Effects of diet interventions on aspiration pneumonia in elderly patients with dysphagia based on multi-disciplinary management

Abstract

Objective To explore the effects of the diet safety instructions and interventions on aspiration pneumonia in elderly patients with dysphagia. Methods The multidisciplinary team was established involved clinical physicians, dietitians, therapists and nurses. The study investigated 40 elderly long-stay patients with dysphagia who were capable of oral feeding were selected according with the inclusive criteria. After the swallowing assessment and diet safety instructions, the participants were divided into intervention group (n=20) and control group (n=20) under the principle of voluntariness and matching selection. The patients of intervention groups were supplied with all mushy diet; the patients of control group had semi-solid, thick liquid, partial mushy diet, etc. depended on participants′ swallowing situations and tastes. Both groups of patients were oral feeding on their own or with help. The incidence of bucking, food refusal and feeding time per meal were investigated during the three months, and the aspiration pneumonia incidence of two groups were retrospectively analyzed three months before interventions. Results In the intervention group, the incidence of bucking (109), food refusal (22) and feeding time per meal [(18.64±5.05) min] were lower than those in the control group [bucking (272); food refusal (135); feeding time per meal (25.78±8.37)min] (χ2=7.369, 4.433; t=-4.363; P<0.05). After three months′ interventions, the incidence of aspiration pneumonia in both groups was decreased that the intervention group was 13∶4 and the control group was 11∶7 (χ2=20.742, 13.809; P<0.05). The control group had two cases with bucking aspiration and one cases with multiple organ failure and death after nasal feeding; the intervention group had no dropout. Conclusions A close cooperation of multi-discipline team can significantly improve the detection rate and feeding safety management of elderly patients with dysphagia. The diet intervention and safety eating management can reduce the incidence of aspiration pneumonia and promote the patients′ quality of life. Key words: Dysphagia; Elderly; Pneumonia, aspiration; Multidisciplinary management