Jones Ellie, Speyer Renée, Kertscher Berit, Denman Deborah, Swan Katina, Cordier Reinie
College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia.
Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Dysphagia. 2018 Apr;33(2):141-172. doi: 10.1007/s00455-017-9844-9. Epub 2017 Sep 2.
The negative impact of increased bolus modification on health-related quality of life (HRQoL) in persons with oropharyngeal dysphagia (OD) has been described in previous literature; however, findings may have been influenced by the severity of OD and underlying etiology. The current systematic review therefore aims to investigate the relationships between HRQoL and OD and to report on changes in HRQoL and OD following intervention. This review was conducted in accordance with the PRISMA statement. A systematic search of the literature was performed using PubMed and Embase. All available English publications up to February 2016 that reported on OD and HRQoL were included. Articles that studied OD arising from esophageal dysfunction or included less than 15 participants with OD, were excluded. Thirty-five studies met the inclusion criteria. Inverse bidirectional relationships were found between decreased HRQoL and increased OD severity. Following intervention, changes were evident through improved HRQoL with decreased OD severity. The findings of this paper highlight the importance of targeting HRQoL in patients with OD. However, because of the heterogeneity in methodology, terminology, and assessment procedures used in the retrieved articles, the generalization of study results is limited. More research investigating the relationships between HRQoL and OD is needed. Future studies should implement study designs that lead to stronger levels of evidence, quantify the severity of OD and underlying diseases, use validated measures and less ambiguous terminology.
以往文献中已描述了吞咽团块调整增加对口咽吞咽困难（OD）患者健康相关生活质量（HRQoL）的负面影响；然而，研究结果可能受到OD严重程度和潜在病因的影响。因此，本系统评价旨在调查HRQoL与OD之间的关系，并报告干预后HRQoL和OD的变化。本评价按照PRISMA声明进行。使用PubMed和Embase对文献进行系统检索。纳入截至2016年2月所有报道OD和HRQoL的英文出版物。排除研究食管功能障碍引起的OD或纳入OD患者少于15例的文章。35项研究符合纳入标准。发现HRQoL降低与OD严重程度增加之间存在反向双向关系。干预后，随着OD严重程度降低，HRQoL改善，变化明显。本文的研究结果突出了针对OD患者的HRQoL的重要性。然而，由于检索到的文章中使用的方法、术语和评估程序存在异质性，研究结果的推广受到限制。需要更多研究来调查HRQoL与OD之间的关系。未来的研究应采用能得出更强证据水平的研究设计，量化OD和基础疾病的严重程度，使用经过验证的测量方法和不太模糊的术语。
