收稿日期: 2021-04-16
网络出版日期: 2021-10-26
The training workshop on swallowing and ingestion skills for caregivers of patients with dysphagia after stroke
目的 探讨卒中后吞咽障碍患者照顾者培训工作坊的应用效果。方法 选取2020年1月—12月在沈阳市某三级甲等医院康复中心神经康复单元住院治疗的176例卒中后吞咽障碍康复期患者的直接照顾者和患者为研究对象,按照入院时间先后顺序分为对照组(n=85)和试验组(n=91)。对照组采用口头讲解为主的健康教育,试验组采用工作坊进行培训。干预前后对两组照顾者进行吞咽障碍管理知识测评,同时评估两组患者在入院、出院后1个月、出院后3个月的吞咽功能评分。结果 出院后3个月,试验组照顾者吞咽障碍管理知识得分为22.67±3.45,对照组照顾者吞咽障碍管理知识得分为18.14±2.29,两组得分比较差异有统计学意义(t=10.326,P=0.001)。应用广义估计方程分析显示,两组患者在出院后1个月、出院后3个月两个时点的吞咽功能均较入院时有所提高(P<0.05);试验组患者出院1个月和出院3个月后的吞咽功能均优于对照组,差异有统计学意义(P<0.05)。结论 采用工作坊对卒中后吞咽障碍患者照顾者进行培训,可提升其吞咽照护技能,进而改善患者的吞咽功能。
高岩 , 范玲 , 姜李 , 赵慧 , 王慧敏 , 高雪媚 , 杨柳 . 卒中后吞咽障碍患者照顾者培训工作坊的应用[J]. 中华护理教育, 2021 , 18(10) : 920 -924 . DOI: 10.3761/j.issn.1672-9234.2021.10.012
Objective To investigate the effects of a training workshop for caregivers of patients with dysphagia after stroke. Methods A total of 176 patients with deglutition disorder after stroke and their direct caregires in the neurological rehabilitation unit of a rehabilitation center in a tertiary hospital in Shenyang from January to December 2020 were selected and divided into the control group and the experimental group according to their admission date. Caregivers in the control group received regular health education while caregivers in the experimental group received training workshop on swallowing and feeding skills. Before and after the intervention,the caregivers in the two groups were assessed the knowledge of dysphagia. Besides,the swallowing function scores of patients in the two groups were assessed at admission,1 month and 3 months after discharge. Results After three months,the caregivers’ knowledge score of dysphagia management in the experimental group was 22.67±3.45,and it was 18.14±2.29 in the control group. There was a statistically significant difference between the two groups(t=10.326,P=0.001). The generalized estimating equation showed that the scores of swallowing function of patients in the two groups 1 month after discharge and 3 months after discharge were higher than those at admission(P<0.05). The swallowing function scores of patients in the experimental group 1 month and 3 months after discharge were higher than those of patients in the control group(P<0.05). Conclusion Workshop training on caregivers of patients with dysphagia after stroke can improve caregivers’ swallowing and care skills,and thereby improve the swallowing function of patients.
Key words: Stroke; Deglutition Disorders; Feeding Behavior; Workshop; Caregivers
| [1] | Mancopes R, Smaoui S, Steele CM. Effects of expiratory muscle strength training on videofluoroscopic measures of swallowing:a systematic review[J]. Am J Speech-Lang Pathol, 2020, 29(1):335-356. |
| [2] | 李莉莉, 刘萍, 李慧娟, 等. 护士主导的吞咽障碍分级管理在神经内科脑卒中患者中的应用[J]. 中国护理管理, 2020, 20(2):304-308. |
| [2] | Li LL, Liu P, Li HJ, et al. Effect of nurse-led grading management of dysphagia on patients with stroke in neurology department[J]. Chin Nurs Manag, 2020, 20(2):304-308. |
| [3] | Cichero JAY, Lam P, Steele CM, et al. Development of international terminology and definitions for texture-modified foods and thickened fluids used in dysphagia management:the IDDSI framework[J]. Dysphagia, 2017, 32(2):293-314. |
| [4] | Lieber AC, Hong E, Putrino D, et al. Nutrition,energy expenditure,dysphagia,and self-efficacy in stroke rehabilitation:a review of the literature[J]. Brain Sci, 2018, 8(12):218-240. |
| [5] | 徐蓓蓓, 招少枫, 蔡萍, 等. 看护人员的健康教育对卒中后吞咽障碍患者进食管理的作用[J]. 中国健康教育, 2019, 35(4):371-373. |
| [5] | Xu BB, Zhao SF, Cai P, et al. Effect of paramedic health education on eating management among patients with dysphagia after stroke[J]. Chin J Heal Educ, 2019, 35(4):371-373. |
| [6] | 郑洁. 将工作坊模式应用于康复治疗学专业理疗学实践教学的初步探索[J]. 中国康复理论与实践, 2016, 22(2):241-244. |
| [6] | Zheng J. Application of workshop mode in practical teaching of physiatry in rehabilitation therapy specialty[J]. Chin J Rehabil Theory Prac, 2016, 22(2):241-244. |
| [7] | 中华医学会神经病学分会, 中华医学会神经病学分会康复学组. 中国脑卒中早期康复治疗指南[J]. 中华神经外科杂志, 2017, 50(6):405-412. |
| [7] | Neurology Society of Chinese Medical Association, Rehabilitation Group of Neurology Society of Chinese Medical Association. Guideli-nes for early rehabilitation of stroke in China[J]. Chin J Neurol, 2017, 50(6):405-412. |
| [8] | 中国吞咽障碍康复评估与治疗专家共识组. 中国吞咽障碍评估与治疗专家共识(2017年版)[J]. 中华物理医学与康复杂志, 2017, 39(12):881-892. |
| [8] | Chinese Expert Consensus Group for Rehabilitation Evaluation and Treatment of Swallowing Disorders. Expert consensus on the assessment and treatment of swallowing disorders in China(2017 edition)[J]. Chin J Rehabil Theory Prac, 2017, 39(12):881-892. |
| [9] | 中国吞咽障碍膳食营养管理专家共识组. 吞咽障碍膳食营养管理中国专家共识(2019年版)[J]. 中华物理医学与康复杂志, 2019, 41(12):881-888. |
| [9] | Expert Consensus Group of Dietary Nutrition Management for Swallowing Disorders in China. Chinese expert consensus on dietary nutrition management of swallowing disorders(2019 Edition)[J]. Chin J Rehabil Theory Prac, 2019, 41(12):881-888. |
| [10] | 李惠, 王如蜜, 陈荟菁, 等. 养老护理员吞咽障碍管理知识与技能的调查研究[J]. 中国护理管理, 2019, 19(6):836-842. |
| [10] | Li H, Wang RM, Chen HJ, et al. Survey on knowledge and skills of dysphagia management among geriatric nursing assistants[J]. Chin Nurs Manag, 2019, 19(6):836-842. |
| [11] | 朱亚芳, 张晓梅, 张钦缔, 等. 中文版经口摄食功能评估量表在摄食-吞咽障碍脑卒中患者中的信效度检验[J]. 实用医学杂志, 2017, 33(22):3826-3829. |
| [11] | Zhu YF, Zhang XM, Zhang QD, et al. Reliability and validity of Chinese version of the Function Oral Intoke Scale in stroke patients with dysphagia[J]. J Pract Med, 2017, 23(2):3826-3829. |
| [12] | Wong AK, Moran JA. Extended care unit:a feasible economic solution for longer-term palliative inpatients[J]. Int Med J, 2018, 48(11):1389-1392. |
| [13] | 徐寅, 周峥, 傅巧美, 等. 工作坊在乳腺癌患者术后患肢功能康复中的应用[J]. 中国康复理论与实践, 2017, 23(4):481-484. |
| [13] | Xu Y, Zhou Z, Fu QM, et al. Application of workshop in func-tional rehabilitation of affected limb for postoperative breast cancer patients[J]. Chin J Rehabil Theory Prac, 2017, 23(4):481-484. |
| [14] | 尹志科. 微视频联合情景模拟训练对脑卒中伴吞咽障碍病人居家安全进食的影响[J]. 护理研究, 2020, 34(5):908-910. |
| [14] | Yin ZK. Effects of micro-video combined with situation simulated training on safe eating at home for stroke patients with dysphagia[J]. Chin Nurs Res, 2020, 34(5):908-910. |
/
| 〈 |
|
〉 |