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多方面干预方案对养老院居民进食能力的影响。

Effects of a Multifaceted Intervention Program on the Eating Ability of Nursing Home Residents.

机构信息

Chief of Long-Term Care Department, Jen-Ai Hospital, Taichung 41265, Taiwan.

Head Nurse of Nursing Home, Jen-Ai Hospital, Taichung 41265, Taiwan.

出版信息

Int J Environ Res Public Health. 2021 Aug 25;18(17):8951. doi: 10.3390/ijerph18178951.

Abstract

Oropharyngeal dysphagia is a common problem for nursing home residents that leads to aspiration pneumonia and malnutrition. Musculature surrounding head and neck and tongue strength are crucial for safe and efficient oropharyngeal swallowing. Oral hygiene facilitates the smooth swallowing. The aim of this study was thus to investigate the effects of a multifaceted intervention program which combines the interactive oral activities, tongue strength training and oral cleaning procedure on the eating ability of nursing home residents. A sequential, multiple time series, single-group quasi-experimental research design was used, and 41 residents were recruited to participate in this study. The study was divided into three phases, each lasting two months. In phase 1, the participants were conducting their usual activities, except that the outcome variables were measured on five occasions to obtain baseline data. Phase 2 was a two-month washout period, and phase 3 was the intervention period. Thirty-six residents completed phase 1, and 34 residents completed the phase 3 intervention period. The eight-week phase 3 intervention program comprised three sessions per day, conducted seven days a week, with each session lasting 15-20 min. Outcome variables were measured at weeks 0, 2, 4, 6, and 8 in phases 1 and 3 to evaluate the feasibility of the program. Following the intervention program, controlling for baseline differences, the patients' tongue strength, food consumption, mealtime duration, oral health, and dysphagia severity were significantly improved in phase 3 relative to phase 1. These improvements lasted through to at least 2 months posttest. The study illustrates that this multifaceted intervention program may be an effective approach for improving the eating ability of nursing home residents.

摘要

口咽吞咽困难是养老院居民常见的问题,可导致吸入性肺炎和营养不良。头颈部周围的肌肉和舌部力量对于安全有效的口咽吞咽至关重要。口腔卫生有助于顺利吞咽。因此,本研究旨在探讨一种多方面的干预方案,该方案结合了互动口腔活动、舌部力量训练和口腔清洁程序,以提高养老院居民的进食能力。采用序贯、多次时间序列、单组准实验研究设计,招募了 41 名居民参与本研究。研究分为三个阶段,每个阶段持续两个月。在第 1 阶段,参与者进行常规活动,但在五个时间点测量结果变量,以获得基线数据。第 2 阶段是为期两个月的洗脱期,第 3 阶段是干预期。36 名居民完成了第 1 阶段,34 名居民完成了第 3 阶段的干预期。为期 8 周的第 3 阶段干预方案包括每天进行 3 次,每周进行 7 次,每次持续 15-20 分钟。在第 1 阶段和第 3 阶段的 0、2、4、6 和 8 周测量结果变量,以评估方案的可行性。在干预方案之后,控制基线差异,与第 1 阶段相比,患者的舌部力量、食物摄入量、用餐时间、口腔健康和吞咽困难严重程度在第 3 阶段显著改善。这些改善至少持续到 2 个月后测试。该研究表明,这种多方面的干预方案可能是改善养老院居民进食能力的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd64/8430557/b1f9d254cf75/ijerph-18-08951-g001.jpg

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