河南省护士对脑卒中患者吞咽障碍筛查与评估的现状调查

doi:10.3761/j.issn.0254-1769.2020.08.016

中华护理杂志 ›› 2020, Vol. 55 ›› Issue (8): 1196-1200.DOI: 10.3761/j.issn.0254-1769.2020.08.016

河南省护士对脑卒中患者吞咽障碍筛查与评估的现状调查

马珂珂(),郭园丽(),董小方,杨彩侠,张盼,王敏,高欢欢

450000 郑州市郑州大学第一附属医院神经内科（马珂珂,郭园丽,董小方,杨彩侠,张盼）,护理部（王敏,高欢欢）

收稿日期:2019-12-03 出版日期:2020-08-15 发布日期:2020-08-06
通讯作者: 郭园丽
作者简介:马珂珂:女,硕士,护士,E-mail: <email>809643627@qq.com</email>
基金资助:
河南省科技攻关项目(182102310151)

Current status of screening and assessment of patients with dysphagia after stroke by nurses in Henan province

MA Keke(),GUO Yuanli(),DONG Xiaofang,YANG Caixia,ZHANG Pan,WANG Min,GAO Huanhuan

Received:2019-12-03 Online:2020-08-15 Published:2020-08-06
Contact: Yuanli GUO

摘要/Abstract

摘要：

目的调查河南省护士对脑卒中患者吞咽障碍筛查与评估的现状。方法采用便利抽样,抽取河南省55所医院的965名脑卒中相关科室的护士,调查问卷通过专家咨询法制订,Cronbach’s α系数为0.832,内容效度为0.751,采用SPSS 25.0对数据进行统计分析。结果来自29所三级医院、26所二级医院脑卒中相关科室的965名护士参与调查,回收有效问卷942份,问卷回收有效率为97.62%;知识部分,10个专业相关判断题中,护士正确回答的题目数为（8.36±1.46）个;态度部分,93.71%的护士认为自身专业能够帮助患者改善其吞咽障碍情况,98.34%的护士认为有必要组建多学科团队进行吞咽障碍管理;实践部分,仅36.52%的护士按照最新指南推荐,在患者进食第一口食物、水或药物之前进行早期吞咽功能筛查;64.97%入院后早期吞咽功能筛查由责任护士执行。结论河南省护士对吞咽障碍的基础知识水平及态度尚可,但对脑卒中患者吞咽障碍筛查与评估的现状不容乐观,部分护士未采用指南推荐的方法指导临床实践,提示护理管理人员应高度重视,积极推行循证转化,促进护理质量的提升。

关键词: 护士, 脑卒中, 吞咽障碍, 筛查, 护理评估

Abstract:

Objective To investigate the current status of screening and assessment of patients with dysphagia after stroke by nurses in Henan province. Methods Convenience sampling was conducted in 55 hospitals in Henan Province to enroll nurses from stroke-related departments for questionnaire survey. The questionnaire was formulated by expert consultation method with Cronbach’s α coefficient of 0.832 and the content validity of 0.751. SPSS 25.0 was used to analyze the data. Results A total of 965 nurses from 29 tertiary hospitals and 26 secondary hospitals participated in the survey,and 942 collected questionnaires were valid,with a validity rate of 97.62%. Among the 10 judgment questions in the knowledge part,nurses correctly answered 8.36±1.46 questions. In the attitude part,93.71% of nurses thought they were able to help patients improve their swallowing disorder. 98.34% of nurses thought it was necessary to establish a multidisciplinary team for swallowing disorder management. In the practice part,only 36.52% of nurses followed the latest guidelines to screen the swallowing function of patients before the first bite of food,water or drugs. Conclusion The status of screening and assessment for patients with dysphagia after stroke by nursing staff in Henan Province is not optimistic. Some nurses cannot adopt the recommended instructions to guide clinical practice,and clinical nursing management staff should attach great importance to it and carry out evidence-based translation to improve the nursing quality.

Key words: Nurses, Stroke, Dysphagia, Screening, Nursing Assessment

马珂珂, 郭园丽, 董小方, 杨彩侠, 张盼, 王敏, 高欢欢. 河南省护士对脑卒中患者吞咽障碍筛查与评估的现状调查[J]. 中华护理杂志, 2020, 55(8): 1196-1200.

MA Keke, GUO Yuanli, DONG Xiaofang, YANG Caixia, ZHANG Pan, WANG Min, GAO Huanhuan. Current status of screening and assessment of patients with dysphagia after stroke by nurses in Henan province[J]. Chinese Journal of Nursing, 2020, 55(8): 1196-1200.

图/表 4

表1 护士一般资料（n=942）

表2 护士对脑卒中患者吞咽障碍管理的基础知识水平[n=942,名（百分比,%）]

表3 护士对脑卒中患者吞咽障碍筛查与评估的实践现状（n=942）

表4 脑卒中患者吞咽障碍筛查与评估的执行人员 [n=942,名（百分比,%）]

参考文献 17

[1]	Teismann IK, Suntrup S, Warnecke T, et al. Cortical swallowing processing in early subacute stroke[J]. BMC Neurol, 2011,11:34. URL PMID
[2]	Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 guidelines for the early management of patients with acute ischemic stroke:a guideline for healthcare professionals from the American heart association/American stroke association[J]. Stroke, 2018,49(3):e46-e110. DOI URL PMID
[3]	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)第二部分治疗与康复管理篇[J]. 中华物理医学与康复杂志, 2018,40(1):1-10.
[4]	Hebert D, Patrice Lindsay M, McIntyre A, et al. Canadian stroke best practice recommendations:Stroke rehabilitation practice guidelines,update 2015[J]. Int J Stroke, 2016,11(4):459-484. URL PMID
[5]	Christensen M, Trapl M. Development of a modified swallowing screening tool to manage post-extubation dysphagia[J]. Nurs Crit Care, 2018,23(2):102-107. DOI URL PMID
[6]	董小方, 郭园丽, 吕培华, 等. 脑卒中后吞咽障碍患者管理的最佳证据总结[J]. 中华现代护理杂志, 2019,25(31):4037-4046.
[7]	陈霞, 侯晓红, 崔新, 等. 急性脑卒中患者吞咽障碍识别的证据总结[J]. 护理学杂志, 2019,34(14):97-100.
[8]	郑晓娜, 陈秋华, 邵庭芳, 等. 9种吞咽障碍筛查量表准确性的网状Meta分析[J]. 中华护理杂志, 2019,54(10):1561-1566.
[9]	滑蓉蓉, 丁则昱, 王春育. 苏格兰学院间指南网络:脑血管病患者吞咽困难的识别与治疗临床指南[J]. 中国卒中杂志, 2011,6(6):480-494.
[10]	Farpour S, Farpour HR, Smithard D, et al. Dysphagia management in Iran:knowledge,attitude and practice of healthcare providers[J]. Dysphagia, 2019,34(1):105-111. URL PMID
[11]	陆秋芳, 赵翠松, 覃英雪, 等. 南宁市神经内科护士对脑卒中吞咽障碍患者护理知识和态度的调查报告[J]. 中国实用护理杂志, 2019,35(25):1951-1956.
[12]	Palli C, Fandler S, Doppelhofer K, et al. Early dysphagia screening by trained nurses reduces pneumonia rate in stroke patients[J]. Stroke, 2017,48(9):2583-2585. URL PMID
[13]	黄师菊, 蔡有弟, 李晓玲, 等. 护士主导的高危科室吞咽障碍患者筛查及分级干预效果评价[J]. 中华护理杂志, 2018,53(11):1303-1308.
[14]	Perry L, Hamilton S, Williams J. Formal dysphagia screening protocols prevent pneumonia[J]. Stroke, 2006,37(3):765. URL PMID
[15]	乐革芬, 余鹏, 汪欢, 等. 成人脑卒中患者吞咽障碍管理的证据总结[J]. 护理学杂志, 2019,34(7):42-46.
[16]	张秀英, 蒋红. 2016版成人脑卒中康复指南解读:吞咽困难的护理[J]. 上海护理, 2018,18(8):5-8.
[17]	Osawa A, Maeshima S, Tanahashi N. Water-swallowing test:screening for aspiration in stroke patients[J]. Cerebrovasc Dis, 2013,35(3):276-281. DOI URL PMID

河南省护士对脑卒中患者吞咽障碍筛查与评估的现状调查

Current status of screening and assessment of patients with dysphagia after stroke by nurses in Henan province

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