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三级护理诊所中口咽吞咽困难门诊患者EAT-10相关因素的时间分析

Temporal Analysis of Factors Associated with EAT-10 in Outpatients with Oropharyngeal Dysphagia from a Tertiary Care Clinic.

作者信息

Bartlett R S, Moore J E, Thibeault S L

机构信息

Department of Surgery, University of Wisconsin-Madison, 5118, Wisconsin Institute for Medical Research, 1111 Highland Avenue, Madison, WI, 53705, USA.

Department of Surgery, University of Wisconsin-Madison, 5107, Wisconsin Institute Medical Research, 1111 Highland Avenue, Madison, WI, 53705, USA.

出版信息

Dysphagia. 2018 Aug;33(4):457-467. doi: 10.1007/s00455-018-9874-y. Epub 2018 Jan 20.

Abstract

Self-perception of disease is increasingly recognized as a determinant of health. The Eating Assessment Tool-10 (EAT-10) is a functional health status questionnaire that measures the symptomatic severity of dysphagia from the patient's perspective. The objective of this work was to identify factors (demographics, clinical variables, swallowing physiology, health-related quality of life) associated with longitudinal change in EAT-10 scores in outpatients with oropharyngeal dysphagia at a multi-disciplinary, tertiary care clinic. All patients with swallowing concerns that were included in the UW Madison Voice and Swallowing Outcomes database from 12/2012 to 04/2015 were invited to complete EAT-10 and a general health-related quality of life survey (SF-12v2) at their initial evaluation and six months later. Forty-two patients were included in analysis (n = 42). Weaning from a gastrostomy tube was significantly associated with EAT-10 improvement. Approximately 70% of the sample had mild dysphagia, and floor effects were observed for all EAT-10 items in this sample subset. Mean SF-12v2 Physical Component Summary score was substantially lower than that of the general population. Significant, weak-moderate correlations were found between EAT-10 and SF-12v2 scores for all comparisons except for Physical Health Composite at six months (rs = = 0.24 to - 0.43). Weaning from a feeding tube appears to meaningfully improve self-perceived symptoms of dysphagia. Given the floor effects observed, validity of EAT-10 for patients with mild dysphagia should be examined. Future research should address contributors to self-perceived symptom change across the range of dysphagia severity.

摘要

疾病的自我认知越来越被视为健康的一个决定因素。饮食评估工具10(EAT - 10)是一种功能健康状况问卷,从患者角度衡量吞咽困难的症状严重程度。这项研究的目的是在一家多学科三级护理诊所中,确定与口咽吞咽困难门诊患者EAT - 10评分纵向变化相关的因素(人口统计学、临床变量、吞咽生理学、健康相关生活质量)。2012年12月至2015年4月纳入威斯康星大学麦迪逊分校嗓音与吞咽结果数据库中所有有吞咽问题的患者,邀请他们在初次评估时和六个月后完成EAT - 10以及一项一般健康相关生活质量调查(SF - 12v2)。42名患者纳入分析(n = 42)。胃造瘘管拔除与EAT - 10改善显著相关。大约70%的样本有轻度吞咽困难,在该样本子集中所有EAT - 10项目均观察到地板效应。SF - 12v2身体成分总结评分均值显著低于一般人群。除了六个月时的身体健康综合评分外,所有比较中EAT - 10与SF - 12v2评分之间均发现显著的弱至中度相关性(rs = 0.24至 - 0.43)。从饲管拔除似乎能显著改善吞咽困难的自我感知症状。鉴于观察到的地板效应,应检查EAT - 10对轻度吞咽困难患者的有效性。未来研究应探讨吞咽困难严重程度范围内自我感知症状变化的影响因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0500/6387569/2f9081efafe8/nihms-1013351-f0001.jpg

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