Evaluation of Nursing Care Intervention for Eating and Swallowing in At-home Patients with Cerebrovascular Disease and Family Caregivers

1.本研究的目的在于发展一套可在家庭中推广的护理干预措施及量化干预效果的仪器，以支持脑血管病患者及其家属的生活重建.本研究包括以下两个步骤。(1)家庭进食与吞咽视觉测量装置之研制（2）护理干预效果之评估3.对于（1），由于进食和吞咽功能障碍的个体性和多样性，显然需要进一步的基础研究来开发替代VF的测量装置。我们开发了一种同时测量吞咽功能和呼吸轨迹的方法，作为进食和吞咽功能评估方法，以取代（1），并对其进行了初步研究。结果发表在以下两份报告中：“从RSST和咳嗽能力的角度检查吸入性肺炎的风险” ...更多信息 老年人吞咽能力与生活自理能力的关系。“对于（2），为脑血管疾病患者的进食和吞咽护理干预制定了一项方案。在康复医院和访问护理站收集数据。康复医院不仅评估进食和吞咽能力，而且评估高危状态和晚期脑功能障碍。在5名患者中进行了试点病例研究以准备方案。该方案实际用于5个在家的病人收集数据，从而修改了方案。最后，护理支持计划的重点是姿势保持（2001年至2002年报告）和进食和吞咽（2003年至2004年报告）。该计划的效用进行了检查，在两对脑血管疾病患者在家庭护理和他/她的家庭照顾者。该方案将不断得到评估。少

1. We have aimed to develop a nursing care intervention that can be generalized at home and a device to quantify the effect of the intervention in order to support the reconstruction of the life of patients with cerebrovascular disease and their family caregivers.2. The present study consists of the following two steps.(1) Development of a device to visually measure eating and swallowing at home(2) Evaluation of the effect of nursing care intervention3. For (1), it has become evident that further basic study is required to develop a measurement device to replace VF due to the individuality and diversity of eating and swallowing functional disorders. We developed a method to measure swallowing function and respiratory trajectory at the same time as an eating and swallowing function evaluation method to replace (1), and performed a pilot study on it. The results were published in the following two reports : "Examination of Risk of Aspiration Pneumonia in View of RSST and Coughing Ability … More of the Elderly" and "Relationship of Swallowing Ability with Posture and Activities of Daily Living in the Elderly at Home."For (2), a protocol was prepared for the nursing care intervention for eating and swallowing in patients with cerebrovascular disorder. Data were collected at both rehabilitation hospitals and visiting care stations. Not only eating and swallowing ability, but also high risk state and advanced cerebral function disorder were evaluated at rehabilitation hospitals. A pilot case study was performed in five patients to prepare the protocol. The protocol was actually used in five at-home patients to collect data, thereby modifying the protocol.Finally, a nursing care support program focusing on posture maintenance (2001 to 2002 Report) and eating and swallowing (2003 to 2004 Report) was prepared. The utility of the program was examined in two pairs of a patient with cerebrovascular disease under at-home care and his/her family caregiver. The program will be continuously evaluated. Less