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Learning Objective 1: What are the high risks of dysphagia in psychiatric inpatients?
Learning Objective 2: How to prevent the risks of dysphagia in psychiatric inpatients?
The rate of dysphagia and choking of psychiatric patients are 100 times in the general population. The etiological factors include disease, medicine and other factors. This study aims to understand the relationship of dysphagia among psychiatric inpatients.
Methods:
Starting from June of 2010 to May of 2011, 250 patients who admitted in acute psychiatric ward were interviewed dysphagia, choking experiences and examined extra-pyramidal syndrome, parkinsonism and tardive dyskinesia. Nurses recorded choking status when patients taking oral drugs. The SAS program was used in all statistical analysis.
Results:
The majority of the research subjects were schizophrenia patients (51.6%). Among the 250 patients, 202 (88%) were treated with antipsychotics. Among these antipsychotics-treated patients, 182 subjects (85.6%) used second-generation antipsychotics (SGA), 203 subjects (85.6%) used two or more types of psychiatric therapeutics. Extra- pyramidal syndrome was noticed in 84 subjects (33.6%), parkinsonism or tardive dyskinesia were rare among the subjects. For eating related problems, about 1/3 of the subjects were fast eaters; 38 subjects (15.2%) reported a problem of dysphagia in questionnaire; 127 (50.8%) of subjects had choking experiences during the study period; 44 (17.6%) subjects choked when taking medications orally and discovered by nursing staffs.
Conclusion:
Dysphagia is a common status in psychiatric patients. Dysphagia leading to choking is a importantly issue among patients safety in hospital. Dysphagia is due to a large number of psychotropic drugs, drug side effects and fast eating behavior. Methods to avoid dysphagia and choking include: reducing the types and quantities of psychotropic substances, advise the patient to eat slowly and pay attention to patient medication and intake situation. Improve the quality of patient safety is the most important task of all nurses.
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