基于ICF的脑卒中吞咽障碍患者整体功能评估类目研究

Systematic functional assessment items based on ICF for patients with dysphagia after stroke

目的:为弥补现有吞咽障碍量表的不足,从整体功能评估的视角,基于“国际功能、残疾、健康分类”(ICF)初步确定脑卒中吞咽障碍患者功能评估的类目。方法:检索Cochrane Library、PubMed、Ebsco、CNKI、wanfang、Sinomed等数据库中关于脑卒中吞咽障碍近10年来相关文献,由2名研究人员按照ICF标准链接规则独立对文章进行概念提取及ICF类目链接。结果:最终纳入288篇文献,去重后得到111个功能评价指标,21个功能评价量表,链接到78条ICF唯一类目,其中共有33条出现在超过5%的文献中,包括18条身体功能条目,2条身体结构条目,7条活动与参与条目,6条环境因素条目。结论:初步确定了基于ICF的脑卒中吞咽障碍全面功能评估的类目框架,后续需要进一步的临床应用和专家咨询,以期为临床患者提供综合全面的评估以及个性化、动态化的治疗与护理方案。

Objective:To build the preliminary function assessment items based on international classification of function disability and health(ICF)for patients with dysphagia after stroke from the angle of systematic functional assessment in order to remedy the weaknesses of existing dysphagia scales.Methods:Relevant articles about dysphagia after stroke in recent 10 years were filtrated by Cochrane Library,PubMed,Medline,CNKI,Wanfang and Sinomed.Two researchers extracted the concept of articles.and linked the concept with ICF by ICF linking rules.Results:Finally,288 articles met the criterion.After eliminating redundancy,111 functional evaluation indexes and 21 functional evaluation scales were obtained,78 ICF unique items were linked.Among these items,33 items appeared in over 5%articles,including 18 body function items,2 body structure items,7 activity and participation items,and 6 contextual factors items.Conclusion:The preliminary function assessment items based on ICF have been confirmed,and further clinical application and expert consultation are needed to provide comprehensive assessment and personalized,dynamic therapeutic and nursing schedule for clinical patients.