J Gerontol Nurs. 2021 Jun;47(6):7-12. doi: 10.3928/00989134-20210507-01. Epub 2021 Jun 1.
Hospitalized older adults frequently develop aspiration pneumonia, swallowing dys-function (dysphagia), and sarcopenia. In the current study, we propose a framework that incorporates these three factors into a vicious circle that leads to deconditioning, a condition frequently experienced by this vulnerable population. Viewing aspiration pneumonia, dysphagia, and sarcopenia, along with their interrelationships through the lens of this vicious circle, illuminates the critical role that oral health plays in deconditioning. Moreover, this framework highlights oral care as a key nursing intervention for reducing deconditioning in hospitalized older adults. Supporting this view, several studies have shown that oral care can improve health outcomes for hospitalized older adults. However, despite oral care being an essential nursing intervention that restores oral function and promotes patient wellness, it is one of the most neglected nursing interventions. Missed oral care occurs due to staff's limited awareness of its significance for care-dependent older adults in hospital settings. We hope that this vicious circle paradigm helps raise awareness of the significance of oral care to prevent deconditioning in hospitalized older adults. [(6), 7-12.].
住院的老年人常发生吸入性肺炎、吞咽功能障碍（吞咽困难）和肌肉减少症。在本研究中，我们提出了一个框架，将这三个因素纳入一个恶性循环，导致这个脆弱人群经常经历的去适应状态。通过这个恶性循环的视角来看待吸入性肺炎、吞咽困难和肌肉减少症及其相互关系，阐明了口腔健康在去适应状态中的关键作用。此外，该框架强调口腔护理是减少住院老年人去适应状态的关键护理干预措施。有几项研究支持这一观点，表明口腔护理可以改善住院老年人的健康结果。然而，尽管口腔护理是一项基本的护理干预措施，可以恢复口腔功能并促进患者的健康，但其却是最被忽视的护理干预措施之一。口腔护理被忽视是由于工作人员对其在医院环境中对依赖护理的老年人的重要性认识有限。我们希望这个恶性循环范式能够提高人们对口腔护理预防住院老年人去适应状态的重要性的认识。[(6)，7-12.]。
