Author Affiliations: Department of Nursing, Chang Gung Memorial Hospital, Linkou Branch (Mss MY Liu, Wang, and Lee); Department of Oncology, Chang Gung Memorial Hospital, Linkou Branch (Drs Chang and Wu); School of Nursing, College of Medicine, Chang Gung University (Ms HE Liu); Department of Rheumatology, Chang Gung Memorial Hospital (Ms HE Liu); and Department of Nursing, College of Nursing, Chang Gung University of Science and Technology (Ms HE Liu), Taoyuan, Taiwan.
Cancer Nurs. 2024;47(4):327-335. doi: 10.1097/NCC.0000000000001205. Epub 2023 Jan 26.
Dysphagia is a leading cause of aspiration pneumonia and negatively affects tolerance of chemoradiotherapy in patients with esophageal cancer.
This study aimed to assess a protocol for preventing the occurrence of aspiration pneumonia for adult patients with esophageal cancer experiencing swallowing dysfunction.
This study tested a dysphagia intervention that included high-risk patients confirmed by the Eating Assessment Tool questionnaire and Water Swallowing Test. A protocol guide (Interventions for Esophageal Dysphagia [IED]) to prevent aspiration pneumonia during chemoradiotherapy was also implemented. Thirty participants were randomly assigned to an intervention or control group. The study period was 50 days; participants were visited every 7 days for a total of 7 times. Instruments for data collection included The Eating Assessment Tool, Water Swallowing Test, and personal information. The IED was administered only to the experimental group. All data were managed using IBM SPSS statistics version 21.0.
The IED significantly reduced the occurrence of aspiration pneumonia ( P = .012), delayed the onset of aspiration pneumonia ( P = .005), and extended the survival time ( P = .007) in the experimental group.
For patients with esophageal cancer undergoing chemoradiotherapy, this protocol improved swallowing dysfunction and reduced aspiration pneumonia.
The IED protocol should be included in continuous educational training for clinical nurses to help them become familiar with these interventions and to provide these strategies to patients.
吞咽困难是导致吸入性肺炎的主要原因，会降低食管癌患者对放化疗的耐受性。
本研究旨在评估一种预防成人吞咽功能障碍食管癌患者发生吸入性肺炎的方案。
本研究测试了一种吞咽障碍干预措施，该措施包括通过饮食评估工具问卷和饮水吞咽试验确认的高危患者。还实施了预防放化疗期间吸入性肺炎的协议指南（食管吞咽障碍干预[IED]）。30 名参与者被随机分配到干预组或对照组。研究期间为 50 天；参与者每 7 天接受一次访问，共 7 次。用于数据收集的仪器包括饮食评估工具、饮水吞咽试验和个人信息。IED 仅在实验组中使用。所有数据均使用 IBM SPSS statistics 版本 21.0 进行管理。
IED 显著降低了实验组吸入性肺炎的发生率（P =.012），延迟了吸入性肺炎的发病时间（P =.005），并延长了生存时间（P =.007）。
对于接受放化疗的食管癌患者，该方案改善了吞咽功能障碍，降低了吸入性肺炎的发生率。
IED 方案应纳入临床护士的持续教育培训中，帮助他们熟悉这些干预措施，并为患者提供这些策略。
