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[The Effectiveness of a Multi-Disciplinary Intervention for Deglutition Disorders in Elderly Inpatients]
Qian Chen1, Ju-Hong Guo2, Xiao-Feng Xu3
1PhD, RN, Deputy Director, Center of Gerontology and Geriatrics, and National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Taiwan, ROC.
Background:
While many studies have examined multidisciplinary interventions for swallowing disorder, most have focused on acute stroke patients. It is essential to confirm the efficacy of multidisciplinary interventions for all causes of swallowing disorder.
Purpose:
To investigate the efficacy of a nurse-led, multi-disciplinary intervention for hospitalized elderly patients with swallowing disorder.
Methods:
One hundred and forty-five elderly patients with swallowing problems from a well-respected affiliate hospital of a university were studied. Patients were randomly allocated using cluster sampling and opaque envelop into either the multi-disciplinary intervention group (n = 73) or the control group (n = 72). The participants were interviewed at baseline and at 30 and 90 days after the intervention. The questionnaires included: a demographics datasheet, Charlson Comorbidity index, Acute Physiology and Chronic Health Evaluation II, short portable mental status questionnaire, Barthel Index, Standardized Swallowing Assessment, Short-form min-nutritional assessment, and aspiration pneumonia.
Results:
The intervention group showed a significantly higher ratio of SSA (67.1% vs. 44.5%, p < .05), lower aspiration pneumonia (5.5% vs. 23.6%, p <.05), and lower incidence of malnutrition (2.7% vs. 11.1%, p <.05) at 90 days than the intervention group. Moreover, the intervention group showed a significantly higher ADL (activities of daily living) score at 90 days (83.3 ± 22.1 vs. 81.1 ± 22.1, p <.017) than the control group (p <.05).
Conclusions:
A nurse-led, multi-disciplinary intervention is a potential option for elderly patients with deglutition disorder to improve swallowing function and ADL and to reduce the incidence of inhaled pneumonia and malnutrition.
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