Estupiñán Artiles Constantino, Donnellan Claire, Regan Julie, Mooney Mary
School of Nursing and Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland.
School of Nursing and Midwifery, Edith Cowan University, Perth, WA, Australia.
Dysphagia. 2025 Jun;40(3):614-625. doi: 10.1007/s00455-024-10762-7. Epub 2024 Oct 3.
Dysphagia affects up to 70% of older adults living in residential long-term care settings (RLTCS) and may lead to serious complications if not identified and adequately managed. However, there is a dearth of clinical guidelines tailored to older adults at risk of dysphagia in RLTCS. An online survey consisting of 40 questions was conducted to identify dysphagia screening practices, referral patterns and interventions implemented by nurses in cases of suspected dysphagia, to quantify the number of residents with dysphagia, episodes of aspiration pneumonia in the previous year, and use of modified texture diets and fluids and explore differences between groups of RLTCS. The survey was developed using Qualtrics XM Platform and circulated via email, with one response per RLTCS sought. Data were analysed using RStudio. Of the 429 RLTCS contacted, 45 completed and returned the survey, a 10.5% response rate. Dysphagia screening practices, referral patterns, and dysphagia management interventions varied across participating RLTCS. All participants reported that they observe for signs and symptoms of dysphagia at mealtimes to identify residents at-risk of dysphagia. Ninety six percent of RLTCS reported referring residents with suspected dysphagia to speech and language therapy dysphagia services. A diagnosis of dysphagia was reported in 35.3% of residents. All participating RLTCS reported providing modified texture diets and fluids if residents had suspected dysphagia. The implementation of standardised and validated dysphagia screening protocols in RLTCS in the Republic of Ireland may be useful in supporting the identification of at-risk residents.
吞咽困难影响着居住在长期护理机构（RLTCS）中的多达70%的老年人，如果未被识别和妥善管理，可能会导致严重并发症。然而，针对RLTCS中有吞咽困难风险的老年人，缺乏量身定制的临床指南。开展了一项由40个问题组成的在线调查，以确定护士在疑似吞咽困难病例中的吞咽困难筛查做法、转诊模式和实施的干预措施，量化吞咽困难居民的数量、上一年吸入性肺炎的发作次数，以及改良质地饮食和液体的使用情况，并探讨不同RLTCS组之间的差异。该调查使用Qualtrics XM平台开发，并通过电子邮件分发，每个RLTCS寻求一份回复。使用RStudio对数据进行分析。在联系的429个RLTCS中，45个完成并返回了调查，回复率为10.5%。各参与的RLTCS的吞咽困难筛查做法、转诊模式和吞咽困难管理干预措施各不相同。所有参与者都报告说，他们在进餐时观察吞咽困难的体征和症状，以识别有吞咽困难风险的居民。96%的RLTCS报告将疑似吞咽困难的居民转诊至言语和语言治疗吞咽困难服务部门。35.3%的居民被报告诊断为吞咽困难。所有参与的RLTCS都报告说，如果居民疑似吞咽困难，会提供改良质地的饮食和液体。在爱尔兰共和国的RLTCS中实施标准化和经过验证的吞咽困难筛查方案，可能有助于识别有风险的居民。
