Steele C M, Greenwood C, Ens I, Robertson C, Seidman-Carlson R
Baycrest Centre for Geriatric Care, North York, Ontario, Canada.
Dysphagia. 1997 Winter;12(1):43-50; discussion 51. doi: 10.1007/pl00009517.
A mealtime screening tool was administered to 349 residents of a home for the aged to determine the prevalence of mealtime difficulties including, but not limited to, dysphagia. Mealtime difficulties, as assessed during a single meal observation of each resident, were documented in 87% of these individuals. Though 68% exhibited signs of dysphagia, 46% had poor oral intake, 35% had positioning problems, and 40% exhibited challenging behaviors. An increased prevalence of mealtime difficulties was related to both the presence and degree of cognitive impairment. Oral intake was best among residents with severe cognitive impairment, many of whom received partial to total feeding assistance. In contrast, poor oral intake was associated with mild-moderate cognitive impairment, pointing to a need for more aggressive intervention with this group. The results clearly demonstrate that the prevalence of a wide range of eating-related problems far exceeds accepted estimates of dysphagia alone and support a multidisciplinary approach to mealtime interventions for the institutionalized elderly. Additionally, the magnitude of problems identified has implications for both resource and staff-training requirements in long-term care facilities.
对一家养老院的349名居民使用了一种用餐筛查工具，以确定用餐困难的患病率，包括但不限于吞咽困难。在对每位居民的单次用餐观察中评估出的用餐困难，在这些人中有87%被记录下来。虽然68%的人表现出吞咽困难的迹象，但46%的人口腔摄入量不佳，35%的人有体位问题，40%的人表现出具有挑战性的行为。用餐困难患病率的增加与认知障碍的存在和程度都有关。重度认知障碍居民的口腔摄入量最好，其中许多人接受了部分或全部喂食帮助。相比之下，口腔摄入量不佳与轻度至中度认知障碍有关，这表明需要对这组人采取更积极的干预措施。结果清楚地表明，各种与饮食相关问题的患病率远远超过仅吞咽困难的公认估计，并支持对机构养老老年人的用餐干预采取多学科方法。此外，所发现问题的严重程度对长期护理机构的资源和人员培训要求都有影响。
