Development and Evaluation of a Dysphagia Assessment Tool and an Intervention Program for the Elderly in the Long-Term Care Facilities

Abstract

The purpose of this study was to develop a dysphagia assessment tool and a intervention program for elderly in the long-term care facilities and to evaluate its effect. The dysphagia assessment tool consists of 20 items was developed through literature review, previous studies and discussion with nursing/medical members. The intervention program consisted of 72 items and participants for evaluation were 50 elders who were registered at long-term care facilities in 4 regions of Seoul. Collected data were analyzed using SPSS Statistics 18.0 and Spearman's Correlation, t-test, and x²-test. After the application of the dysphagia assessment tool and intervention program, the weight in experimental group was increased (t=4.913, p=.000) and the total time of swallowing was reduced (t=-4.557, p=.000) than control group. These findings were statistically significant. Considering these results, by applying the dysphagia assessment tool and the intervention program, the lives of the elderly in long-term care facilities are expected to be improved and emergency situations such as aspiration pneumonia and asphyxia will be decreased. 2. 먹는 방법을 몰라서 음식을 주어도 입을 벌리지 않거나 계속 씹는다. 섬망 증상으로 인해 산만하고 섭식을 거부한다.4. 스스로 수직으로 앉지 못한다. 스스로 고개를 가누지 못한다.구강 준비기/구강기 장애 6. 음식 섭취를 위해 스스로 입을 열거나 다물지 못한다. 음식을 씹지 못하여 음식덩이(bolus)를 형성하지 못한다.8. 침을 흘려서 입안에 음식덩이가 쌓인다.9. 혀 움직임이 부족하여 음식덩이를 인두 쪽으로 넘기지 못한다.10. 안면근육 장애가 있다.11. 구강에 음식 잔여물이 있다. 인두기 장애12. 음식을 삼킨 후 가래 낀 젖은 목소리(쉰 목소리/가르랑 거림)가 난다.13. 음식 삼킬 때 사레들림 증상이 있다.14. 비강역류 증상이 있다.15. 음식을 삼킬 때가 되었는데도 삼키지 못하고 음식을 머금고 있다. 음식을 삼킬 때 안면 청색증/호흡곤란이 있다.17. 음식 흡인시 자발적 기침을 하지 못한다. 식도기 장애18. 음식 섭취 후 가슴 답답함을 호소하고 트림이나 딸꾹 질을 자주한다.

Research trends on dysphagia among Korean older adults in long-term care facilities: A scoping review

“…For the analysis of topics and content within the included articles, the data were categorized by author(s), year of publication, study design, study aims, participants, instruments used for dysphagia evaluation, and key findings (Table 2). Research on dysphagia among Korean older adults in long-term care facilities began in 2011 with a study [26] exploring the prevalence and related factors of dysphagia, followed by a study [28] on the development of dysphagia assessment tools and intervention programs, and an evaluation of their effectiveness. Subsequent research has addressed the prevalence and related factors of dysphagia, dysphagia assessment, the development of nursing protocols, and dysphagia intervention programs.…”

“…The Swallowing Symptom Questionnaire and Iowa Oral Performance Instrument were used in two studies [38,39]. Other tools included warning signs and symptoms in one article [9], the Functional Oral Intake Scale in one article [39], a newly developed dysphagia assessment tool in one article [28], and its application in another article [29].…”

“…Research has primarily focused on dysphagia related to the community [22], community-dwelling older adults [23], hospital inpatients [24], and users of welfare centers [25]. Studies targeting Korean older adults in long-term care facilities began with the research by Park [26], including the development and application of dysphagia intervention programs within facilities [27], the development of assessment tools for dysphagia [28], and surveys on related factors [29]. However, there is a lack of scoping and systematic reviews on this topic.…”

Effect of blanching time on the quality characteristics of elderly-friendly kkakdugi

“…These types of foods are specially prepared to deal with difficulties in mastication and deglutition (13). Many elders suffer from decreased sensory and neural regulation, appetite and digestive function with teeth loss, and difficulties in swallowing foods and beverages (14). In addition, more than half of the elderly population is exposed to health risks due to malnutrition (15,16).…”

The Effect of an Exercise-based Swallowing Training Program for Nursing Home Residents with Stroke

“…외국에서는 연하 근육을 강화하는 운동과 보상적 수기를 적용하는 중재 연구 (Carnaby, Hankey, & Pizzi, 2006)가 활발하게 진행되어, 연하장애가 개선되고 (Lazarus, Logemann, Huang, & Rademaker, 2003), 혀 압 력이 증가하고 (Robbins et al, 2007), 영양상태가 개선되는 효과 (Lin et al, 2003)가 보고되었다. 국내 연하장애 연구는, 시설 거주 노인의 연하장애 유병율 조사 (Park et al, 2013), 감각자극 연구 (Park & Kang, 2002), 연하 단계 별 장애에 대 한 72개 항목의 중재 프로그램을 개발한 연구 (Kim, 2011 (Burkhead et al, 2007;Lin et al, 2003). Table 3과 같다 T0=Pretest; T2=8-week post-intervention; GUSS=Gugging swallowing screen; SSQ=Swallowing symptom questionnaire; BMI=Body Mass Index; MAMC=Mid Arm Muscle Circumference.…”