Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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Development and Evaluation of a Dysphagia Assessment Tool and an Intervention Program for the Elderly in the Long-Term Care Facilities

노인요양시설 노인의 연하곤란 사정도구, 중재프로그램 개발 및 평가

  • 김치영 (그랜드너싱홈) ;
  • 이영미 (부산가톨릭대학교 간호대학) ;
  • 하은호 (중앙대학교 적십자간호대학)
  • Received : 2011.12.21
  • Accepted : 2012.02.10
  • Published : 2012.02.29
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Abstract

The purpose of this study was to develop a dysphagia assessment tool and a intervention program for elderly in the long-term care facilities and to evaluate its effect. The dysphagia assessment tool consists of 20 items was developed through literature review, previous studies and discussion with nursing/medical members. The intervention program consisted of 72 items and participants for evaluation were 50 elders who were registered at long-term care facilities in 4 regions of Seoul. Collected data were analyzed using SPSS Statistics 18.0 and Spearman's Correlation, t-test, and $x^2$-test. After the application of the dysphagia assessment tool and intervention program, the weight in experimental group was increased (t=4.913, p=.000) and the total time of swallowing was reduced (t=-4.557, p=.000) than control group. These findings were statistically significant. Considering these results, by applying the dysphagia assessment tool and the intervention program, the lives of the elderly in long-term care facilities are expected to be improved and emergency situations such as aspiration pneumonia and asphyxia will be decreased.

본 연구는 노인요양시설의 노인 연하곤란 조기 발견 및 중재를 목적으로 연하곤란 사정도구를 개발하고 개발된 사정도구를 중심으로 제작된 중재프로그램 적용 효과를 평가하기 위해 실시하였다. 연구대상은 사정도구의 동시타당도 및 신뢰도 검증을 위해 노인요양시설 9곳에 근무하는 간호사 18명을 편의추출하였으며 중재 프로그램 효과 검정을 위해 노인요양시설 4곳의 입소자 50명을 대상자로 선정하여 실시하였다. 연구 결과 연하곤란 사정도구와 중재프로그램 적용 후 실험군의 체중은 증가하였으며(t=4.913, p=.000), 연하 총 시간은 감소하였다(t= -4.557, p=.000). 따라서 본 연구에서 도출된 연하곤란 사정도구와 중재프로그램을 노인요양시설에 적용한다면 노인의 삶의 질 증진과 흡인성 폐렴, 질식과 같은 응급 상황은 감소할 것이다.

Keywords

References

  1. Statistics Korea. "Elderly Statistics in 2010". Retrieved September 7, 2011, from http://www.kostat.go.kr, 2010, September 30.
  2. Byun JK. "Elderly Long-term Care: Basic Frame Work and Policy Tasks". Health and Welfare Policy Forum, No. 51, pp. 5-11, 2001.
  3. Han TR & Bang MS. "Rehabilitation medicine(3rd ed)". Seoul: Koonja publishing. 2008.
  4. Long Term Care Insurance. "Long Term Care Insurance Law". Retrieved August 10, 2011, from http://www.longtermcare.or.kr/portal/site/nydev/menuitem.07837af963d5c07596cb63e484b310a0/, 2010, April 1.
  5. Shanley C & O'Loughlin G. "Dysphagia among nursing home residents: an assessment and management protocol". Journal of Gerontological Nursing, Vol. 26, No. 8, pp. 35-48, 2000.
  6. Oh BM & Lee KJ. "Rehabilitation of Dysphagia (2nd ed)". Seoul: Pacific Publishing. 2007.
  7. Kin HS, Jung YM & Lee HS. "Cognitive Impairment, Behavioral Problems, and Mental Health in Institutionalized Korean Elders-An Eligibility Issue for Care Settings-". Journal of Korean Academy of Nursing, Vol. 39, No. 5, pp. 741-750, 2009. https://doi.org/10.4040/jkan.2009.39.5.741
  8. Song JA, Lim YM & Hong GR. "Wandering Behavior in Korean Elders with Dementia Residing in Nursing Homes". Journal of Korean Academy of Nursing, Vol. 38, No. 1, pp. 29-38, 2008. https://doi.org/10.4040/jkan.2008.38.1.29
  9. Lin LC, Wu SC, Chen HS, Wang TG & Chen MY. "Prevalence of impaired swallowing in institutionalized older people in taiwan". Journal of the American Geriatrics Society, Vol. 50, No. 6, pp. 1118-1123, 2002. https://doi.org/10.1046/j.1532-5415.2002.50270.x
  10. Leonard R & Kendall K. "Dysphagia Assessment and Treatment Planing (2 nd)". Oxfordshire in United Kingdom: Plural Publishing, 2007.
  11. Baek JY. "A Study on the Characteristics of Dysphagia of Older Adults with Neurologic Disorders". The Journal of Korean Society of Occupational Therapy, Vol. 15, No. 1, pp. 47-56, 2007.
  12. Daniels SK, Ballo LA, Mahoney MC, & Foundas AL. "Clinical predictors of dysphagia and aspiration risk: outcome measures in acute stroke patients". Archives of Physical Medicine and Rehabilitation, Vol. 81, No. 8, pp. 1030-1033, 2000. https://doi.org/10.1053/apmr.2000.6301
  13. Wieseke A, Bantz D, Siktberg L & Dillard N. "Assessment and early diagnosis of dysphagia". Geriatric Nursing, Vol. 29, No. 6, pp. 376-383, 2008. https://doi.org/10.1016/j.gerinurse.2007.12.001
  14. Kim DY, Koh ES, Kang BS, Han TR & Lee SU. "Effects of Electrical Stimulation for Dysphagia Caused by Stroke". Journal of Korean Academy of Rehabilitation Medicine, Vol. 32, No. 1, pp. 9-14, 2008.
  15. Park MK. "The Effect of Olfactory Stimulation on the Swallowing Function Recovery of Stroke Patient". Unpublished master's thesis, Taegu University, Taegu, 2009.
  16. Park HJ & Kang HS. "The Effects of Sensory Stimulation for Ingestion in Dysphagic Patients with Stroke". The Korean Journal of Rehabilitation Nursing, Vol. 5, No. 1, pp. 38-48, 2002.
  17. Paek EK, Moon KH, Kim HJ, Lee ES, Lee JH, Lee SH, et al. "Dysphagia Assessment Tool for Post-Stroke Patients". Clinical Nursing Research, Vol. 13, No. 3, pp. 19-30, 2007.
  18. Tanaka Y. "Feeding and dysphagia elderly management II". Paper presented at the meeting of the Iwha womans university research institute of nursing science, Seoul. August. 2007,
  19. Perry L. "Screening swallowing function of patients with acute stroke. Part one: Identification, implementation and initial evaluation of a screening tool for use by nurses". Journal of Clinical Nursing, Vol. 10, No. 4, pp. 463-473. 2001. https://doi.org/10.1046/j.1365-2702.2001.00501.x
  20. Nishiwaki K, Tsuji T, Liu M, Hase K, Tanaka N, & Fujiwara T. "Identification of a simple screening tool for dysphagia in patients with stroke using factor analysis of multiple dysphagia variables. Journal of Rehabilitation Medicine, Vol. 37, No. 4, pp. 247-251, 2005. https://doi.org/10.1080/16501970510026999
  21. Westergren A. "Detection of eating difficulties after stroke: a systematic review". International Nursing Review, Vol. 53, No. 2, pp. 143-149, 2006. https://doi.org/10.1111/j.1466-7657.2006.00460.x
  22. Miura H, Kariyasu M, Yamasaki K & Arai Y. "Evaluation of chewing and swallowing disorders among frail community-dwelling elderly individuals". Journal of Oral Rehabilitation, Vol. 34, No. 6, pp. 422-427, 2007. https://doi.org/10.1111/j.1365-2842.2007.01741.x
  23. Han TR., Park NJ & Park JW. "The Functional Dysphagia Scale Using Videofluoroscopic Swallowing Study in Stroke Patients". Journal of Korean Academy of Rehabilitation Medicine, Vol. 23, No. 6, pp. 1118-1126, 1999.
  24. Logemann JA, Gensler G, Robbins J, Lindblad AS, Hind JA, Kosek S, et al. "A Randomized Study of Three Interventions for Aspiration of Thin Liquids in Patients With Dementia or Parkinson's Disease". Journal of Speech, Language, and Hearing Research, Vol. 51, No. 1, pp. 173-183, 2008. https://doi.org/10.1044/1092-4388(2008/013)
  25. Kim KM-J, Kim KJ, Cha YN, Jang HS, Han HS, Jung JS, et al. "NANDA Nursing Diagnoses, Goals and Intervention". Seoul: Hyunmoon Publishing, 2006.
  26. Kim SJ & Lee KJ "Comparison of the Hyoid Movement during the Pharyngolaryngeal Swallowing at the Healthy Young and Old Person". Journal of Korean Academy of Rehabilitation Medicine, Vol. 30, No. 5, pp. 485-490, 2006.
  27. Robbins J, Hamilton JW, Lof GL & Kempster GB. "Oropharyngeal swallowing in normal adults of different ages". Gastroenterology, Vol. 103, No. 3, pp. 823-829, 1992. https://doi.org/10.1016/0016-5085(92)90013-O
  28. Woo JH, Jeong WM, Kim YG, Koo JW. " The relevant factors and effect of swallowing function on oropharyngeal stimulation program in stroke patients with swallowing disorder". The Journal of Korean Society of Occupational Therapy, Vol. 17, No. 4, pp. 1-12, 2009.

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