PURPOSE
Aspiration pneumonia (AP) is the major complication of dysphagia in patients with acute stroke. Nursing management for dysphagia influences on patients' health outcomes. The purpose of this study was to develop and evaluate the effects of Dysphagia Nursing Protocol (DNP) for patients with acute stroke. We aimed to examine the incidence of AP and the dependency rate at the discharge.
METHODS
We used a non-equivalent control group posttest only design in this study. DNP was developed with content validity index > 0.75 in all items. This protocol was composed of the evaluation, education, complication prevention, and checking phases. After training the staff nurses, we applied DNP protocol to the experimental group. The control group was enrolled from June to August 2013 (n=80), and the experimental group was June to August 2014 (n=64).
RESULTS
The incidence of AP was 16.3% in control group while 4.7% in experimental group (p=.028), and the Odds Ratio (OR) was 0.26 (p=.045). The dependency ratio was 66.3% in control group while 43.8% in experimental group (p=.011), and the OR was 0.33 (p=.011).
CONCLUSION
DNP was beneficial for the reducing the risk of AP and the improved the functional status.

Citations

• Dysphagia and daily oral fluids among cerebrovascular stroke patients: an theory-based nursing intervention protocol
  Zeinab Hussein Ali, Marwa Abd-Elaziz, Amany Abdrbo
  Frontiers of Nursing.2023; 10(2): 213.     CrossRef

PURPOSE
The aim of this study was to describe the risk of dysphagia among older adults in senior centers and to find the relationships between the risk of dysphagia and dysphagia-specific quality of life.
METHODS
The participants were 260 community-dwelling older adults, aged 65 years in two senior centers. Data were collected by self-report questionnaires or face to face interviews. The instruments were the modified dysphagia risk assessment scale for elderly and dysphagia-specific quality of life questionnaire. The data were analyzed using t-test, chi2-test, logistic regression, and pearson's correlation.
RESULTS
162 older adults (62.3%) were classified as having the risk of dysphagia. Severe dry mouth (OR=15.677, CI=2.986~82.297), neurologic disease (OR=10.125, CI=1.092~93.899), gastritis (OR=5.731, CI=1.482~22.173), denture discomfort (OR=2.969, CI=1.016~8.677), teeth discomfort (OR=2.61, CI=1.311~5.196) were the significant factors predicting the risk of dysphagia. There is a significant correlation between the risk of dysphagia and dysphagia-specific quality of life.
CONCLUSION
Dysphagia could be a major health problem among community dwelling older adults. It can affect the dysphagia-specific quality of life. Older adults having severe dry mouth, neurologic disease, or gastritis should receive dysphagia risk assessment and proper management on a regular basis. An effective nursing intervention needs to be developed for the older adults with risk factors of dysphagia.

Citations

• Dysphagia and quality of life: a narrative review
  Jung Mi Song
  Annals of Clinical Nutrition and Metabolism.2024; 16(2): 43.     CrossRef
• Oral Health-Related Factors Associated with Dysphagia Risk among Older, Healthy, Community-Dwelling Korean Adults: A Pilot Study
  Da-Som Lee, Hee-Eun Kim, Jun-Seon Choi
  Healthcare.2024; 12(2): 267.     CrossRef
• Depression and Dysphagia-Specific Quality of Life in Patients Who Have Undergone Esophageal Cancer Surgery
  Jun-An Jeong, Yeon-Hwan Park
  Journal of the Korean Dysphagia Society.2024; 14(1): 41.     CrossRef
• The Review of Interventions to Improve the Swallowing Function in the Elderly
  Na-Yeon Tak, Hanna Gu, Hyoung-Joo Kim, Jun-Yeong Kwon, Hee-Jung Lim
  Journal of Dental Hygiene Science.2023; 23(2): 69.     CrossRef
• A qualitative research on the needs for oral care according to the subjective oral health status of the elderly
  
  Journal of Korean Society of Dental Hygiene.2023;[Epub]     CrossRef
• Effects of dental hygienist knowledge of dysphagia and preventive attitudes on educational needs for oral health in the older adults
  
  Journal of Korean Society of Dental Hygiene.2023;[Epub]     CrossRef
• Chief Complaints of Swallowing Problems in Korean Community-Dwelling Older Adults
  Han Kyeol Kim, Ja Young Kim, Soomin Kim, Ga-Young Kim, Nam-Bin Cho, Seok In Nam, Heecheon You, HyangHee Kim
  Communication Sciences & Disorders.2021; 26(2): 463.     CrossRef
• Risk Factors of Dysphagia Among Community-Dwelling Middle-Aged Women
  Young Hee Lee, Dukyoo Jung, Ok Jong Yun, Hyesoon Lee, Minkyung Lee
  Gastroenterology Nursing.2020; 43(2): 164.     CrossRef
• The Effects of the Oral Care Program for Improving Swallowing Function of the Elderly Using Welfare Centers on Depression, Self Efficacy, Subjective Oral Health Status and Swallowing related Quality of Life
  Gi Ran Lee, Doo Ree Kim, Hyo Nam Lim, Kyung Hee Kang
  Journal of Korean Academy of Community Health Nursing.2020; 31(2): 166.     CrossRef
• The Effects of Orofacial Myofunctional Training on the Changes of Lip and Tongue Strength in Elderly People
  Seol-Hee Kim, Min-Ju Kim, Seung-Hyun Lee, Bo-Wha Choi, Yae-Jee Heo
  Journal of Dental Hygiene Science.2019; 19(4): 279.     CrossRef
• Importance and Performance of Nutrition Management for In-Patients with Dysphagia Perceived by Dietitians at Clinical Settings in Seoul and Gyeonggi Areas
  Kyung-Eun Lee, Dasom Kim
  Journal of the East Asian Society of Dietary Life.2019; 29(5): 421.     CrossRef
• Nutrition Care Management Practices for In-Patients with Dysphagia in Korean Clinical Settings
  Dasom Kim, Kyung-Eun Lee
  Clinical Nutrition Research.2019; 8(4): 272.     CrossRef
• Comparative Analysis of Cognitive and Physical Function according to Dysphagia of Aged Patients in Geriatric Hospitals
  Jin Su Kim, Jeong Soo Kim
  Journal of Korean Gerontological Nursing.2019; 21(3): 190.     CrossRef
• Socio-demographic factors and diet-related characteristics of community-dwelling elderly individuals with dysphagia risk in South Korea
  Youngsuk Lim, Chorong Kim, Haeryun Park, Sooyoun Kwon, Oksun Kim, Heeyoung Kim, Youngmi Lee
  Nutrition Research and Practice.2018; 12(5): 406.     CrossRef
• Content Validity of the Swallowing Monitoring and Assessment Protocol for the Elderly
  HyangHee Kim, Ga-Young Kim, Hyun-Joung Lee
  Communication Sciences & Disorders.2018; 23(4): 1042.     CrossRef
• Prevalence and influencing factors of dysphagia in elderly patients
  Hyo-Jin Son, Yu-Mi Park, Sun-Young Yim, Yu-Ri Heo, Mee-Kyoung Son
  Oral Biology Research.2018; 42(4): 208.     CrossRef

Dysphagia is common and serious problem in intracerebral hemorrhage patients. Nasogastric-tube intubation is an important method for dysphagic patients who have an intracerebral hemorrhage. But many discomforts develope in patients with a nasogastric-tube. Therefore, it is necessary to decide when to remove the tube and as early as possible. The purpose of this study is to decide the applying time of training program to facilitate deglution for dysphagic patients who have intracerebral hemorrhage. Among the 343 patients with intracerebral hemorrhage who had been admitted to P-university hospital from April, 1994 to December, 1998, the medical record of the 110 patients with nasogastric tube were reviewed retrospectively. Results from the study were as follows: 1. Nasogastric tube insert duration of improved patients was a mean of 23.2 days 2. When a L-tube was inserted and removed, the L.O.C. of improved patients was 2.6+/-0.8(in the midst of stupor or a semicoma), 1.9+/-0.5(close to drowsy), respectively. This was signifcantly different(P=0.000). 3. When a L-tube was inserted and removed, GCS of improved patients was 9.3+/-2.9, 12.1+/-2.2 respectively. This was significantly different (P=0.000). 4. The duration of nasogastric tube insertion was the longest when in a stupor(L.O.C), 6~8 points(GCS).