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帕金森病患者对吞咽困难评估与治疗的认知

Perceptions of Dysphagia Evaluation and Treatment Among Individuals with Parkinson's Disease.

作者信息

Bartlett Rebecca S, Walters Andrew S, Stewart Rosa S, Wayment Heidi A

机构信息

Communication Sciences and Disorders, Northern Arizona University, Rm 313 208 E. Pine Knoll Drive, Flagstaff, AZ, 86011, USA.

Department of Psychological Sciences, Northern Arizona University, Rm 323, Flagstaff, United States.

出版信息

Dysphagia. 2025 Feb;40(1):248-262. doi: 10.1007/s00455-024-10723-0. Epub 2024 Jun 5.

Abstract

Dysphagia is a leading cause of morbidity and mortality among individuals with Parkinson's disease (PD). The primary objectives of the present study were to explore patients' narrative reports focused on what information and evaluation and treatment experiences they identified as they manage dysphagia, and to identify practice patterns relevant to dysphagia management. A secondary objective was to produce an educational resource for this population that addressed their questions about dysphagia. A sample of individuals with oropharyngeal dysphagia secondary to PD (n = 25) across all regions of the United States were interviewed using open- and closed questions and a written questionnaire. Verbatim interview transcripts were interrogated using qualitative content analysis (QCA) with an inductive approach to identify themes from the participants' reported knowledge of dysphagia and experiences with swallowing evaluation and treatment. Authors developed a pamphlet addressing common questions that participants posed in the interviews and conducted a member check to revise it with their feedback. Most participants reported having been asked about their swallowing function by a healthcare professional. 60% of the sample reported having had a swallowing evaluation. Only 20% (5/25) of participants reported having completed swallowing therapy. Some participants did not know that swallowing therapy exists. Nearly all participants reported having a strong desire to know more about dysphagia and preferred a pamphlet as a resource format. Few of the study participants had received swallowing therapy, and nearly all participants were eager to learn about the nature of dysphagia, its progression, and treatment options. Given the physical, emotional, and social ramifications of living with dysphagia, access to swallowing education and treatment needs to be a stronger focus of PD management.

摘要

吞咽困难是帕金森病(PD)患者发病和死亡的主要原因。本研究的主要目的是探讨患者的叙述性报告,重点关注他们在应对吞咽困难时所确定的信息、评估和治疗经历,并确定与吞咽困难管理相关的实践模式。次要目的是为该人群制作一份教育资源,以解答他们关于吞咽困难的问题。我们对美国所有地区患有继发于帕金森病的口咽吞咽困难的个体样本(n = 25)进行了访谈,采用开放式和封闭式问题以及书面问卷。逐字记录的访谈转录本采用定性内容分析(QCA)和归纳法进行分析,以从参与者报告的吞咽困难知识以及吞咽评估和治疗经历中识别主题。作者编写了一本小册子,解答参与者在访谈中提出的常见问题,并进行了成员核对,根据他们的反馈进行修订。大多数参与者报告称医疗保健专业人员曾询问过他们的吞咽功能。60%的样本报告接受过吞咽评估。只有20%(5/25)的参与者报告完成了吞咽治疗。一些参与者不知道有吞咽治疗。几乎所有参与者都表示强烈希望更多地了解吞咽困难,并更喜欢小册子作为资源形式。很少有研究参与者接受过吞咽治疗,几乎所有参与者都渴望了解吞咽困难的性质、进展和治疗选择。鉴于吞咽困难对身体、情感和社会的影响,获得吞咽教育和治疗需要成为帕金森病管理中更关注的重点。

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