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与被诊断为口咽吞咽困难的患者坚持吞咽治疗相关的因素。

Factors associated with adherence to swallowing therapy among patients diagnosed with oropharyngeal dysphagia.

作者信息

Ezeh Uche C, Balou Matina, Crosby Tyler, Kwak Paul E, Amin Milan R

机构信息

Department of Otolaryngology-Head and Neck Surgery NYU Langone Health New York New York USA.

出版信息

Laryngoscope Investig Otolaryngol. 2024 Sep 14;9(5):e1318. doi: 10.1002/lio2.1318. eCollection 2024 Oct.

Abstract

OBJECTIVE

The objective of this study is to assess disparities in adherence to swallowing therapy for clinically diagnosed oropharyngeal dysphagia (OD) patients.

METHODS

Analysis was conducted on data from 600 patients with OD and confirmed impairments in swallowing safety and/or efficiency on a videofluoroscopic swallow study. Patients were classified based on their adherence to treatment sessions, defined as the number of swallow treatment sessions attended. The outcome of treatment adherence was categorized into two groups: those who attended fewer than 50% of the prescribed treatment sessions and those who attended 50% or more of the sessions. Continuous variables were presented as mean ± standard deviation or median ± interquartile range. Categorical variables were compared using Pearson chi-square tests and Fisher's exact test when appropriate. Univariable and multivariable binary logistic regression models were employed to identify factors associated with successful adherence.

RESULTS

Approximately 79% adhered to swallowing treatment. We found no significant relationship between adherence and age, sex, race, ethnicity, primary language, marital status, insurance status, occupation, median income, distance, education, OD severity, and diagnosis year ( > 0.05). We found no covariables to be significant predictors to swallowing treatment nonadherence in both univariable and multivariable binary regression models ( > 0.05).

CONCLUSION

The variables analyzed in this study were not significantly associated with nonadherence to swallow therapy. Nevertheless, our study still addressed an important knowledge gap and future studies would benefit from exploring other relevant socioeconomic and disease-related factors.

LEVEL OF EVIDENCE

Level 4.

摘要

目的

本研究的目的是评估临床诊断为口咽吞咽困难(OD)患者在吞咽治疗依从性方面的差异。

方法

对600例OD患者的数据进行分析,这些患者在视频荧光吞咽造影检查中证实存在吞咽安全性和/或效率受损。根据患者对治疗疗程的依从性进行分类,依从性定义为参加吞咽治疗疗程的次数。治疗依从性结果分为两组:参加规定疗程少于50%的患者和参加50%或更多疗程的患者。连续变量以均值±标准差或中位数±四分位数间距表示。分类变量在适当情况下使用Pearson卡方检验和Fisher精确检验进行比较。采用单变量和多变量二元逻辑回归模型来确定与成功依从相关的因素。

结果

约79%的患者坚持吞咽治疗。我们发现依从性与年龄、性别、种族、民族、主要语言、婚姻状况、保险状况、职业、收入中位数、距离、教育程度、OD严重程度和诊断年份之间无显著关系(P>0.05)。在单变量和多变量二元回归模型中,我们均未发现任何协变量是吞咽治疗不依从的显著预测因素(P>0.05)。

结论

本研究中分析的变量与吞咽治疗不依从无显著关联。尽管如此,我们的研究仍填补了一个重要的知识空白,未来的研究将受益于探索其他相关的社会经济和疾病相关因素。

证据水平

4级。

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