1Chonnam National University Hospital, Gwangju
2College of Nursing, Chonnam National University․CRINS, Gwangju, Korea
© 2013 Korean Society of Adult Nursing
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| Characteristics | Categories | n (%) | Assessment | Intervention | ||||
|---|---|---|---|---|---|---|---|---|
| M±SD | t or F | p | M±SD | t or F | p | |||
| Age (year) | ≤59a | 22 (22.7) | 0.54±0.28 | 5.62 | .005 | 0.47±0.33 | 1.65 | .199 |
| 60~69b | 28 (28.8) | 0.40±0.21 | a>c | 0.35±0.29 | ||||
| ≥70c | 47 (48.5) | 0.36±0.16 | 0.32±0.30 | |||||
| Gender | Male | 58 (59.8) | 0.41±0.21 | 0.14 | .890 | 0.36±0.30 | -0.06 | .956 |
| Female | 39 (40.2) | 0.41±0.22 | 0.37±0.32 | |||||
| Diet | Regular dieta | 54 (55.7) | 0.39±0.16 | 9.84 c | <.001 | 0.33±0.26 | 3.11 | .030 |
| Soft dietb | 15 (15.5) | 0.32±0.11 | c>a, b, d | 0.28±0.27 | ||||
| Liquid dietc | 11 (11.3) | 0.70±0.28 | 0.61±0.33 | |||||
| Water feedingd | 17 (17.5) | 0.37±0.26 | 0.38±0.40 | |||||
| Stroke site | Left cerebrum | 47 (48.4) | 0.40±0.23 | 1.05 | .373 | 0.36±0.31 | 1.83 | .148 |
| Right cerebrum | 12 (22.7) | 0.44±0.21 | 0.41±0.33 | |||||
| Brain stem | 15 (15.5) | 0.35±0.14 | 0.22±0.12 | |||||
| Other | 13 (13.4) | 0.48±0.23 | 0.47±0.35 | |||||
| Paralysis site | Right | 50 (51.5) | 0.40±0.21 | 0.39 | .764 | 0.38±0.32 | 0.61 | .608 |
| Left | 29 (29.9) | 0.45±0.22 | 0.38±0.31 | |||||
| Limbs | 7 (7.3) | 0.41±0.30 | 0.29±0.30 | |||||
| None | 11 (11.3) | 0.38±0.20 | 0.26±0.23 | |||||
| Facial palsy | Yes | 77 (79.4) | 0.43±0.23 | 2.97 | .004 | 0.37±0.31 | 0.61 | .546 |
| No | 20 (20.6) | 0.32±0.12 | 0.33±0.30 | |||||
| History of aspiration pneumonia | Yes | 7 (7.2) | 0.80±0.35 | 3.12 | .020 | 0.72±0.38 | 3.32 | .001 |
| No | 90 (92.8) | 0.38±0.17 | 0.34±0.28 | |||||
| Previous CVA | Yes | 10 (10.3) | 0.42±0.24 | 0.15 | .881 | 0.26±0.20 | -1.11 | .272 |
| No | 87 (89.7) | 0.41±0.21 | 0.38±0.31 | |||||
| Type of CVA† | Large artery atherosclerosis | 28 (28.9) | 0.47±0.26 | 1.67 | .194 | 0.44±0.34 | 1.15 | .323 |
| Cardioembolism | 44 (45.4) | 0.37±0.18 | 0.34±0.31 | |||||
| Small artery occlusion | 23 (23.6) | 0.42±0.23 | 0.33±0.27 | |||||
| Stroke severity‡ | Mild | 68 (70.1) | 0.41±0.18 | 0.35 | .708 | 0.35±0.27 | 0.40 | .679 |
| Moderate | 20 (20.6) | 0.44±0.30 | 0.40±0.37 | |||||
| Severe | 9 (9.3) | 0.37±0.26 | 0.42±0.42 | |||||
Pilot Test for Internal Reliability of Checklist for Post-stroke Dysphagia (N=20)
| Variables | Assessment | Intervention | ||
|---|---|---|---|---|
| No of items | Cronbach's ⍺ | No of items | Cronbach's ⍺ | |
| Total | 19 | .85 | 70 | .98 |
| Awake and alert mental status | 1 | - | 4 | .23 |
| Sitting position for at least 15 minutes | 1 | - | 5 | .71 |
| Head control | 1 | - | 3 | .68 |
| Spontaneous cough | 1 | - | 2 | .92 |
| Lip open | 1 | - | 6 | .92 |
| Lip closing | 1 | - | 3 | .88 |
| Facial symmetry | 1 | - | 4 | .73 |
| Tongue movement | 1 | - | 3 | .88 |
| Jaw movement | 1 | - | 6 | .95 |
| Oral stasis | 1 | - | 4 | .90 |
| Swallow reflex | 1 | - | 3 | .92 |
| Wet voice | 1 | - | 6 | .95 |
| Shortness of breath after swallowing | 1 | - | 3 | .90 |
| Coughing during swallowing | 1 | - | 4 | .85 |
| Nasal regurgitation | 1 | - | 2 | .96 |
| Spontaneous cough after aspiration | 1 | - | 2 | .95 |
| Coughing after swallowing | 1 | - | 5 | .95 |
| Vomiting or regurgitation | 1 | - | 3 | .87 |
| Unpleasant breathing odor | 1 | - | 2 | .94 |
No=number.
Factor Analysis of Assessment Checklist for Post-stroke Dysphagia (N=97
| No | Components/Factor | Factor loading | Eigen value | Explained variance (%) | Accumulative variance (%) |
|---|---|---|---|---|---|
| General appearance (3) | 1.79 | 9.96 | 59.10 | ||
| 2 | Sitting position for at least 15 minutes | .84 | |||
| 1 | Awake and alert mental status | .65 | |||
| 3 | Head control | .44 | |||
| Preparation of oropharynx (5) | 2.48 | 13.80 | 38.42 | ||
| 10 | Oral stasis | .68 | |||
| 11 | Swallow reflex | .64 | |||
| 18 | Vomiting or regurgitation | .56 | |||
| 6 | Lip closing | .53 | |||
| 5 | Lip open | .48 | |||
| Preparation of swallowing (2) | 1.46 | 8.10 | 67.20 | ||
| 7 | Facial symmetry | .84 | |||
| 14 | Coughing during swallowing | .58 | |||
| Swallowing condition (2) | 1.93 | 10.72 | 49.14 | ||
| 4 | Spontaneous cough | .82 | |||
| 8 | Tongue movement | .81 | |||
| Early symptoms of aspiration (6) | 4.43 | 24.62 | 24.62 | ||
| 13 | Shortness of breath after swallowing | .86 | |||
| 16 | Spontaneous cough after aspiration | .82 | |||
| 15 | Nasal regurgitation | .75 | |||
| 19 | Unpleasant breathing odor | .74 | |||
| 17 | Coughing after swallowing | .74 | |||
| 12 | Wet voice | .73 |
No=number.
Internal Consistency of Checklist for Post-stroke Dysphagia (N=97
| Variables | Assessment | Intervention | ||
|---|---|---|---|---|
| No of items | Cronbach's ⍺ | No of items | Cronbach's ⍺ | |
| Total | 18 | .84 | 64 | .98 |
| General appearance | 3 | .42 | 12 | .78 |
| Sitting position for at least 15 minutes | 1 | 5 | .71 | |
| Awake and alert mental status | 1 | 4 | .75 | |
| Head control | 1 | 3 | .72 | |
| Preparation of oropharynx | 5 | .76 | 19 | .96 |
| Oral stasis | 1 | 4 | .90 | |
| Swallow reflex | 1 | 3 | .92 | |
| Vomiting or regurgitation | 1 | 3 | .87 | |
| Lip closing | 1 | 3 | .88 | |
| Lip open | 1 | 6 | .92 | |
| Preparation of swallowing | 2 | .55 | 8 | .84 |
| Facial symmetry | 1 | 4 | .73 | |
| Coughing during swallowing | 1 | 4 | .85 | |
| Swallowing condition | 2 | .71 | 5 | .92 |
| Spontaneous cough | 1 | 2 | .92 | |
| Tongue movement | 1 | 3 | .89 | |
| Early symptoms of aspiration | 6 | .89 | 20 | .99 |
| Shortness of breath after swallowing | 1 | 3 | .90 | |
| Spontaneous cough after aspiration | 1 | 2 | .95 | |
| Nasal regurgitation | 1 | 2 | .96 | |
| Unpleasant breathing odor | 1 | 2 | .98 | |
| Coughing after swallowing | 1 | 5 | .96 | |
| Wet voice | 1 | 6 | .95 | |
No=number.
Utilization of Checklists for Post-stroke Dysphagia (N=97)
| Variables | Assessment | Intervention |
|---|---|---|
| M±SD | M±SD | |
| Total | 0.42±0.21 | 0.36±0.31 |
| General appearance | 0.90±0.20 | 0.67±0.21 |
| Sitting position for at least 15 minutes | 0.88±0.33 | 0.55±0.26 |
| Awake and alert mental status | 0.98±0.14 | 0.80±0.21 |
| Head control | 0.86±0.35 | 0.65±0.36 |
| Preparation of oropharynx | 0.37±0.34 | 0.33±0.37 |
| Oral stasis | 0.41±0.49 | 0.39±0.43 |
| Swallow reflex | 0.34±0.48 | 0.35±0.44 |
| Vomiting or regurgitation | 0.28±0.45 | 0.29±0.40 |
| Lip closing | 0.33±0.47 | 0.30±0.41 |
| Lip open | 0.47±0.50 | 0.34±0.40 |
| Preparation of swallowing | 0.69±0.38 | 0.44±0.33 |
| Facial symmetry | 0.74±0.44 | 0.35±0.35 |
| Coughing during swallowing | 0.63±0.49 | 0.54±0.41 |
| Swallowing | 0.34±0.41 | 0.31±0.40 |
| Spontaneous cough | 0.43±0.50 | 0.37±0.47 |
| Tongue movement | 0.25±0.43 | 0.25±0.39 |
| Early symptoms of aspiration | 0.16±0.29 | 0.22±0.37 |
| Shortness of breath after swallowing | 0.14±0.35 | 0.19±0.36 |
| Spontaneous cough after aspiration | 0.12±0.33 | 0.22±0.41 |
| Nasal regurgitation | 0.10±0.31 | 0.24±0.42 |
| Unpleasant breathing odor | 0.12±0.33 | 0.22±0.40 |
| Coughing after swallowing | 0.21±0.41 | 0.22±0.37 |
| Wet voice | 0.24±0.43 | 0.25±0.39 |
Utilization of Two Checklists for Post-stroke Dysphagia according to General Characteristics (N=97)
| Characteristics | Categories | n (%) | Assessment | Intervention | ||||
|---|---|---|---|---|---|---|---|---|
| M±SD | t or F | p | M±SD | t or F | p | |||
| Age (year) | ≤59a | 22 (22.7) | 0.54±0.28 | 5.62 | .005 | 0.47±0.33 | 1.65 | .199 |
| 60~69b | 28 (28.8) | 0.40±0.21 | a>c | 0.35±0.29 | ||||
| ≥70c | 47 (48.5) | 0.36±0.16 | 0.32±0.30 | |||||
| Gender | Male | 58 (59.8) | 0.41±0.21 | 0.14 | .890 | 0.36±0.30 | -0.06 | .956 |
| Female | 39 (40.2) | 0.41±0.22 | 0.37±0.32 | |||||
| Diet | Regular dieta | 54 (55.7) | 0.39±0.16 | 9.84 c | <.001 | 0.33±0.26 | 3.11 | .030 |
| Soft dietb | 15 (15.5) | 0.32±0.11 | c>a, b, d | 0.28±0.27 | ||||
| Liquid dietc | 11 (11.3) | 0.70±0.28 | 0.61±0.33 | |||||
| Water feedingd | 17 (17.5) | 0.37±0.26 | 0.38±0.40 | |||||
| Stroke site | Left cerebrum | 47 (48.4) | 0.40±0.23 | 1.05 | .373 | 0.36±0.31 | 1.83 | .148 |
| Right cerebrum | 12 (22.7) | 0.44±0.21 | 0.41±0.33 | |||||
| Brain stem | 15 (15.5) | 0.35±0.14 | 0.22±0.12 | |||||
| Other | 13 (13.4) | 0.48±0.23 | 0.47±0.35 | |||||
| Paralysis site | Right | 50 (51.5) | 0.40±0.21 | 0.39 | .764 | 0.38±0.32 | 0.61 | .608 |
| Left | 29 (29.9) | 0.45±0.22 | 0.38±0.31 | |||||
| Limbs | 7 (7.3) | 0.41±0.30 | 0.29±0.30 | |||||
| None | 11 (11.3) | 0.38±0.20 | 0.26±0.23 | |||||
| Facial palsy | Yes | 77 (79.4) | 0.43±0.23 | 2.97 | .004 | 0.37±0.31 | 0.61 | .546 |
| No | 20 (20.6) | 0.32±0.12 | 0.33±0.30 | |||||
| History of aspiration pneumonia | Yes | 7 (7.2) | 0.80±0.35 | 3.12 | .020 | 0.72±0.38 | 3.32 | .001 |
| No | 90 (92.8) | 0.38±0.17 | 0.34±0.28 | |||||
| Previous CVA | Yes | 10 (10.3) | 0.42±0.24 | 0.15 | .881 | 0.26±0.20 | -1.11 | .272 |
| No | 87 (89.7) | 0.41±0.21 | 0.38±0.31 | |||||
| Type of CVA |
Large artery atherosclerosis | 28 (28.9) | 0.47±0.26 | 1.67 | .194 | 0.44±0.34 | 1.15 | .323 |
| Cardioembolism | 44 (45.4) | 0.37±0.18 | 0.34±0.31 | |||||
| Small artery occlusion | 23 (23.6) | 0.42±0.23 | 0.33±0.27 | |||||
| Stroke severity |
Mild | 68 (70.1) | 0.41±0.18 | 0.35 | .708 | 0.35±0.27 | 0.40 | .679 |
| Moderate | 20 (20.6) | 0.44±0.30 | 0.40±0.37 | |||||
| Severe | 9 (9.3) | 0.37±0.26 | 0.42±0.42 | |||||
CVA=cardiovascular attack.
†Excluded 2 undetermined cases;
‡Stroke severity was three levels as mild, moderate and severe, and range scores for three levels were 0 to 5, 6 to 13, and 14 and more than 14 in National Institutes of Health Stroke Scale (NIHSS), respectively.
No=number.
No=number.
No=number.
CVA=cardiovascular attack. Excluded 2 undetermined cases; Stroke severity was three levels as mild, moderate and severe, and range scores for three levels were 0 to 5, 6 to 13, and 14 and more than 14 in National Institutes of Health Stroke Scale (NIHSS), respectively.