Effect of Feeding Management on Aspiration Pneu-monia in Elderly Patients with Dysphagia

Min Li; Zheng Wang; Wei-Jia Han; Shi-Yin Lu; Ya-Zhen Fang

doi:10.1016/j.cnre.2015.09.004

摘要：Objective: To investigate the effects of feeding safety instructions and dietary intervention on as-piration pneumonia in elderly patients with dysphagia. Methods: The study included 40 long-term hospitalized elderly patients with dysphagia who nee-ded oral intake. According to the voluntary and matching principle, participants were divided into the intervention group ( n=20) and control group ( n=20) . We formed a multi-disciplinary team including clinical nurses, rehabilitation therapists and nutritionists. Clinical nurses collaborated with nutritionists and rehabilitation therapists to carry out feeding management. The patients in the control group were fed with semi-solid food, thick liquid, a partial mushy diet and so on accord-ing to their swallowing situations and tastes or preferences. The patients in the intervention group were fed with an all mushy diet. Patients in both groups were able to eat foods on their own or with assistance. Results: After a three-month intervention, the incidence of aspiration pneumonia in both groups was decreased, and the difference was statistically significant ( P<0. 05) . In the control group, seven patients had aspiration pneumonia, including two cases who died after nasogastric feeding due to aggravated dysphagia. In the control group, seven patients had aspiration pneumonia, in-cluding two cases was given nasogastric feeding due to aggravated dysphagia and then one case died. In the intervention group, four patients had aspiration pneumonia. There was no dropouts in either group. Conclusions: Elderly patients with dysphagia require a multidisciplinary team to work closely with them to carry out feeding management. Nurses should conduct safety guidance for care cate-ring and encouraging patients to actively eat a mushy diet. The diet can reduce the incidence of as-piration pneumonia, maintain oral intake and improve the quality of life.