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针对吞咽困难养老院居民的干预措施——一项范围综述

Interventions for Nursing Home Residents with Dysphagia-A Scoping Review.

作者信息

Melgaard Dorte, Westergren Albert, Skrubbeltrang Conni, Smithard David

机构信息

Department of Clinical Medicine and Centre for Clinical Research, Aalborg University and North Denmark Regional Hospital, 9800 Hjoerring, Denmark.

The Research Platform for Collaboration for Health and the PRO-CARE Group, Faculty of Health Science, Kristianstad University, 291 88 Kristianstad, Sweden.

出版信息

Geriatrics (Basel). 2021 May 21;6(2):55. doi: 10.3390/geriatrics6020055.

Abstract

Oropharyngeal dysphagia is common in nursing home residents. The objective of this scoping review was to summarize and disseminate the findings from the literature on interventions for dysphagia in nursing home residents. Searches were conducted in four databases. The criteria for including the studies were nursing home residents, dysphagia, interventions, original research, published in English, Danish, Norwegian, or Swedish with no restriction placed regarding publication date. Excluded were literature reviews, editorial comments, conference abstracts, protocols, papers not available in full text, and studies with a mixed population, for example, geriatric patients and nursing home residents and where the results were not separated between the groups. A total of 14 papers were included and analyzed. The included papers represented interventions focusing on feeding intervention, oral hygiene, caregiver algorithm, stimulation (taste and smell), teaching the residents what to eat, mobilization of the spine, exercises/training, and positioning. This scoping review identifies sparse knowledge about interventions affecting nursing home residents' dysphagia. But the results indicate that multi-component interventions, including staff training, training of residents, and/or next of kin, might be successful. This scoping review clarifies that there is a need for well-designed studies that uncover which specific interventions have an effect in relation to nursing home residents with dysphagia and can serve as a guide for designing multi-component person-centered intervention studies. Future studies should implement high evidence study designs, define the measures of dysphagia, and quantify the severity of dysphagia, its underlying diseases, and comorbidities.

摘要

口腔吞咽困难在养老院居民中很常见。本综述的目的是总结和传播关于养老院居民吞咽困难干预措施的文献研究结果。我们在四个数据库中进行了检索。纳入研究的标准为:养老院居民、吞咽困难、干预措施、原创研究、以英文、丹麦文、挪威文或瑞典文发表,且对发表日期无限制。排除的文献包括文献综述、编辑评论、会议摘要、方案、无法获取全文的论文,以及研究对象为混合人群(如老年患者和养老院居民)且未对结果进行分组区分的研究。共纳入并分析了14篇论文。纳入的论文所代表的干预措施主要集中在喂食干预、口腔卫生、护理人员算法、刺激(味觉和嗅觉)、教导居民如何饮食、脊柱活动、锻炼/训练以及体位摆放。本综述发现,关于影响养老院居民吞咽困难的干预措施的知识较为匮乏。但结果表明,包括工作人员培训、居民培训和/或亲属培训在内的多成分干预措施可能会取得成功。本综述明确指出,需要开展精心设计的研究,以揭示哪些特定干预措施对养老院吞咽困难居民有效,并可为设计以患者为中心的多成分干预研究提供指导。未来的研究应采用高证据研究设计,明确吞咽困难的测量方法,并量化吞咽困难的严重程度、其潜在疾病和合并症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0537/8162353/1de9a2b4be59/geriatrics-06-00055-g001.jpg

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