Purpose:
To explore the incidence of dysphagia among hospitalized-rehabilitation stroke patients and the related determinants of dysphagia and prevention of aspiration pneumonia incidence.
Methods:
This descriptive and correlational research design employed a convenience sample of 130 hospitalized stroke patients from rehabilitation wards at a northern regional hospital in Taiwan. A questionnaire and functional assessment were used to collect data. Instruments used included personal and clinical characteristics data questionnaire, the stroke severity of National Institute of Health Stroke Scale (NIHSS), Barthel Index, Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Standardization Swallowing Assessment (SSA), and Acute Stroke Dysphagia Screening (ASDS). Data analyses contained descriptive statistics and logistic regression.
Results:
The incidence of stroke dysphagia was 63.8% (SSA) and 64.6% (ASDS), respectively. Age, marital status, stroke site, stroke severity (NIHSS) severe vs. mild (p=.004, OR: 75.30 [ CI =3.85~ 1,471.36] ), and cognitive status (MMSE) severe vs. normal(p=.046 OR=144.84 [ CI=1.09, 19,321.47])were identified as significant determinants of dysphagia in bivariate logistic regression, whereas stroke severity and cognitive status were identified as significant independent determinants of dysphagia in multivariate logistic regression.
Conclusion:
Two-thirds of the participant sample were affected by dysphagia, for which NIHSS and cognitive status were identified as significant determinants. Thus, nurses may conduct early screening for high risk populations based on patients’ clinical characteristics in order to reduce aspiration pneumonia problems and to improve the quality of clinical care for dysphagia patients. Researchers because of Considering the high correlation between dysphonia and dysarthria, and the evaluation of dysarthria. It is estimated that there is a need for trained trainers to use specialized tools, it is not included. SSA and ADSS assessment tools are all topics Contains: Impaired swallow reflex, jaws asymmetric, involuntary cough, abnormal gag reflex,Suggest Future studies may investigate whether dysarthria is a stroke in hospital during rehabilitation determinants of dysphagia in patients.
Key Words: stroke, dysphagia, swallowing assessment, stroke severity.