University of Rochester School of Nursing, New York.
Gerontologist. 2018 Jul 13;58(4):749-758. doi: 10.1093/geront/gnw203.
Although many older adults suffer from dysphagia and are required to eat texture-modified diets, little is known about the experiences and challenges faced in doing so at home. In this study, we explored the perspectives of community-dwelling older adults as they struggled to balance dysphagia symptoms and recommended diet modifications with their preferred lifestyles.
Using an interpretive descriptive design, we conducted 37 in-home semi-structured interviews and 5 member-checking interviews, participant observations during a meal, and reviewed the medical charts of 20 participants recruited through maximum variation purposeful sampling. Meaning units and codes were identified and synthesized into 4 themes.
Participants faced a frightening choice between eating and breathing. Hiding dysphagia symptoms from the public eye was important to preserve self-identity. Following the recommended diet created a feeling that life was "falling apart." We also found that adhering to the diet was not an "all or none" phenomenon.
Given that correct adherence to the restrictive diet is rare, to effectively manage dysphagia symptoms, clinicians must appreciate the full range of impact of dysphagia and texture-modified diets on the lives of older adults.
尽管许多老年人患有吞咽困难,需要食用经质地改良的饮食,但对于他们在家中如何应对这些困难和挑战,我们知之甚少。在这项研究中,我们探讨了社区居住的老年人的观点,他们在努力平衡吞咽困难症状和推荐的饮食改变与他们喜欢的生活方式时所面临的困难。
我们采用解释性描述设计,对 20 名通过最大变异目的抽样法招募的参与者进行了 37 次上门半结构化访谈和 5 次成员检查访谈、用餐期间的参与者观察,并查阅了他们的医疗记录。确定了意义单位和代码,并将其综合成 4 个主题。
参与者面临着在进食和呼吸之间做出可怕的选择。向公众隐瞒吞咽困难的症状对维护自我身份很重要。遵循推荐的饮食会让人感到生活“分崩离析”。我们还发现,遵守饮食并不是“非此即彼”的现象。
鉴于正确遵守限制饮食的情况很少见,为了有效地管理吞咽困难症状,临床医生必须充分认识到吞咽困难和质地改良饮食对老年人生活的全面影响。