吞咽障碍患者饮食管理方案的构建

doi:10.3761/j.issn.0254-1769.2022.12.003

摘要/Abstract

摘要：

目的参照国际吞咽障碍食物标准行动委员会的食品分级标准,基于吞咽功能分级构建吞咽障碍患者饮食管理方案。方法 2021年1月—3月,系统检索吞咽障碍患者饮食营养管理临床实践指南、手册、专家共识、证据总结和系统评价后进行证据提取整合,经研究小组讨论制订吞咽障碍患者饮食管理方案初稿,采用德尔菲法进行专家函询,针对专家意见,小组讨论后进行修改。结果共15名专家完成2轮函询,问卷有效回收率为100%;专家的权威系数为0.880,第2轮专家意见重要性及可操作性肯德尔和谐系数为0.396和0.412。形成的吞咽障碍患者饮食管理方案包括5个一级指标（未通过、4级、3级、2级、1级）,41个二级指标。结论专家意见协调程度好,权威性高。形成的吞咽障碍患者饮食管理方案科学可行,可为吞咽障碍患者的饮食管理提供借鉴。

关键词: 吞咽障碍, 功能评估, 食品分级, 饮食管理, 护理

Abstract:

Objective According to the food hierarchical standard of the International Dysphagia Diet Standardisation Initiative（IDDSI）,the food management plan for patients with swallowing disorders was constructed based on the swallowing function classification. Methods From January to March 2021, clinical practice guidelines,manuals,expert consensuses,evidence summaries,and systematic evaluation of dietary nutrition management in patients with swallowing disorders were systemically retrieved,and then the evidence was extracted and integrated. The first draft of the diet management plan was formulated by the research group,using Delphi method for 2 rounds of expert consultations,and expert opinions were modified by group discussion. Results 15 experts participated in 2 rounds of consultations,and the effective recovery rate of questionnaire was 100%. The expert authority scores of 2 rounds were 0.88,and the importance and operability of the second round of expert opinions Kendall harmony were 0.396 and 0.412. The diet management plan for patients with swallowing disorders,includes 5 first-level items（failed,level 4,level 3,level 2,level 1） and 41 second-level items. Conclusion There were high levels of coordination,enthusiasm,and authority in experts. The diet management plan of patients with swallowing disorders is scientific and feasible,which can provide references for the diet management of patients with swallowing disorders.

Key words: Swallowing Disorders, Function Assessment, Food Classification, Diet Management, Nursing Care

吕孟菊, 柳俊杰, 李雪琳. 吞咽障碍患者饮食管理方案的构建[J]. 中华护理杂志, 2022, 57(12): 1427-1434.

LU Mengju, LIU Junjie, LI Xuelin. Construction of the hierarchical diet management plan of swallowing function in patients with swallowing disorders[J]. Chinese Journal of Nursing, 2022, 57(12): 1427-1434.

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