Wakabayashi Hidetaka
Dept. of Rehabilitation Medicine, Yokohama City University Medical Center.
Gan To Kagaku Ryoho. 2010 Dec;37 Suppl 2:198-200.
Community coordination is necessary in nutrition care management and dysphagia rehabilitation, because they are not completed in one hospital or facility. For seamless community coordination of rehabilitation nutrition care management in patients with dysphagia, it is useful to define why, who, when, where, what, and how. Common communication materials of nutrition support team and dysphagia rehabilitation made by Kanagawa society of dysphagia rehabilitation is effective in promoting community coordination. In qualitative research for participants in community nutrition support team at Yokohama south area, two issues were emerged: strengthening collaboration of the community nutrition support team including visiting medical staffs and offering opportunity to learn clinical nutrition and dysphagia rehabilitation. Concept of rehabilitation nutrition is also useful for community coordination. Rehabilitation nutrition is to assess with the International Classification of Functioning, Disability and Health including nutrition status and to practice rehabilitation nutrition care plan under adequate prognosis prediction. It is not enough for patients with dysphagia to coordinate only clinical nutrition or rehabilitation. Seamless community coordination of rehabilitation nutrition care management is important for patients with dysphagia to improve their activities of daily living and quality of life.
社区协调在营养护理管理和吞咽困难康复中是必要的，因为这些工作并非在一家医院或机构就能完成。为了实现吞咽困难患者康复营养护理管理的无缝社区协调，明确原因、人员、时间、地点、内容和方式是很有用的。神奈川吞咽困难康复协会制作的营养支持团队和吞咽困难康复的通用沟通材料，对促进社区协调有效。在对横滨南区社区营养支持团队参与者的定性研究中，出现了两个问题：加强包括上门医护人员在内的社区营养支持团队的协作，以及提供学习临床营养和吞咽困难康复的机会。康复营养的概念对社区协调也很有用。康复营养是指依据包括营养状况在内的《国际功能、残疾和健康分类》进行评估，并在充分的预后预测下实施康复营养护理计划。对于吞咽困难患者来说，仅协调临床营养或康复是不够的。康复营养护理管理的无缝社区协调对于吞咽困难患者改善其日常生活活动能力和生活质量至关重要。
