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对进行性神经疾病中自我报告的吞咽评估的系统评价。

A systematic review of self-reported swallowing assessments in progressive neurological disorders.

作者信息

Keage Megan, Delatycki Martin, Corben Louise, Vogel Adam

机构信息

Speech Neuroscience Unit, The University of Melbourne, 550 Swanston Street, Melbourne, VIC, 3010, Australia,

出版信息

Dysphagia. 2015 Feb;30(1):27-46. doi: 10.1007/s00455-014-9579-9. Epub 2014 Oct 4.

Abstract

Dysphagia experienced as a consequence of neurodegenerative disease can have severe consequences on a patient's health and well-being. Regular assessment of swallowing function can assist to achieve adequate nutrition and hydration. Here we review subjective swallowing assessments currently available are suitable for use in people with neurodegenerative disease. Measurement properties were reviewed for each tool and coverage of the World Health Organization's International Classification of Functioning, Disability and Health (WHO ICF) was considered. Assessments were identified following a review of the published literature Instruments were reviewed on the basis of reliability and validity, as well as administrative properties, such an interpretability, acceptability, and feasibility. Tools were also evaluated according to the WHO ICF framework. In total, 19 studies were identified for full-text review from 13,315 abstracts. Nine self-reported dysphagia assessment tools suitable for use in progressive neurological disorders were identified. The Swallowing Quality of Life Questionnaire (SWAL-QOL) yields the strongest combination of reliability (including internal consistency and test-retest reliability) and convergent validity while simultaneously covering all WHO ICF domains. Lengthy administration time was identified as a limitation of the SWAL-QOL. The review highlights a relative lack of well-validated self-report questionnaires in dysphagia for people with progressive neurological disease. Additional validation and evaluation of the clinical utility of the tools currently available is required to further promote an informed selection of available assessments.

摘要

神经退行性疾病导致的吞咽困难会对患者的健康和幸福产生严重影响。定期评估吞咽功能有助于实现充足的营养和水分摄入。在此,我们回顾目前可用的主观吞咽评估方法,这些方法适用于神经退行性疾病患者。对每种工具的测量特性进行了回顾,并考虑了世界卫生组织《国际功能、残疾和健康分类》(WHO ICF)的覆盖范围。在对已发表文献进行回顾后确定了评估方法。根据可靠性和有效性以及管理特性(如可解释性、可接受性和可行性)对工具进行了审查。还根据WHO ICF框架对工具进行了评估。从13315篇摘要中总共确定了19项研究进行全文审查。确定了9种适用于进行性神经疾病的自我报告吞咽困难评估工具。吞咽生活质量问卷(SWAL-QOL)在可靠性(包括内部一致性和重测可靠性)和收敛效度方面具有最强的组合,同时涵盖了所有WHO ICF领域。较长的施测时间被确定为SWAL-QOL的一个局限性。该综述强调,对于患有进行性神经疾病的人,吞咽困难方面经过充分验证的自我报告问卷相对较少。需要对现有工具的临床效用进行进一步验证和评估,以进一步促进对可用评估方法的明智选择。

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