Seedat Jaishika, Penn Claire
Department of Speech Pathology and Audiology, University of the Witwatersrand, South Africa.
S Afr J Commun Disord. 2016 Feb 16;63(1):102. doi: 10.4102/sajcd.v63i1.102.
Oral care is a crucial routine for patients with dysphagia that, when completed routinely, can prevent the development of aspiration pneumonia. There is no standardised protocol for oral care within government hospitals in South Africa. This study aimed to investigate the outcome of an oral care protocol. Participants were patients with oropharyngeal dysphagia, with either stroke or traumatic brain injury as the underlying medical pathology, and nurses. All participants were recruited from one tertiary level government hospital in Gauteng, South Africa. 139 nurses participated in the study and received training on the oral care protocol. There were two groups of participants with oropharyngeal dysphagia. Group one (study group, n = 23) was recruited by consecutive sampling, received regular oral care and were not restricted from drinking water; however, all other liquids were restricted. Group two (comparison group, n = 23) was recruited via a retrospective record review, received inconsistent oral care and were placed on thickened liquids or liquid restricted diets. Results showed that a regimen of regular oral care and free water provision when combined with dysphagia intervention did prevent aspiration pneumonia in patients with oropharyngeal dysphagia. The article highlights two key findings: that regular and routine oral care is manageable within an acute government hospital context and a strict routine of oral care can reduce aspiration pneumonia in patients with oropharyngeal dysphagia. An implication from these findings is confirmation that teamwork in acute care settings in developing contexts must be prioritised to improve dysphagia management and patient prognosis.
口腔护理对于吞咽困难患者来说是一项至关重要的日常护理，若能定期完成，可预防吸入性肺炎的发生。南非政府医院内尚无标准化的口腔护理方案。本研究旨在调查一项口腔护理方案的效果。参与者包括患有口咽吞咽困难的患者（潜在医学病理为中风或创伤性脑损伤）以及护士。所有参与者均来自南非豪登省的一家三级政府医院。139名护士参与了该研究，并接受了口腔护理方案的培训。有两组患有口咽吞咽困难的参与者。第一组（研究组，n = 23）通过连续抽样招募，接受定期口腔护理且饮水不受限制；然而，所有其他液体均受限。第二组（对照组，n = 23）通过回顾性病历审查招募，接受不规律的口腔护理，并采用增稠液体或液体限制饮食。结果表明，定期口腔护理和提供自由饮水的方案与吞咽困难干预相结合时，确实可预防口咽吞咽困难患者发生吸入性肺炎。本文突出了两个关键发现：在急性政府医院环境中，定期和常规的口腔护理是可行的，且严格的口腔护理常规可减少口咽吞咽困难患者的吸入性肺炎。这些发现的一个启示是，在发展中环境的急性护理环境中，必须优先考虑团队合作，以改善吞咽困难管理和患者预后。
