Estudo multicêntrico sobre escalas para grau de comprometimento em disfagia orofaríngea neurogênica

Abstract

OBJETIVO: Analisar a concordância entre distintas escalas para grau de comprometimento em disfagia orofaríngea neurogênica. MÉTODOS: Foi realizado estudo clínico transversal. Participaram 200 indivíduos com disfagia orofaríngea neurogênica, 108 do gênero masculino e 92 do gênero feminino, com idades de 3 meses a 91 anos. Foram aplicadas quatro escalas para classificar o grau de comprometimento da disfagia orofaríngea, sendo duas escalas clínicas e duas videofluoroscópicas. Análises estatísticas foram realizadas para verificar a concordância entre as escalas clínicas e objetivas. RESULTADOS: Os resultados mostraram concordância muito boa entre as escalas clínicas estudadas (Kappa=0,92) e concordância moderada entre as escalas objetivas (Kappa=0,52). CONCLUSÃO: Embora a concordância entre as escalas clínicas tenha sido muito boa e entre as escalas objetivas tenha sido moderada, ainda é necessária ampla discussão e possível revisão dos parâmetros que definem o grau de comprometimento da disfagia orofaríngea em pacientes neurológicos.

Associação entre escalas de avaliação de funcionalidade e severidade da disfagia pós-acidente vascular cerebral

“…The rating scales of the involvement level of the oropharyngeal dysphagia are tools used in the diagnostic process of this symptom at the deglutition clinical and objective evaluations, to help identifying the risk at dysfunction classification, as an instrument to define the procedures or as a parameter at the rehabilitation efficiency control. These scales have been suggested in several studies and not always use consensual criteria (8) . Dysphagia Outcome and Severity Scale -DOSS (7) is a scale developed to systemically evaluate the dysphagia functional severity based on the objective evaluation and to make recommendations on the type of diet, level of independency and type of nutrition.…”

Acessibilidade à atenção fonoaudiológica em serviço de média complexidade

“…The children in this study presented sociodemographic and clinical profile similar to those studies developed in specialized services at SUS in the South, Southeast and Northeast regions: predominance of boys aged 5 to 9 years, with disturbances in the speech and language disorders [17][18][19][20] . The increased demand in this age group would result in intensification of the social interactions, especially at the entry of school where children are requested more in his/ her performance of the oral language and learning [17][18] .…”

“…The increased demand in this age group would result in intensification of the social interactions, especially at the entry of school where children are requested more in his/ her performance of the oral language and learning [17][18] . The reasons pointed out to explain a male preponderance as the biological factors (maturing of the brain is slower and genetics) and socially (higher charges on the performance), needing scientific confirmation.…”

“…The non-use of the waiting list with an appointment at MFS began only when the service had vacancy available to be filled in a short time, darkening the magnitude of excess of demand. Also minimized the waiting time for the first consultation: 76.3% of the children waited for 15 days, a short interval of time, comparing to six to seven months in Brazilian studies 7,[18][19][20] and other countries 9,22 .…”

“…In Brazil, some studies that refer to the accessibility in speech therapy affirm long waiting hours after making an appointment for the first speech therapy consultation at the SUS [17][18][19][20][21] . Barriers for diagnosis and appropriate treatment of communication disorders were also identified in Ontario 22 (Canada) and in London 9 (England).…”