Lu Qing-Yi, Bu Man-Rong, Zhu Yang, Huang Zhi-Yu, Gao Shi-Hao, Yuan Changyan
Department of Rehabilitation, Daping Hospital, Army Medical University, Chongqing, 40042, People's Republic of China.
Nursing Department, Daping Hospital, Army Medical University, Chongqing, 40042, People's Republic of China.
J Multidiscip Healthc. 2025 Aug 4;18:4629-4641. doi: 10.2147/JMDH.S531891. eCollection 2025.
Dysphagia is one of the most common complications in post-stroke patients, post-stroke medical disease management (eg, thrombectomy procedures) do have a huge influence on the long-term outcomes, with frontline clinical nurses serving as pivotal gatekeepers for early identification and management in post-stroke dysphagia (PSD). However, nurses, especially those in low- and middle-income countries, generally lack the ability to manage PSD, and the current state of Chinese public hospital registered nurses' relevant clinical practice remains unclear.
This study aims to evaluate how registered nurses, on initial clinical contact, screen and manage post-stroke dysphagia. A multi-center descriptive cross-sectional design was utilized.
From March 2 to April 18, 2024, 1010 nurses from 14 provinces in China completed an online questionnaire through convenient sampling. After applying inclusion and exclusion criteria, 943 valid questionnaires were included in the final analysis-the self-reported questionnaire collected data on knowledge of dysphagia, attitude and practices. Data were analyzed using descriptive statistics. This study adhered to the STROBE checklist guidelines.
The study involved 943 nurses, mostly from tertiary hospitals (71.05%) and stroke-related departments (68.93%). Only 2.86% were specialized dysphagia nurses. Dysphagia was identified using formal screening tools, with the 30-ml water swallowing test (87.8%) and repeated saliva swallowing test (77.2%) being most common. Screening was often conducted before the first intake of food, water, or medication (65.11%), and involved multiple personnel, including nurses (67.44%) and doctors (77.62%). Management strategies included nutritional support (83.46%), oral hygiene improvements (86.96%), rehabilitation exercises (86.96%), medication adjustments (75.4%), and referrals, primarily to doctors (71.58%), rehabilitation therapists (68.82%) and SLPs were referred after positive testing (44.54%).
This study reflects the current practices of Chinese nurses in screening and managing dysphagia, highlighting gaps between clinical practice and guidelines. The findings provide a theoretical foundation for policymakers to enhance training programs and workforce development, ultimately improving nursing practice quality.
吞咽困难是中风后患者最常见的并发症之一，中风后的医疗疾病管理（如血栓切除术）对长期预后有巨大影响，一线临床护士是中风后吞咽困难（PSD）早期识别和管理的关键把关人。然而，护士，尤其是低收入和中等收入国家的护士，通常缺乏管理PSD的能力，中国公立医院注册护士的相关临床实践现状仍不明确。
本研究旨在评估注册护士在初次临床接触时如何筛查和管理中风后吞咽困难。采用多中心描述性横断面设计。
2024年3月2日至4月18日，来自中国14个省份的1010名护士通过便利抽样完成了一份在线问卷。应用纳入和排除标准后，943份有效问卷纳入最终分析——自我报告问卷收集了关于吞咽困难知识、态度和实践的数据。数据采用描述性统计进行分析。本研究遵循STROBE清单指南。
该研究涉及943名护士，大多来自三级医院（71.05%）和中风相关科室（68.93%）。只有2.86%是专门的吞咽困难护士。使用正式筛查工具识别吞咽困难，30毫升水吞咽试验（87.8%）和反复唾液吞咽试验（77.2%）最为常见。筛查通常在首次摄入食物、水或药物之前进行（65.11%），且涉及多名人员，包括护士（67.44%）和医生（77.62%）。管理策略包括营养支持（83.46%）、改善口腔卫生（86.96%）、康复锻炼（86.96%）、药物调整（75.4%）以及转诊，主要转诊给医生（71.58%）、康复治疗师（68.82%），阳性检测后转诊给言语语言病理学家的比例为44.54%。
本研究反映了中国护士在筛查和管理吞咽困难方面的当前实践，突出了临床实践与指南之间的差距。研究结果为政策制定者加强培训项目和劳动力发展提供了理论基础，最终提高护理实践质量。
