老年吞咽障碍患者的生活质量及其影响因素

doi:10.3969/j.issn.1006-9771.2020.11.003

摘要/Abstract

摘要：

目的调查老年吞咽障碍患者的生活质量并分析影响因素。方法 2019年1月至12月,方便抽取本院老年(≥ 60岁)住院患者523例,采用吞咽生活质量量表(SWAL-QOL)、进食评估问卷调查工具-10 (EAT-10)、透视荧光吞咽检查(VFSS)、营养风险筛查2002 (NRS-2002)和FRIED量表进行调查。结果共有160例诊断吞咽障碍(30.59%)。老年吞咽障碍患者SWAL-QOL总分(45.15±13.31)分,各维度分由低到高依次为食欲、社会交往、吞咽症状、心理健康、睡眠、进食恐惧、进食时间、疲劳、心理负担、语言交流。EAT-10评分≥ 19为SWAL-QOL总分的危险因素,健康状况良好和接受吞咽治疗是保护因素。结论老年吞咽障碍患者总体生活质量较低,应重视早期筛查,积极采取干预措施。

关键词: 吞咽障碍, 老年, 生活质量, 影响因素

Abstract:

objective To investigate the quality of life in old patients with dysphagia and the related factors.Methods From January to December, 2019, 523 old inpatients were selected and investigated with Swallowing-Quality of Life Questionnaire (SWAL-QOL), Eating Assessment Tool-10 (EAT-10), videofluoroscopic swallowing study (VFSS), Nutritional Risk Screening 2002 (NRS-2002) and FRIED scale.Results There were 160 inpatients diagnosed dysphagia (30.59%). The total score of SWAL-QOL in the inpatients with dysphagia was (45.15±13.31), and the dimension scores from low to high were appetite, social function, swallowing symptoms, mental health, sleep, eating fear, eating time, fatigue, swallowing burden and communication. For the total score of SWAL-QOL, EAT-10 score ≥ 19 was the risk factor, while good health condition and accepting swallowing treatment were the protective factors.Conclusion The quality of life is poor for the old inpatients with dysphagia, and early screening and intervention for dysphagia are needed.

Key words: dysphagia, aged, quality of life, related factors

中图分类号:

R592

赖小星,薄琳,朱宏伟,霍晓鹏. 老年吞咽障碍患者的生活质量及其影响因素[J]. 《中国康复理论与实践》, 2020, 26(11): 1263-1268.

LAI Xiao-xing,BO Lin,ZHU Hong-wei,HUO Xiao-peng. Quality of Life in Old Patients with Dysphagia and Its Related Factors[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(11): 1263-1268.

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变量		n	SWAL-QOL总分	t/F值	P值
性别	男	113	44.82±13.33	-0.593	0.554
性别	女	47	46.19±13.35
年龄(岁)	60~69	40	45.52±14.98	0.892	0.374
	70~79	44	49.96±11.91
	≥ 80	76	43.15±13.49
文化程度	小学及以下	32	42.08±11.96	1.609	0.203
	初高中	92	45.29±13.39
	大专及以上	36	47.85±14.02
婚姻	配偶健在	118	46.45±13.40	3.888	0.051
	其他	42	41.78±12.58
居住情况	单独居住	6	34.94±9.78	2.434	0.067
	与保姆居住	12	39.25±13.60
	与配偶居住	115	46.51±13.50
	与子女居住	27	44.68±11.91
费用支付	城镇居民保险	70	47.61±13.12	2.454	0.065
	公费医疗	55	45.34±12.78
	农村合作医疗	33	40.15±13.40
	自费	2	42.05±21.70
健康状况	差	65	37.81±10.85	22.991	< 0.001
	一般	90	49.82±11.83
	好	5	58.75±21.32
引起吞咽障碍的疾病	脑血管病	33	45.04±13.32	2.309	0.047
	帕金森病	35	49.38±13.66
	头颈部肿瘤	20	46.73±12.18
	运动神经元病	16	36.46±13.15
	增龄引起老化	43	44.08±12.60
	其他	13	46.72±13.26
接受吞咽治疗	否	108	43.58±13.07	4.746	0.031
	是	52	48.46±13.37
NRS-2002	无营养风险	63	48.82±11.53	7.895	0.006
NRS-2002	有营养风险	97	42.89±13.92
EAT-10	< 19	89	52.14±9.93	81.723	< 0.001
	≥ 19	71	36.55±11.90
FRIED量表评级	衰弱	75	39.45±12.45	16.589	< 0.001
	衰弱前期	58	49.21±11.87
	健康	27	52.67±12.05

变量	B	S.E	t	P	95%CI
常量	2234.248	167.090	13.372	< 0.001	1904.180~2564.316
EAT10(≥19)	-605.712	70.553	-8.585	< 0.001	-745.081~-466.343
健康状况	343.610	64.324	5.342	< 0.001	216.544~470.676
接受吞咽治疗	209.340	72.503	2.887	0.004	66.118~352.562