护理主导的吞咽风险评估工具在养老院居民中的评估：一项前瞻性诊断准确性研究。
Evaluation of a nurse-led swallowing risk assessment tool in care-home residents: a prospective diagnostic accuracy study.
作者信息
Heaney Patricia, Annis-Marley Deborah, Gray William, Jones Louise, Scott Julia, Witham Miles D
机构信息
Department of Speech and Language Therapy, Northumbria Healthcare NHS Foundation Trust, North Shields, UK.
Speech & Language Therapy, The Oxford Centre, Newcastle upon Tyne, NE12 8LT, UK.
出版信息
Eur Geriatr Med. 2025 May 3. doi: 10.1007/s41999-025-01194-z.
PURPOSE
To develop and test a screening tool enabling care-home staff to identify residents with high-risk swallowing problems (dysphagia).
METHODS
The Nurse Dysphagia Screening Tool (NDST) was developed via an iterative, participatory process. A diagnostic evaluation study was performed in North-East of England care homes. We compared NDST with gold-standard speech and language therapist swallowing assessment risk category to derive sensitivity, specificity, and positive and negative predictive values.
RESULTS
One hundred and seventy two residents (101 women) were included from 14 care homes, mean age 82.1 years (SD 10.6). Residents known to SLT, or with Percutaneous Endoscopic Gastrostomy (PEG) were excluded. 18/172 (11%) had high-risk swallow by gold-standard assessment. NDST was completed successfully on all participants. Sensitivity, specificity, and positive and negative predictive values were 72%, 92%, 50%, and 97%, respectively. Sensitivity was higher (100%) in high-volume care homes and for those recruited late in the study, suggesting a learning curve.
CONCLUSION
NDST requires additional testing but can potentially identify high-risk dysphagia in care homes.
目的
开发并测试一种筛查工具，使养老院工作人员能够识别有吞咽问题高风险（吞咽困难）的居民。
方法
护士吞咽筛查工具（NDST）通过迭代式参与过程开发。在英格兰东北部的养老院进行了一项诊断评估研究。我们将NDST与金标准言语和语言治疗师吞咽评估风险类别进行比较，以得出敏感性、特异性以及阳性和阴性预测值。
结果
从14所养老院纳入了172名居民（101名女性），平均年龄82.1岁（标准差10.6）。已知接受言语和语言治疗师治疗或有经皮内镜下胃造口术（PEG）的居民被排除。根据金标准评估，18/172（11%）有吞咽高风险。所有参与者均成功完成了NDST。敏感性、特异性以及阳性和阴性预测值分别为72%、92%、50%和97%。在入住人数多的养老院以及研究后期招募的人群中，敏感性更高（100%），表明存在学习曲线。
结论
NDST需要进一步测试，但有可能识别养老院中吞咽困难的高风险人群。
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