• Title/Summary/Keyword: Dysphagia

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Effects of dental hygienist knowledge of dysphagia and preventive attitudes on educational needs for oral health in the older adults (치과위생사의 연하장애 지식 및 예방 태도가 노인구강건강 관련 교육요구도에 미치는 영향)

  • Woo-Jung Noh ;Seon-Yeong Kim
    • Journal of Korean society of Dental Hygiene
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    • v.23 no.4
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    • pp.261-268
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    • 2023
  • Objectives: In this study, we aimed to examine the dysphagia knowledge, preventive attitudes toward dysphagia, and educational needs concerning geriatric oral health, of dental hygienists, and to provide fundamental information for recognizing the necessity of knowledge and education concerning geriatric oral health and for increasing educational needs. Methods: From April 1 to June 30, 2022, a questionnaire survey was administered to 198 dental hygienists via an online link. SPSS Statistics ver. 22.0 was used to conduct the frequency analysis, t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple regression analysis. Results: Regarding the difference in knowledge of dysphagia depending on general characteristics, the study participants had more knowledge of dysphagia when they were more interested in dysphagia and had a higher geriatric treatment frequency. The preventive attitudes toward dysphagia were strong in those who graduated from graduate school or higher, had more prevention and education at work, became more interested in dysphagia, received more education about dysphagia, had intention to receive additional education on dysphagia, and had a higher geriatric treatment frequency. Positive correlations were observed between knowledge of dysphagia, preventive attitudes toward dysphagia, and educational needs related to geriatric oral health. The educational needs related to geriatric oral health were found to be, significantly and positively influenced by preventive attitudes toward dysphagia, having master's degree or higher, knowledge of dysphagia, and intention to receive additional education on dysphagia. Conclusions: It is necessary to improve the quality of oral health services offered to older patients by having accurate knowledge of dysphagia implementing appropriate prevention practices for dysphagia, and understanding the educational content needed by the oral hygienists and developing an effective education program to enhance their professionalism.

Clinical Study of Dysphagia in Stroke Patients (1) (Preliminary paper) (뇌졸중환자의 연하장애에 관한 임상적 연구 (1))

  • Ko, Seong-Gyu
    • The Journal of Internal Korean Medicine
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    • v.18 no.1
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    • pp.62-68
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    • 1997
  • Dysphagia generally has a good prognosis after stroke involving cerebral hemisphere or braibstem, but it could have serious consquence with dehydration leading to haemoconcentration, renal failure and aspiration leading to pneumonia. This preliminary report was written for main report. The main report will be written to give an objective guide post of management and treatment in stroke patient with dysphagia. The objective guide posts were follows as, 1. Close examination for relationship between dysphagia in stroke patients and other neurological deficits 2. Influence on the prognosis of dysphagia in stroke patients by the grade of dysphagia at admission time. 3. The realtionship between the site and size of brain damage and the grade and prognosis of dysphagia 4. The frequency and prognosis of dysphagia in stroke patients according to sex and age. 5. The rate and speed of recovery with dysphagia after stroke. 6. Frequency and process of complications, aspiration pneumonia, weight loss, sore, in stroke patient group with dysphagia.

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The Risk of Dysphagia and Dysphagia-specific Quality of Life among Community Dwelling Older Adults in Senior Center (복지회관 이용 노인의 연하장애 위험성과 연하 관련 삶의 질)

  • Kim, Min-Su;Park, Yeon-Hwan
    • Korean Journal of Adult Nursing
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    • v.26 no.4
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    • pp.393-402
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    • 2014
  • Purpose: The aim of this study was to describe the risk of dysphagia among older adults in senior centers and to find the relationships between the risk of dysphagia and dysphagia-specific quality of life. Methods: The participants were 260 community-dwelling older adults, aged 65 years in two senior centers. Data were collected by self-report questionnaires or face to face interviews. The instruments were the modified dysphagia risk assessment scale for elderly and dysphagia-specific quality of life questionnaire. The data were analyzed using t-test, $x^2$-test, logistic regression, and pearson's correlation. Results: 162 older adults (62.3%) were classified as having the risk of dysphagia. Severe dry mouth (OR=15.677, CI=2.986~82.297), neurologic disease (OR=10.125, CI=1.092~93.899), gastritis (OR=5.731, CI=1.482~22.173), denture discomfort (OR=2.969, CI=1.016~8.677), teeth discomfort (OR=2.61, CI=1.311~5.196) were the significant factors predicting the risk of dysphagia. There is a significant correlation between the risk of dysphagia and dysphagia-specific quality of life. Conclusion: Dysphagia could be a major health problem among community dwelling older adults. It can affect the dysphagia-specific quality of life. Older adults having severe dry mouth, neurologic disease, or gastritis should receive dysphagia risk assessment and proper management on a regular basis. An effective nursing intervention needs to be developed for the older adults with risk factors of dysphagia.

Clinical Review about Dysphagia associated with Acute Ischemic Stroke (급성 허혈성 뇌졸중에 수반된 연하장애에 관한 임상적 고찰)

  • 한명아;김동웅
    • The Journal of Korean Medicine
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    • v.22 no.3
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    • pp.42-50
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    • 2001
  • Objectives : Dysphagia is common and severe problems of acute stroke determining the prognosis of stroke only second to mental change, and results in secondary fatal complications such as aspiration pneumonia, malnutrition, dehydration, etc. Therefore, we were to investigate the clinical characteristics of dysphagia accompanied by acute ischemic stroke. Methods : We selected subjects through clinical notes retrospectively, whose main problems included dysphagia resulted from acute stroke within 72 hours from onset who were admitted to the Internal Medicine Department of Wonkwang Oriental Medicine Hospital from Jan. 2000 to Apr. 2001. We assessed the severity of dysphagia from admission to discharge using a staging method : stage 0 is normal without dysphagia, stage 1 is nearly normal except for intermittent dysphagia, stage 2 is compensated abnormal swallowing requiring adjusted diets or delayed feeding time, stage 3 is uncompensated abnormal swallowing resulted in weight loss down to 10% of initial and daily aspiration, coughing, and vomiting, stage 4 is uncompensated abnormal swallowing resulting in weight loss beyond 10% and recommended for non-oral feeding, and stage 5 is 100% non-oral feeding by L-tube, or gastrostomy or NPO state. Results : Dysphagia was improved statistically significantly from the mean stage of $3.6{\pm}0.29$ on admission to $1.88{\pm}0.32$ on discharge (P<0.05). On average $7.1{\pm}1.48$ days were required for improving more than one stage level. As patients were older and the stage of dysphagia was worse on admission, severity of dysphagia was more difficult to improve (correlation coefficiency was 0.55 and 0.77 respectively, P<0.05). Aspiration pneumonia was complicated in 13 patients of the total 25 at mean dysphagia stage of $3.36{\pm}0.37$. However, any specific values such as lesion size, lesion site, sex, age, past history and NIH Stroke Scale on admission did not affect it (P>0.05). Conclusion : Clinical course of dysphagia was determined about I week from the onset. Aspiration pneumonia was mainly complicated during oral feeding periods. If there were no improvement of dysphagia over 2-3 weeks, then non-oral feeding such as Levin tube or gastrostomy must be considered.

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Home Based Dysphagia Rehabilitation for Stroke Patients Using Information and Communication Technology

  • Kim, Heejeong;Kown, Yonghwa;Choi, Heesu
    • Journal of International Academy of Physical Therapy Research
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    • v.12 no.1
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    • pp.2267-2271
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    • 2021
  • Background: Recently, a new home-based dysphagia rehabilitation method using information and communications technology (ICT) has been reported, but clinical evidence is still lacking. Objectives: To investigate the effects of home-based dysphagia rehabilitation using ICT on tongue muscle strength and volume in patients with developed dysphagia after stroke. Design: Randomized controlled trial design. Methods: Twenty patients who developed dysphagia after stroke were enrolled. The experimental group received dysphagia rehabilitation in the form of ICT-based home care. In contrast, the control group received traditional rehabilitation based on swallowing under the supervision of occupational therapists. All interventions were conducted five times a week for four weeks. Results: Both groups showed statistically significant increases in tongue muscle strength and volume after the intervention (P<.05, both). However, there were no significant differences in tongue strength or volume between the two groups after the intervention (P>.05, both). Conclusion: Home-based dysphagia rehabilitation using ICT showed effects similar to those of conventional swallowing rehabilitation in patients who developed dysphagia after stroke. These findings suggest that dysphagia rehabilitation can be conducted at home without the help of a therapist.

Development of Evidence-based Dysphagia Nursing Care Protocol for Nursing Home Residents (노인요양시설 거주 노인을 위한 한국형 근거기반 연하장애 간호 프로토콜 개발)

  • Bang, Hwal Lan;Park, Yeon-Hwan
    • Journal of muscle and joint health
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    • v.20 no.1
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    • pp.31-42
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    • 2013
  • Purpose: The purpose of this study was to develop an evidence-based dysphagia nursing care protocol for nursing home (NH) residents in Korea. Methods: The protocol was developed based on international guidelines and literatures. After testing content validity by experts, the protocol was applied to the intervention group (n=35) for 4 weeks at one NH in December, 2011, whereas the control group (n=34) received routine care. Results: The protocol was composed of one-page algorithm and detailed guidelines. Algorithm pathway was organized in 3 parts, including screening dysphagia risk, grouping by dysphagia risk level, and assigning nursing care into each group. The nursing care included positioning, oral care, meal time care, diet modification, providing exercise and maneuver, and checking dysphagia signs and symptoms. The experts verified the content validity. Protocol was revised to fit NH practice after the participant observation. Clinical validity was established upon evaluating usefulness, appropriateness, and convenience of the protocol by NH nurses. Dysphagia risk of the intervention group was significantly decreased. Conclusion: Developed protocol will improve the quality of dysphagia care in nursing homes as it can serve as a consistent and integrated standard for nursing care of residents with dysphagia.

The Effect of Neck Strengthening Exercise Using Proprioceptive Neuromuscular Facilitation on Swallow ability of Patient with Dysphagia: A Single Case Study (고유수용성신경근촉진법을 이용한 목근육 강화운동이 삼킴 장애환자에게 미치는 영향: 단일사례연구)

  • Lee, Soon-Hyun;Won, Young-Sick
    • PNF and Movement
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    • v.13 no.3
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    • pp.163-168
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    • 2015
  • Purpose: The current study seeks to identify the effect of neck muscle strengthening exercise using proprioceptive neuromuscular facilitation (PNF) on the swallowing ability of patients diagnosed with dysphagia due to stroke. Methods: As a single case study, the current research conducted neck muscle strengthening exercise using PNF on the patient with dysphagia for 40 minutes, four times per week for a six-week period. At the same time, typical rehabilitation therapy for dysphagia was provided. This type of therapy included food-swallowing and the relation of the muscles surrounding the neck. The functional dysphagia scale and the penetration-aspiration scale were used to assess swallowing ability. Results: After the therapy, the functional dysphagia scale and the penetration-aspiration scale decreased by 18 points and 3 points, respectively, which proves the effectiveness of this type of therapy for dysphagia. Conclusion: The results of the current study indicate that neck muscle strengthening exercise using PNF reduces penetration-aspiration in patients with dysphagia, and that PNF can be clinically utilized to improve the swallowing ability of dysphagic patients.

Socio-demographic factors and diet-related characteristics of community-dwelling elderly individuals with dysphagia risk in South Korea

  • Lim, Youngsuk;Kim, Chorong;Park, Haeryun;Kwon, Sooyoun;Kim, Oksun;Kim, Heeyoung;Lee, Youngmi
    • Nutrition Research and Practice
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    • v.12 no.5
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    • pp.406-414
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    • 2018
  • BACKGROUND/OBJECTIVES: The objective of this study was to determine dysphagia risk among community-dwelling elderly people living at home. We also examined the impact of socio-demographic variables on dysphagia risk as well as the relationship between dysphagia risk and dietary characteristics. SUBJECTS/METHODS: The study sample included 568 community-dwelling individuals, aged 65 years and above, who were living independently in their own home in Seoul, Gyeonggi, or Gwangju in South Korea. We used a dysphagia risk assessment scale to screen for dysphagia risk and the Mini nutritional assessment to evaluate the nutritional status. Associations between dysphagia risk and other variables were assessed using logistic regression analysis. RESULTS: Of the 568 subjects, 350 (61.6%) were classified into the dysphagia risk group (DR) and 218 (38.4%) were classified into the normal group (non-DR). Being female (odds ratio (OR) = 1.82, 95% confidence interval (CI) = 1.28-2.59), being 75 years and older (OR = 2.40, 95% CI = 1.69-3.42), having a lower education level (OR = 2.29, 95% CI = 1.33-3.97), and having a lower perceived economic status (OR = 2.18, 95% CI = 1.32-3.60) were more frequently observed with dysphagia risk compared to those who did not have such characteristics. Lowered mastication ability (OR = 14.40, 95% CI = 4.43-46.95), being at risk of malnutrition or malnourished (OR = 2.72, 95% CI = 1.75-4.23), lowered appetite (OR = 3.27, 95% CI = 2.16-4.93), and decreased food intake (OR = 2.95, 95% CI = 1.83-4.78) were observed more frequently in the DR group than in the non-DR group when adjusting for potential confounding factors. CONCLUSIONS: It is necessary to develop and apply integrated programs to improve the dietary habits and nutritional status of elderly individuals at risk for dysphagia, especially for women aged 75 years or older with lower educational and economic levels.

Two Cases of Post-Stroke Dysphagia by Korean Medical Treatment with Electroacupuncture (전침을 포함한 한의학적 치료로 호전된 2명의 뇌졸중 환자의 연하장애 : 증례보고)

  • Kim, Yoon-jung;Je, Yu-ran;Kim, Koang-lok
    • The Journal of Internal Korean Medicine
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    • v.40 no.2
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    • pp.236-245
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    • 2019
  • Objectives: The aim of this study is to report the effects of Korean medical treatment with electroacupuncture on post-stroke dysphagia. Methods: Two stroke patients with dysphagia received Korean medical treatment including electroacupuncture for about six months and three months respectively. A Numerical Rating Scale (NRS), Video Fluoroscopic Swallowing Study (VFSS) were used to confirm efficacy of electroacupuncture therapy as outcome measurements. Results: After treatment, swallowing function was improved, and symptoms related to dysphagia were decreased. NRS, VFSS showed improvement in stroke patients with dysphagia. Conclusions: This study shows that Korean medical treatment with electroacupuncture can be useful for dysphagia.

Research for Education Status, Knowledge and Awareness of Dysphagia Therapy Among Occupational Therapy University Students (작업치료 전공 학생들의 연하재활치료 교육 실태, 지식 및 인식도 조사)

  • Min, Kyoung-chul;Seo, Sang-min
    • Therapeutic Science for Rehabilitation
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    • v.12 no.3
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    • pp.19-32
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    • 2023
  • Objective : The purpose of this study was to investigate the educational status, knowledge, awareness, and readiness for dysphagia therapy among university occupational therapy students. Methods : One hundred and five online questionnaires completed by senior-year students at an occupational therapy university were analyzed. The questionnaire assessed the educational status, knowledge, awareness, and readiness for dysphagia therapy. Descriptive statistics and differences between those with and without practical experience were analyzed. The relationships among educational status, knowledge, and readiness were analyzed. Results : Independent opening of the dysphagia therapy class (69.5%) and experience in dysphagia practice were high (79.0%). Dysphagia education and knowledge in university and practice were moderate and item scores were higher for university education. Knowledge of adult dysphagia therapy was higher than that of pediatric dysphagia therapy. Scores on awareness, knowledge, and readiness for dysphagia therapy were significantly higher among students with practical experience. Conclusion : Education and knowledge of dysphagia therapy were moderate. Knowledge and readiness in adults are higher than in children. Systematic dysphagia therapy education in university and associated practices are needed to enhance the specialty of dysphagia therapy.