为支持神经发育障碍幼儿的进食、饮水和吞咽困难而提供家长主导的干预措施，创建 FEEDS 工具包：基于神经发育诊断和医疗保健专业角色的干预使用情况。

Informing creation of the FEEDS Toolkit to support parent-delivered interventions for eating, drinking and swallowing difficulties in young children with neurodisability: intervention use by neurodevelopmental diagnosis and healthcare professional role.

机构信息

Newcastle University Population Health Sciences Institute, Newcastle upon Tyne, UK.

Northumbria Healthcare NHS Foundation Trust, North Shields, UK.

出版信息

BMJ Paediatr Open. 2024 Aug 24;8(1):e002394. doi: 10.1136/bmjpo-2023-002394.

DOI:10.1136/bmjpo-2023-002394

PMID:39181695

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11733779/

Abstract

BACKGROUND

The FEEDS (Focus on Early Eating, Drinking and Swallowing) study focused on interventions used to improve feeding for children with neurodisability and eating, drinking and swallowing difficulties (EDSD), and the outcomes viewed as important by healthcare professionals (HPs) and parent carers. The FEEDS Toolkit was created subsequently as an intervention decision aid to be used collaboratively by parent carers and HPs. This study aimed to inform on current intervention practices and influence toolkit design by ascertaining whether specific intervention use varied by a child's main diagnosis and by specific HP role.

METHODS

FEEDS survey data were grouped by child's main diagnosis and HP role. Main diagnoses included autism spectrum disorder (ASD) n=183; Down syndrome (DS) n=69; cerebral palsy (CP) n=30). HPs included were speech and language therapists (SLT) n=131; occupational therapists (OT) n=63; physiotherapists (PT) n=57; paediatricians n=50; dieticians n=40; nurses n=32 and health visitors n=14.

RESULTS

Most interventions were used commonly across diagnoses. However, some interventions were used more commonly with specific conditions, for example, positioning (CP 85%, DS 70%, ASD 23%, strategies/programmes aimed at changing behaviour at mealtimes (ASD 52%, CP 8%, DS 11%); visual supports (ASD 58%, CP 0%, DS 21%). HPs reported using a broad range of interventions, SLTs (mean=13.9), dieticians (12.3), OTs (12.7) and paediatricians (11.1). There was overlap between intervention use and HP role, for example, positioning (100% PT, 97% SLT, 94% OT, 73% paediatricians and 69% nurses).

CONCLUSIONS

Interdisciplinary working is common when managing EDSD, with all HP types using multiple interventions. A child's main diagnosis does not substantially influence intervention use, and the individual context of each child requires consideration in intervention selection. Study findings have supported development of the FEEDS Toolkit for use in feeding services.

摘要

背景

FEEDS（关注早期进食、饮水和吞咽）研究侧重于改善神经发育障碍儿童的喂养以及进食、饮水和吞咽困难（EDSD）的干预措施，以及医疗保健专业人员（HPs）和家长照顾者认为重要的结果。随后创建了 FEEDS 工具包，作为一种干预决策辅助工具，由家长照顾者和 HPs 共同使用。本研究旨在通过确定特定干预措施的使用是否因儿童的主要诊断和特定 HP 角色而异，来了解当前干预措施的实践情况并影响工具包的设计。

方法

FEEDS 调查数据按儿童的主要诊断和 HP 角色进行分组。主要诊断包括自闭症谱系障碍（ASD）n=183；唐氏综合征（DS）n=69；脑瘫（CP）n=30）。HPs 包括言语治疗师（SLT）n=131；作业治疗师（OT）n=63；物理治疗师（PT）n=57；儿科医生 n=50；营养师 n=40；护士 n=32 和健康访视员 n=14。

结果

大多数干预措施在不同诊断中普遍使用。然而，一些干预措施在特定情况下更常用，例如定位（CP 85%，DS 70%，ASD 23%），旨在改变用餐时间行为的策略/方案（ASD 52%，CP 8%，DS 11%）；视觉支持（ASD 58%，CP 0%，DS 21%）。HPs 报告使用了广泛的干预措施，SLTs（平均 13.9），营养师（12.3），OT（12.7）和儿科医生（11.1）。干预措施的使用与 HP 角色之间存在重叠，例如定位（100% PT、97% SLT、94% OT、73% 儿科医生和 69% 护士）。