Evde Bakım Hizmeti Alan Geriatrik Hastalarda Disfaji Sıklığı ve İlişkili Risk Faktörleri

Year 2023, , 236 - 242, 22.06.2023

Nur Şimşek Yurt , Esra Böcek Aker

https://doi.org/10.18521/ktd.1230312

Abstract

Amaç: Çalışmamızda evde bakım hizmeti alan 65 yaş ve üstü hastalarda disfaji prevalansının belirlenmesi ve disfaji ile ilişkili faktörlerin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Araştırmamız kesitsel tanımlayıcı bir çalışma olup 1 Aralık 2021 ile 1 Mart 2022 tarihleri arasında Samsun Eğitim ve Araştırma Hastanesi Evde Sağlık Hizmetlerine kayıtlı hastalar ile gerçekleştirildi. Katılımcıların demografik özellikleri, yatağa bağımlılık durumu, beslenme yöntemleri, enteral beslenme ürün kullanımı, beden kitle indeksi (BKİ) verileri ile eşlik eden kronik hastalıklarının belirlenmesi amacı ile Charlson Komorbidite İndeksi (CCI), disfaji belirtileri açısından Yeme Değerlendirme Aracı (EAT-10), beslenme durumunun değerlendirilmesi için Nütrisyonel Risk Tarama-2002 (NRS) yüz yüze uygulanarak veriler kaydedildi.
Bulgular: Çalışmaya %62,5'i (n=258) kadın olmak üzere toplam 413 hasta dahil edildi. %44,6’sında (n=184) disfaji semptomları mevcuttu. Erkeklerde (p=0,025), 85 yaş ve üzeri kişilerde (p=0,001), CCI puanı yüksek olanlarda (p<0,001), serebrovasküler hastalık (p<0,001), demans (p<0,001), hemipleji tanısı olanlarda (p=0,001), yatağa tam bağımlı kişilerde (p<0,001) disfaji oranı yüksekti. Benzer şekilde beslenme riski mevcut bireylerde ve enteral beslenme ürünü kullananlarda disfaji oranı anlamlı derecede yüksek saptandı (p<0,001). Multivaryat lojistik regresyonda demansın ve artmış beslenme riskinin disfaji semptomlarının varlığında bağımsız risk faktörleri olduğu tespit edildi (p<0,001).
Sonuç: Çalışmamız evde bakım hizmeti alan geriatrik hasta popülasyonunda yüksek disfaji prevalansını göstermiştir. İleri yaş, artmış beslenme riski, demans, serebrovasküler hastalık ve çoklu komorbiditesi olan hastalarda disfaji oranının arttığı belirlenmiştir.

Keywords

Evde bakım hizmetleri, yutma bozuklukları, yaşlı, komorbidite

Dysphagia Frequency and Associated Risk Factors in Geriatric Patients Receiving Home Care

Abstract

Objective: In our study, it was aimed to determine dysphagia prevalence in patients 65 years of age and older who were received home care and to assess factors associated with dysphagia.
Methods: This cross-sectional, descriptive study was conducted in patients who were registered to Home Care Services of Samsun Training and Research Hospital between December 1, 2021, and March 1, 2022. In all patients, demographic data, level of dependence, nutrition methods, use of enteral nutrition supplement, body mass index (BMI), and comorbidity were assessed by Charlson Comorbidity Index (CCI) while dysphagia symptoms were assessed by Eating Assessment Tool (EAT-10) and nutritional status was assessed by Nutritional Risk Screening-2002 (NRS) using face-to-face interview method.
Results: A total of 413 patients were included in our study, of which 62.5% (n=258) were female. Dysphagia symptoms were present in 44.6% (n=184). The dysphagia prevalence was significantly high in male patients (p=0.025), in patients aged ≥85 years (p=0.001), in those with high CCI score (p<0.001), in those with cerebrovascular disease (p<0.001), dementia (p<0.001), and hemiplegia (p=0.001), and in bedridden patients (p<0.001). Similarly, dysphagia prevalence was higher in patient with nutritional risk and those using enteral nutrition supplement (p<0.001). In multivariate logistic regression analysis, it was found that dementia and increased nutritional risk were independent risk factors for presence of dysphagia symptoms (p<0.001).
Conclusion: Our study showed a high prevalence of dysphagia in the geriatric patient population receiving home care. It has been determined that the rate of dysphagia is increased in patients with older age, nutritional risk, dementia, cerebrovascular disease, and multiple comorbidities.

Keywords

Home care services, deglutition disorders, aged, comorbidity, Evde bakım hizmetleri

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