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专业护理机构中仪器吞咽评估后患者饮食状况/限制的分析

Analysis of Patients' Dietary Status/Restrictions Following Instrumental Swallow Evaluations in Skilled Nursing Facilities.

作者信息

Hopkins-Rossabi Theresa, Lenze Amy, Lindler Sarah Carter, Hardy Catherine, Temple Sarah Labruce

机构信息

Department of Rehabilitation Sciences, College of Health Professions, Medical University of South Carolina, 151B Rutledge Ave, 416A, Charleston, SC, 29425, USA.

出版信息

Dysphagia. 2025 Apr;40(2):476-488. doi: 10.1007/s00455-024-10750-x. Epub 2024 Aug 30.

Abstract

Many residents in Skilled Nursing Facilities (SNFs) present with dysphagia and receive altered diets or liquids to minimize the risk of complications. Limited access to timely instrumental evaluations of swallow may impede the best management of these dysphagic residents. De-identified FEES reports completed by a mobile FEES company during a single month, January 2019, were reviewed. Descriptive statistics were used to summarize the pre-study diet/liquid levels and the post-study diet/liquid recommendations. FEES reports (n = 952) were reviewed. Before the FEES evaluation, 209 residents were receiving only non-oral nutrition. After the FEES evaluation, 76% of these residents were recommended to receive oral nutrition. Before the FEES evaluation, 442 (46%) residents were receiving thickened liquids, after the FEES evaluation, 244 (26%) were recommended to have a less restrictive liquid level. Before the FEES evaluation, 576 (60%) residents were receiving altered food texture, after the FEES evaluation, 413 (43%) were recommended to have a less restrictive food texture. The percentage of residents recommended to receive thin liquids increased from 32 to 68% and those recommended to receive a regular diet increased from 18 to 34%. These data indicate that access to instrumental swallow evaluations in the SNF setting generally resulted in lifting liquid and diet restrictions for many residents in the cohort reviewed and potentially improved their quality of life.

摘要

许多入住专业护理机构(SNFs)的居民存在吞咽困难,因此接受调整后的饮食或流食,以尽量降低并发症风险。难以获得及时的吞咽仪器评估可能会妨碍对这些吞咽困难居民的最佳管理。我们回顾了一家移动吞咽功能内镜检查(FEES)公司在2019年1月这一个月内完成的匿名FEES报告。使用描述性统计来总结研究前的饮食/流食水平以及研究后的饮食/流食建议。共回顾了952份FEES报告。在进行FEES评估之前,209名居民仅接受非经口营养。FEES评估之后,这些居民中有76%被建议接受经口营养。在FEES评估之前,442名(46%)居民接受增稠流食,FEES评估之后,244名(26%)居民被建议采用限制较少的流食水平。在FEES评估之前,576名(60%)居民接受改变质地的食物,FEES评估之后,413名(43%)居民被建议采用限制较少的食物质地。被建议接受稀流食的居民比例从32%增至68%,被建议接受常规饮食的居民比例从18%增至34%。这些数据表明,在SNF环境中进行吞咽仪器评估,通常会使所回顾队列中的许多居民解除流食和饮食限制,并可能改善他们的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d0a/11893628/f4896513091e/455_2024_10750_Fig1_HTML.jpg

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