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3D视频中吞咽动作的生理学与执行:将该技术融入患者护理

Physiology and Execution of Swallowing Maneuvers in 3D Videos: Integrating the Technology into Patient Care.

作者信息

Gatti Marina, Wen Chao Lung, Guedes Renata Lígia Vieira, Berretin-Felix Giédre

机构信息

Department of Speech Therapy, Faculty of Dentistry of Bauru, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Otávio Pinheiro Brisola, 9-75 - Vila Nova - Cidade Universitária - Bauru - SP - 17012-901, Bauru, São Paulo, Brazil.

Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.

出版信息

Dysphagia. 2024 Sep 20. doi: 10.1007/s00455-024-10753-8.

Abstract

Educational technologies have proven to be an effective way to guide and educate patients, allowing them to increase awareness of their dysphagia condition and how treatment will help them. In this sense, this study aimed to develop and validate the content and appearance of 3D iconographic videos, which addressed the physiological demonstration and execution of protective and facilitating swallowing maneuvers, as well as verifying the feasibility of its use in teleconsultation, having adults and elderly people with oropharyngeal dysphagia as the main target audience. The development of the 3D videos was elaborated based on a guiding scientific script, constructed from an integrative literature review. After the development of the 3D videos by the digital designer, a committee of 12 expert judges evaluated the material produced to validate the content and appearance where a minimum agreement index of 0.8 among the judges was considered satisfactory. Subsequently with the validated material, the proof of concept was conducted together with the target population of 10 dysphagic patients through individual teleconsultation via Google Meet platform. After the teleconsultation, patients responded to a Google Forms questionnaire, analyzing the videos presented. From the integrative literature review, 29 studies that contained relevant information about the physiological effects caused by swallowing maneuvers were selected. Based on this information, the scientific script was created, allowing a detailed description of the physiological events that occurred during swallowing while executing the maneuvers. With the finished script, 3D videos of swallowing maneuvers were produced. After developing the material, the committee of expert judges validated the content and appearance. The twelve items that had an agreement index below 0.8 were adjusted. Once the adjustments were completed, the videos were analyzed again, obtaining approval from the judges, and ensuring the validation of content and appearance of the material developed. A proof of concept was conducted on ten dysphagic patients. The maneuver applied was chosen according to the patient's physiological changes, causing only 4 of the 9 maneuvers to be tested, as the patients did not demonstrate changes in swallowing that would justify the use of the other maneuvers. After this, patients answered a form in which all items covered received positive evaluations, related to both ease of understanding and learning. This study allowed the development of the 3D videos with a didactic demonstration of the physiology and execution of protective and facilitating swallowing maneuvers, in addition to having its content and appearance validity assured through analysis by the committee of expert judges.

摘要

教育技术已被证明是指导和教育患者的有效方式,使他们能够提高对吞咽困难状况的认识以及了解治疗将如何帮助他们。从这个意义上说,本研究旨在开发和验证3D图像视频的内容和外观,这些视频涉及保护性和促进性吞咽动作的生理演示和执行,同时验证其在远程会诊中的使用可行性,主要目标受众为患有口咽吞咽困难的成年人和老年人。3D视频的开发基于一份指导性科学脚本,该脚本由综合文献综述构建而成。在数字设计师制作出3D视频后,一个由12名专家评委组成的委员会对所制作的材料进行评估,以验证内容和外观,评委之间的最低一致性指数达到0.8被认为是令人满意的。随后,使用经过验证的材料,通过谷歌Meet平台与10名吞咽困难患者的目标人群进行了个人远程会诊,开展概念验证。远程会诊后,患者对谷歌表单问卷做出回应,分析所展示的视频。通过综合文献综述,挑选出29项包含有关吞咽动作所引起生理效应相关信息的研究。基于这些信息,创建了科学脚本,从而能够详细描述在执行动作时吞咽过程中发生的生理事件。根据完成的脚本,制作了吞咽动作的3D视频。在制作完材料后,专家评委委员会对内容和外观进行了验证。对一致性指数低于0.8的12个项目进行了调整。调整完成后,再次对视频进行分析,获得评委的批准,并确保所开发材料的内容和外观得到验证。对10名吞咽困难患者进行了概念验证。根据患者的生理变化选择应用的动作,9个动作中仅测试了4个,因为患者并未表现出吞咽方面的变化,从而无法证明使用其他动作的合理性。在此之后,患者填写了一份表格,其中涵盖的所有项目均获得了与易于理解和学习相关的积极评价。本研究不仅开发出了具有保护性和促进性吞咽动作生理学及执行的教学演示的3D视频,还通过专家评委委员会的分析确保了其内容和外观的有效性。

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