Shortland Hollie-Ann L, Hewat Sally, Webb Gwendalyn, Vertigan Anne E
Speech Pathology, School of Health Sciences, College of Health, Medicine & Wellbeing, University of Newcastle, Newcastle, Australia.
John Hunter Hospital, Newcastle, Australia.
Pilot Feasibility Stud. 2022 Aug 19;8(1):187. doi: 10.1186/s40814-022-01148-3.
Poor oral health is a known predictor of aspiration pneumonia in vulnerable populations such as the elderly and chronically ill and has been linked to systemic disease, morbidity, and mortality. Reduced oral health not only places individuals at a greater risk of aspiration pneumonia but may result in pain or poorer dentition which can impact on mastication and swallowing. Consequences of this may include reduced oral intake, malnutrition, poorer health outcomes, and reduced quality of life. Few evidence-based protocols exist to manage oral care in aged care populations, and maintenance of good oral hygiene is difficult for nursing and care staff to facilitate. However, a recent literature review found that improvements in oral hygiene, oral behaviors, and swallowing, along with breathing and speech have been found to be associated with the use of myofunctional devices due to positive changes in orofacial functions such as lip seal, mastication, swallowing, and nasal breathing patterns. The primary aim of this study is to assess the feasibility of using a myofunctional device to improve oral care and swallowing function in an aged care population.
METHODS/DESIGN: This project is a feasibility study that involves a 5-week intervention for oral hygiene and dysphagia for residents >65 years old in an aged care setting. Feasibility will be determined by the acceptability of the intervention, study recruitment and retention, and adherence to the intervention. Feasibility testing will also include an evaluation of clinical outcome measures, and sensitivity to detect changes in oral health and swallowing in an aged care population.
The results of this trial will provide important information regarding the feasibility of utilizing a myofunctional device to improve oral care and dysphagia in elderly patients in an aged care facility. This knowledge will further guide and inform design of a larger trial or future research.
This trial was registered August 10, 2021, with the Australian New Zealand Clinical Trials Registry and allocated the ACTRN: ACTRN12621001359820.
口腔健康状况不佳是老年人和慢性病患者等弱势群体发生吸入性肺炎的已知预测因素，并且与全身性疾病、发病率和死亡率相关。口腔健康状况下降不仅会使个体发生吸入性肺炎的风险更高，还可能导致疼痛或牙齿状况较差，进而影响咀嚼和吞咽。其后果可能包括口腔摄入量减少、营养不良、健康状况较差以及生活质量下降。在老年护理人群中，几乎没有基于证据的方案来管理口腔护理，护理人员很难促进良好口腔卫生的维持。然而，最近的一项文献综述发现，由于口面部功能（如唇闭合、咀嚼、吞咽和鼻呼吸模式）的积极变化，口腔卫生、口腔行为、吞咽以及呼吸和言语的改善与使用肌功能矫治器有关。本研究的主要目的是评估在老年护理人群中使用肌功能矫治器改善口腔护理和吞咽功能的可行性。
方法/设计：本项目是一项可行性研究，对老年护理机构中65岁以上的居民进行为期5周的口腔卫生和吞咽困难干预。可行性将由干预的可接受性、研究招募和保留情况以及对干预的依从性来决定。可行性测试还将包括对临床结局指标的评估，以及在老年护理人群中检测口腔健康和吞咽变化情况的敏感性。
本试验的结果将提供有关在老年护理机构中利用肌功能矫治器改善老年患者口腔护理和吞咽困难可行性的重要信息。这些知识将进一步指导和为更大规模试验或未来研究的设计提供信息。
本试验于2021年8月10日在澳大利亚新西兰临床试验注册中心注册，注册号为：ACTRN12621001359820。
