Department of Anesthesiology, NIDO, Danmark, Gødstrup Hospital, Herning, Denmark.
Research Centre for Health and Welfare Technology, VIA University College, Aarhus N, Denmark.
Scand J Caring Sci. 2021 Dec;35(4):1290-1300. doi: 10.1111/scs.12950. Epub 2020 Dec 26.
Dysphagia related to intubation affects almost one in five patients in the intensive care unit; it may vary due to fluctuations in cerebral status and fatigue and lead to pneumonia, re-intubation and increased mortality. Taking care of patients' nutritional needs is an integral part of nursing and nurses must therefore be able to assess risk of dysphagia at all hours. However, Danish validated methods for use in the critically ill patient population are lacking.
To translate and adapt the Yale Swallow Protocol method for implementation in a Danish intensive care unit setting.
Translation and adaption followed WHO's recommendations for translation and adaption of instruments. Face validity of the Danish version was evaluated in four group interviews. These were digitally recorded, transcribed and analysed using deductive content analysis. All interviewees gave informed consent.
The translated version of the Yale Swallow Protocol was easy to understand, although nurses needed to have the method explained and needed training in using the method. In addition, the Yale Swallow Protocol must be adapted to local practice in terms of identifying patients at risk of dysphagia and deciding where to document results of the screening.
The translated version of the Yale Swallow Protocol proved conceptually and culturally sound and acceptable to intensive care unit nurses. Implementation should be followed by theoretical and practical training to build a nursing vocabulary relating to dysphagia and strengthen nurses' sensitivity to clinical manifestations consistent with dysphagia.
与插管相关的吞咽困难影响了 ICU 中近五分之一的患者；由于大脑状态和疲劳的波动，它可能会有所不同，并导致肺炎、再次插管和死亡率增加。满足患者的营养需求是护理的一个组成部分，因此护士必须能够在任何时候评估吞咽困难的风险。然而，丹麦缺乏用于危重症患者人群的经过验证的方法。
翻译和改编耶鲁吞咽协议方法，以便在丹麦的重症监护病房环境中实施。
翻译和改编遵循世界卫生组织（WHO）关于仪器翻译和改编的建议。在四个小组访谈中评估了丹麦语版本的表面有效性。这些访谈被数字记录、转录并使用演绎内容分析进行分析。所有受访者均表示同意。
虽然护士需要解释该方法并接受使用该方法的培训，但翻译后的耶鲁吞咽协议版本易于理解。此外，必须根据识别有吞咽困难风险的患者以及确定记录筛查结果的位置来调整耶鲁吞咽协议。
翻译后的耶鲁吞咽协议在概念和文化上是合理且可接受的，适用于重症监护病房的护士。实施后应进行理论和实践培训，以建立与吞咽困难相关的护理词汇，并增强护士对与吞咽困难一致的临床表现的敏感性。
