Therapeutic Science for Rehabilitation (재활치료과학)

Korean Society of Neurological Occupational Therapy (대한신경계작업치료학회)
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A Survey About Awareness and Necessity of Community Based Dysphagia Therapy of Community Dwelling Older Adults

지역사회 거주 노인들의 연하장애 인식과 중재 필요성

  • 민경철 (서울특별시 어린이병원 재활의학과) ;
  • 김은희 (의왕시 보건소 치매지원팀) ;
  • 우희순 (원광대학교 의과대학 작업치료학과)
  • Received : 2022.02.14
  • Accepted : 2022.03.10
  • Published : 2022.05.31
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Abstract

Objective : This study aimed to investigate the awareness and experience of community-based dysphagia therapy and related education in community-dwelling older adults. Methods : A total of 89 older adults were recruited from a public health center in Gyeonggi-do. Awareness, experience, and related education regarding community-based dysphagia therapy were analyzed using descriptive statistics. Results : We analyzed 89 questionnaires. Awareness, treatment experience, and education regarding dysphagia were low; however, the importance and intention to participate were high. Respondents wanted education about proper chewing and safe swallowing, oral health, oral motor exercise, and participation in community-based dysphagia programs in public health centers. The reason for the lack of experience in dysphagia education and therapy is insufficient information and opportunities. The respondents had a good understanding of dysphagia symptoms. Conclusion : Dysphagia therapy maintains swallowing and eating functions as a life-long Activity of Daily Living, and is a very important area in community rehabilitation. Based on the results of this survey, the necessity and importance of community-based dysphagia were identified. It is time to provide correct information and develop a systematic education program for community-based dysphagia therapy. Occupational therapists need to play an active role in improving quality of life by early detection and providing proper intervention.

목적 : 본 연구는 지역사회 거주 노인을 대상으로 연하재활 인식도, 교육 및 치료 경험과 현황을 설문을 통해 확인하여 지역사회 연하재활 중재 서비스 제공의 필요성을 파악하기 위하여 진행되었다. 연구방법 : 경기도 내 일개 보건소에 내소하는 지역사회 거주 노인에게 지역사회 연하장애 인식, 교육, 치료에 관한 직접 설문을 진행한 후 기술통계 및 빈도분석을 활용하여 분석하였다. 결과 : 총 89명의 응답 결과를 분석하였다. 지역사회 노인들의 연하장애에 대한 인식도 및 교육, 치료 경험은 높지 않았으나, 중요성 및 참여도는 높은 것으로 나타났다. 원하는 교육 주제로는 구강 건강 및 관리, 씹기 및 삼킴, 구강운동법으로 다양하였으며, 추후 보건소에 연하재활 프로그램이 생기면 참여한다고 응답하였다. 연하재활 교육 및 치료 참여가 어려운 이유는 정보 및 기회 부족을 꼽았다. 대부분의 연하장애 증상에 대한 이해도는 높은 것으로 나타났다. 결론 : 연하재활은 일생에 걸친 주요 일상 활동인 먹기 및 삼킴 기능을 유지시키고 삶의 질에도 직접적으로 영향을 미치는 지역사회 재활의 주요 영역이다. 본 연구를 통해 지역사회 연하재활의 필요성과 중요성을 확인하였으므로, 지역사회 노인을 포함한 지역사회 대상자들에게 연하재활에 관련된 정확한 인식 제공과 체계화된 프로그램 개발이 필요한 시점이다. 더불어 지역사회 노인들의 연하장애 증상 조기 발견과 중재 제공을 통해 삶의 질 증진을 위한 작업치료사들의 적극적 역할이 필요하다.

Keywords

Acknowledgement

본 연구는 2022년 대한연하재활학회 연구비 지원으로 진행되었습니다.

References

  1. Adkins, C., Takakura, W., Spiegel, B. M., Lu, M., Vera-Llonch, M., Williams, J., & Almario, C. V. (2020). Prevalence and characteristics of dysphagia based on a population-based survey. Clinical Gastroenterology and Hepatology, 18(9), 1970-1979. https://doi.org/10.1016/j.cgh.2019.10.029
  2. Bahat, G., Yilmaz, O., Durmazoglu, S., Kilic, C., Tascioglu, C., & Karan, M. A. (2019). Association between dysphagia and frailty in community dwelling older adults. The Journal of Nutrition, Health & Aging, 23(6), 571-577. https://doi.org/10.1007/s12603-019-1191-0
  3. Bang, H. L., & Park, Y. H. (2013). Development of evidence-based dysphagia nursing care protocol for nursing home residents. Journal of Muscle and Joint Health, 20(1), 31-42. http://dx.doi.org/10.5953/JMJH.2013.20.1.31
  4. Chen, P. H., Golub, J. S., Hapner, E. R., & Johns, M. M. (2009). Prevalence of perceived dysphagia and quality-of-life impairment in a geriatric population. Dysphagia, 24(1), 1-6. https://doi.org/10.1007/s00455-008-9156-1
  5. Choi, H. S., & Kim, Y. J. (2019). Current status of the elderly's swallowing disorder and changes in quality of life related to swallowing after swallowing education in the elderly in the community: Around the Gangdong-gu area. Journal of Korea Aging Friendly Industry Association, 11(1), 11-21. https://doi.org/10.34264/jkafa.2019.11.1.11
  6. Di Pede, C., Mantovani, M. E., Del Felice, A., & Masiero, S. (2016). Dysphagia in the elderly: Focus on rehabilitation strategies. Aging Clinical and Experimental Research, 28(4), 607-617. https://doi.org/10.1007/s40520-015-0481-6
  7. Egan, A., Andrews, C., & Lowit, A. (2020). Dysphagia and mealtime difficulties in dementia: Speech and language therapists' practices and perspectives. International Journal of Language and Communication Disorders, 55(5), 777-792. https://doi.org/10.1111/1460-6984.12563
  8. Ekberg, O., Hamdy, S., Woisard, V., Wuttge-Hannig, A., & Ortega, P. (2002). Social and psychological burden of dysphagia: Its impact on diagnosis and treatment. Dysphagia, 17(2), 139-146. https://doi.org/10.1007/s00455-001-0113-5
  9. Gonzalez-Fernandez, M., Humbert, I., Winegrad, H., Cappola, A. R., & Fried, L. P. (2014). Dysphagia in old-old women: Prevalence as determined according to self-report and the 3-ounce water swallowing test. Journal of the American Geriatrics Society, 62(4), 716-720. https://doi.org/10.1111/jgs.12745
  10. Holland, G., Jayasekeran, V., Pendleton, M., Horan, M., Jones, M., & Hamdy, S. (2011). Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population: A self-reporting questionnaire survey. Diseases of the Esophagus, 24(7), 476-480. https://doi.org/10.1111/j.1442-2050.2011.01182.x
  11. Howells, S. R., Cornwell, P. L., Ward, E. C., & Kuipers, P. (2019). Understanding dysphagia care in the community setting. Dysphagia, 34(5), 681-691. https://doi.org/10.1007/s00455-018-09971-8
  12. Howells, S. R., Cornwell, P. L., Ward, E. C., & Kuipers, P. (2021). Client perspectives on living with dysphagia in the community. International Journal of Speech-Language Pathology, 23(2), 201-212. https://doi.org/10.1080/17549507.2020.1765020
  13. Kim, M. S., & Park, Y. H. (2014). The risk of dysphagia and dysphagia-specific quality of life among community dwelling older adults in senior center. Korean Journal of Adult Nursing, 26(4), 393-402. https://doi.org/10.7475/kjan.2014.26.4.393
  14. Lee, A., Sitoh, Y. Y., Lieu, P. K., Phua, S. Y., & Chin, J. J. (1999). Swallowing impairment and feeding dependency in the hospitalised elderly. Annals of the Academy of Medicine, Singapore, 28(3), 371-376.
  15. Madhavan, A., Lagorio, L. A., Crary, M. A., Dahl, W. J., & Carnaby, G. D. (2016). Prevalence of and risk factors for dysphagia in the community dwelling elderly: A systematic review. The Journal of Nutrition, Health & Aging, 20(8), 806-815. https://doi.org/10.1007/s12603-016-0712-3
  16. McHutchion, L. D., Pringle, J. M., Tran, M. N., Ostevik, A. V., & Constantinescu, G. (2021). A survey of public awareness of dysphagia. International Journal of Speech-Language Pathology, 614-621. https://doi.org/10.1080/17549507.2021.1912179
  17. Min, K. C., Kim, E. H., & Woo, H. S. (2020). Job characteristics and status of community occupational therapist: Focus on OTs in public health centers. The Journal of Korean Society of Community Based Occupational Therapy, 10(3), 37-52. https://doi.org/10.18598/kcbot.2020.10.3.04
  18. Ministry of Health and Welfare. (2020). Survey of oral motor and chewing limitation. http://www.mohw.go.kr/react/jb/sjb1101vw.jsp?SEQ=88&MENU_ID=03320101&page=2&PAR_MENU_ID=03#
  19. Morisaki, N. (2018). Effects of oral exercise on oral function among Japanese dependent elderly individuals living in nursing facilities. International Journal of Nursing and Clinical Practices, 5, 1-4. https//doi.org/10.15344/2394-4978/2018/301
  20. Nund, R. L., Scarinci, N. A., Cartmill, B., Ward, E. C., Kuipers, P., & Porceddu, S. V. (2016). Third-party disability in carers of people with dysphagia following non-surgical management for head and neck cancer. Disability and Rehabilitation, 38(5), 462-471. http://dx.doi.org/10.3109/09638288.2015.1046563
  21. Rofes, L., Arreola, V., Almirall, J., Cabre, M., Campins, L., Garcia-Peris, P., Speyer, R., & Clave, P. (2011). Diagnosis and management of oropharyngeal dysphagia and its nutritional and respiratory complications in the elderly. Gastroenterology Resarch and Practice, 1-13. http://doi.org/10.1155/2011/818979
  22. Roy, N., Stemple, J., Merrill, R. M., & Thomas, L. (2007). Dysphagia in the elderly: Preliminary evidence of prevalence, risk factors, and socioemotional effects. Annals of Otology, Rhinology & Laryngology, 116(11), 858-865. http://doi.org/10.1177/000348940711601112
  23. Seo, S. M., Song, Y. J., & Woo, H. S. (2020). Study on the status of dysphagia rehabilitation. Journal of the Korean Dysphagia Society, 10(1), 47-55. https://doi.org/10.34160/jkds.2020.10.1.006
  24. Whang, S. A. (2014). Prevalence and influencing factors of dysphagia risk in the community-dwelling elderly. Journal of the Korean Gerontological Society, 34(1), 37-48.
  25. Yeo, H. J., & Lee, Y. J. (2020). A study on the awareness and necessity of occupational therapy for the elderly in the community. Society of Occupational Therapy for the Aged and Dementia, 14(1), 49-58. http://doi.org/10.34263/jsotad.2020.14.1.49