Farri A, Accornero A, Burdese C
Department of Clinical Pathophysiology, University of Turin, Turin, Italy.
Acta Otorhinolaryngol Ital. 2007 Apr;27(2):83-6.
Until now, a limited number of studies have been carried out on the social importance of dysphagia and its consequences on the quality of life. Dysphagia is considered a disabling disorder for the individual from the functional point of view of swallowing, as well as the emotional-relational viewpoint. Aim of the study was to detect both the social consequences and the emotional implications which lead the dysphagic patient to evaluate the worsening of the quality of life after the onset of the disorder and how speech therapy can improve it. A survey was carried out on 73 patients, aged between 40-80 years, who had undergone one of the following operations: ENT, maxillo-facial, neurological and presbiphagic. A questionnaire was prepared comprising 25 questions concerning: medical history, eating habits, personal feelings, information about dysphagia and state of health. Research was carried out on a sample of patients who were still actively working and enjoyed an intense social life; almost 50% were under 60 years of age. After the surgical operation, they were found to be more fragile, lacked self-confidence, with limited social relationships and consequently, a tendency to isolation. Most patients, who had previously considered mealtimes an opportunity to meet others and a social gathering, no longer believed them to be a pleasant aspect of their day on account of the difficulty in swallowing. As a result, food consistency had to be changed and strategies had to be invented in order to make the meal less embarrassing. All patients agree they received, initially, little information on dysphagia. They maintain they benefited from speech therapy re-education and placed their confidence in the doctors who were treating them. Dysphagia is a disorder which has a negative influence on the patient's life, worsening it qualitatively from both a social and an emotional point of view. The patient tends to isolate him/herself, and experiences a sense of discomfort and diversity compared to his/her fellows, leading to a decrease in self-esteem. Research shows that patients are duly informed by doctors and health care professionals concerning the problems related to dysphagia and the rehabilitation therapy to be followed. Patients feel more safeguarded and there is an overall improvement in their lives.
到目前为止,关于吞咽困难的社会重要性及其对生活质量的影响,仅有有限的研究。从吞咽功能以及情感关系的角度来看,吞咽困难被认为是一种使个体致残的疾病。本研究的目的是检测导致吞咽困难患者在疾病发作后评估生活质量恶化的社会后果和情感影响,以及言语治疗如何改善这种情况。对73名年龄在40至80岁之间、接受过以下手术之一的患者进行了调查:耳鼻喉科、颌面外科、神经外科和老年吞咽障碍手术。编制了一份包含25个问题的问卷,内容涉及:病史、饮食习惯、个人感受、吞咽困难信息和健康状况。研究对象为仍在积极工作且社交生活丰富的患者样本;近50%的患者年龄在60岁以下。手术后,他们被发现更加脆弱,缺乏自信,社交关系有限,因此有孤立倾向。大多数患者此前认为用餐时间是与他人见面和社交聚会的机会,但由于吞咽困难,不再认为这是一天中愉快的时光。结果,必须改变食物的稠度,并想出一些策略,以使用餐不那么尴尬。所有患者都同意,他们最初收到的关于吞咽困难的信息很少。他们表示受益于言语治疗再教育,并信任治疗他们的医生。吞咽困难是一种对患者生活有负面影响的疾病,从社会和情感角度都会使其生活质量在质上恶化。患者往往会自我孤立,与同龄人相比会感到不适和不同,从而导致自尊下降。研究表明,医生和医护人员已就与吞咽困难相关的问题以及后续的康复治疗向患者进行了适当告知。患者感到更有保障,生活总体上有所改善。