• 한국치위생학회지
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• 제23권4호
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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.

• 대한한방내과학회지
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• 제18권1호
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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.

• 성인간호학회지
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• 제26권4호
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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.

• 대한한의학회지
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• 제22권3호
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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.

• 국제물리치료학회지
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• 제12권1호
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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.

• 근관절건강학회지
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• 제20권1호
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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.

• PNF and Movement
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• 제13권3호
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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.

• Nutrition Research and Practice
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• 제12권5호
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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.

• 대한한방내과학회지
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• 제40권2호
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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.

• 재활치료과학
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• 제12권3호
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• pp.19-32
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• 2023

목적 : 본 연구는 작업치료 전공 학생을 대상으로 학교 및 실습에서의 연하재활치료 교육 실태, 지식, 인식도 및 준비도를 확인하기 위해 진행되었다. 연구방법 : 국내 작업치료과 및 작업치료학과에 재학 중인 졸업 년도 학생(3학년, 4학년)을 대상으로 온라인 설문 프로그램을 통해 수거된 105부의 설문지를 분석하였다. 설문지는 연하재활치료 교육 실태, 지식, 연하재활치료 인식도 및 준비도로 구성되어 있다. 설문지는 빈도 및 기초 통계 분석, 실습 여부에 따른 차이를 비교하였고, 학교 및 실습에서의 교육, 지식, 준비도 간 상관관계를 확인하였다. 결과 : 연하재활치료 교과목은 단독 개설된 경우가 많았으며(69.5%), 실습 경험은 79.0%였다. 학교와 실습 모두 연하재활치료 교육 및 지식이 보통 정도였으며 학교에서의 교육 점수가 높았다. 지식 및 임상 준비도는 아동보다 성인이 높은 것으로 조사되었다. 연하재활치료에 대한 인식, 지식 및 준비도 모두 실습 경험이 있는 학생의 점수가 유의미하게 높았다. 결론 : 본 연구를 통하여 작업치료 전공 학생들의 연하재활치료 교육 및 지식은 보통 수준으로 확인되었으며, 성인 연하재활치료 지식 및 준비도가 아동보다 높았다. 작업치료의 임상 전문분야 중 하나인 연하재활치료에 대한 지식 및 준비도 강화를 위한 체계적인 학교, 실습 교육이 필요하며 학교-임상 연계 교육 과정이 요구된다.