摄食细节护理对吞咽困难老年患者的影响

Effect of Feeding Detail Nursing on Elderly Patients with Dysphagia

目的:本研究探讨摄食细节护理对吞咽困难老年患者的影响。方法:选取2018年7月-2021年7月中国科学院大学深圳医院(光明)中医康复疼痛科的吞咽困难患者98例,脱落6例,根据随机数字表法将其分为观察组47例和对照组45例。两组均用功能经口摄食量表(functional oral intake scale,FOIS)评估患者饮食状况后行吞咽功能训练。在此基础上,对照组实施常规饮食护理,观察组实施摄食细节护理。比较两组护理3个月后营养指标、吞咽困难症状及SWAL-QOL评分。结果:护理3个月后,观察组白蛋白(ALB)和血红蛋白(Hb)水平均高于对照组(P<0.05)。护理3个月后,观察组摄食会呛噎,摄食会咳嗽,喝汤类会呛噎,会咳嗽出嘴里正吃的食物,吃时必须清嗓子,食物会卡在喉咙,摄食会有呕吐感,有咀嚼问题,食物会粘在嘴里,会流口水,食物或液体会从鼻子流出,会有浓稠的唾液或痰,过多的唾液或痰发生率均低于对照组(P<0.05)。护理3个月后,观察组压力、食物、进餐时长、欲望、恐惧、睡眠、疲劳、沟通、心理健康、社会功能、症状评分及总分均显著高于对照组(P<0.05)。结论:摄食细节护理能有效地改善患者的营养状况和吞咽困难症状,提高患者的生活质量。

Objective:To explore the effect of feeding detail nursing on elderly patients with dysphagia.Method:From July 2018 to July 2021,98 patients with dysphagia were selected from the Rehabilitation Pain Department of Traditional Chinese Medicine in University of Chinese Academy of Sciences-Shenzhen Hospital(Guangming),6 cases fell out,according to the random number table method,they were divided into observation group 47 cases and control group 45 cases.Both groups used functional oral intake scale(FOIS)to evaluate the dietary status of patients,and then underwent swallowing function training.On this basis,the control group implemented routine diet nursing,and the observation group implemented feeding detail nursing.Nutritional indexes,dysphagia symptoms and SWAL-QOL score were compared between the two groups after 3 months of nursing.Result:After 3 months of nursing,the levels of albumin(ALB)and hemoglobin(Hb)in the observation group were higher than those in the control group(P<0.05).After 3 months of nursing,the incidences of choked when eating,coughed when eating,choked when drinking soup,and coughed out the food when they were eating,when eating,they must clear their throat,the food would get stuck in their throat,when eating,they would feel vomiting,had chewing problems,food was stick to their mouth,drool,and the food or liquid would flow out of their nose,with thick saliva or sputum,excessive saliva or sputum in the observation group were lower than those in the control group(P<0.05).After 3 months of nursing,the scores of stress,food,meal time,desire,fear,sleep,fatigue,communication,mental health,social function,symptoms and total scores in the observation group were significantly higher than those in the control group(P<0.05).Conclusion:Feeding detail nursing can effectively improve the nutritional status and dysphagia symptoms of patients and improve the quality of life of patients.