뇌졸중 환자의 연하곤란 사정도구 개발

Abstract

Purpose: This study was done using the parameters of oro-pharyngeal function and swallowing difficulties to develop an assessment tool for clinical appraisal. Method: Preliminary parameters were selected from common parameters, related to dysphagia and aspiration in stroke patients, originating from 11 articles in the literature. First 39 parameters were classified by the following characteristics, 16 were related to disease, 13 to oro-pharyngeal function assessment and 10 to swallowing difficulties. Validity of the parameters was determined by a 75% or more agreement by expert consultants. Reliability of the parameters was determined by using the assessment tool with 45 patients who had a stroke. Results: All 39 parameters were determined as adequate for the assessment tool by the opinions of the experts. Tongue movement and soft palate function showed 96.9% agreement among the experts. Cronbach's α for oro-pharyngeal functions and swallowing difficulties were 0.76 and 0.78, respectively. Intraclass correlation coefficients (ICC) for oro-pharyngeal functions and swallowing signs were 0.73 and 0.76, respectively. Conclusion: In conclusion, this clinical assessment tool which was validated by experts and tested for reliability may be a useful bedside assessment tool for early detection of dysphagia and for prevention of complications of dysphagia in clinical nursing