The Effect of Education about Thickeners on the Prevention of Aspiration Pneumonia in Hospitalized Patients with Dysphagia

초록

Purpose: It is important that patients at high risk for aspiration should have precautions when putting foods in place of mouth before swallowing to reduce the risk. Food thickeners increase the liquid viscosity and reduce the flow capacity into the pharynx and esophagus, thereby increasing sensory awareness, making swallowing safe and efficient. The aims of this study were to 1) educate medical staff about how to use food thickeners properly and evaluate the effect of education and 2) identify the effect of education on the incidence of aspiration pneumonia. Methods: This is a prospective observational study including medical staff of 25 physicians, 118 nurses, and 10 nurse aides. We developed the education programs with videos, leaflets, and posters. Education contents included how to use food thickeners and cautions for diets with dysphagia. Survey tests about knowledge of dysphagia patients’ diets including food thickeners, the usefulness of food thickeners education, and self-confidence about the use of food thickeners were performed pre and post-education. Medical records of hospitalized patients with aspirated pneumonia were reviewed and analyzed to compare the incidence of aspiration pneumonia before and after the education program. Results: For the education effect, the score of knowledge for dysphagia patients’ diets including food thickeners showed an increased score compared with pre-education (p<0.001). The score on the usefulness of food thickeners education increased from 4.02±0.58 to 4.45±0.66, which was statistically significant (p<.001). Confidence about the use of food thickeners also increased (p<.001). For the incidence of aspiration pneumonia, during the 7 months, the average monthly incidence rate of hospital-acquired aspiration pneumonia patients was 1.18±0.29% before the education, and decreased significantly to 0.48±0.09 during the 7 months after the education (p<.001). Conclusions: The results of this study imply that the education on the proper use of food thickeners is very important and food thickeners would be helpful to reduce the risk of aspiration pneumonia in hospitalized patients with dysphagia or aspiration pneumonia.

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