事实，提出了培训的有效性。少