Abstract
The demand for methods to ensure safe oral consumption of food and liquids in order to prevent aspiration pneumonia has increased over the last decade. This study investigated the safety of swallowing care selected by adding ultrasound-based observation, evaluated its efficacy, and determined effective content of selected swallowing care. The study employed a pragmatic quasi-experimental research design. Participants were 12 community-dwelling adult patients (age: 44–91 years) who had experienced choking within 1 month prior to the study. After the control phase, in which conventional swallowing care was provided, trained nurses provided ultrasound observation-based swallowing care for a minimum period of 2 weeks. Outcome measurements were compared across three points, namely T1—beginning of the control phase, T2 and T3—before and end of the intervention phase. The mean durations of intervention were 30.8 days in the control phase and 36.5 days in the intervention phase. Pneumonia and suffocation did not occur in the control phase or the intervention phase. The safe intake food level and the food intake level score significantly improved during the intervention phase (p = 0.032 and 0.017, respectively) by adding eating training based on the ultrasound observation. However, there was no significant improvement in the strength of the muscle related to swallowing by the selected basic training. Our results suggest that swallowing care selected based on the ultrasound observation, especially eating training, safely improved safe oral intake among community-dwelling adults with swallowing dysfunction.
Highlights
Aspiration pneumonia is one of the leading causes of death in patients with swallowing dysfunction [1]
The swallowing care regime was selected based on the algorithm; the nurses modified the swallowing care regime in patients who could not perform basic training, posture adjustment, or residue clearance due to cognitive or physical impairments (Table 2)
Our findings suggest that ultrasound observation of postswallowing residues in the epiglottis valley and algorithm-based swallowing care by well-trained general nurses would not increase the risk of aspiration pneumonia
Summary
Aspiration pneumonia is one of the leading causes of death in patients with swallowing dysfunction [1]. As over 50% patients believe that relying on a feeding tube to live is the same as or even worse than death [5], a basic strategy in dysphagia care is to help patients with swallowing dysfunction continue to consume food and liquid safely for as long as possible [6] This strategy contributes to preventing community-dwelling patients from presenting into a hospital due to pneumonia caused by aspiration and pharyngeal residues. The gold standard methods for direct observation of aspiration and pharyngeal postswallow residue include the videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES) [7,8] Direct observation such as VFSS and VEES is usually provided by physicians or dentists in Japan [9,10]. Nurses have some difficulties providing swallowing care because correct information is lacking about the patient’s swallowing function more than 1 month until physicians perform VESS or VFSS [13]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
