社区老人吞咽障碍发生现状及影响因素分析  

Current status and related factors of dysphagia among community elderly

作　　者：张欣 田家利[2] 公冶慧娟 何帆[3] 张素[2] 刘宇 谢海燕[3] 郭桂芳[1] 裴晓梅[5] Zhang Xin;Tian Jiali;Gongye Huijuan;He Fan;Zhang Su;Liu Yu;Xie Haiyan;Guo Guifang;Pei Xiaomei(Teaohing and Researching Section of Community Nursing,School of Nursing,Peking University,Beijing 100191,China;Respiratory Medicine,Peking University People＇s Hospital,Bei.iing 100044,Chin;Department of Outpatient,Peking Union Medical College Hospital,Beijing 100032,China;Teaohing and Researching Section of Community Nursing,School of Nursing,China Medical University,Shenyang 110001,Chin;Department of Sociology,Tsinghua University,Beijing 100084,China)

机构地区：[1]北京大学护理学院社区护理教研室,100191 [2]北京大学人民医院呼吸内科,北京100044 [3]北京协和医院门诊部,100032 [4]中国医科大学护理学院社区护理教研室,沈阳110001 [5]清华大学社会学系,北京100084

出　　处：《中华现代护理杂志》2018年第26期3117-3123,共7页Chinese Journal of Modern Nursing

基　　金：2016年北京市东城区社区卫生服务管理中心课题基金（o107160）

摘　　要：目的 了解北京市东城区社区老人吞咽障碍发生现状,并探讨其影响因素.方法 2016年5月―2017年2月应用InterRAI家庭护理评估工具（InterRAI HC）对社区老人（≥60岁）的居家照护需求评估的数据（n=229）进行吞咽功能的聚焦分析,以InterRAI HC量表中＂营养摄入方式＂条目的评价结果作为判断是否存在吞咽障碍的标准.采用χ^2检验和Logistic回归对社区老人吞咽障碍影响因素进行分析.结果 229名社区老人中,存在吞咽障碍的老人有49名,发生率为21.4％.平衡能力受损（OR=4.913,95％CI：1.772～13.618,P=0.002）、摄水量〈1000 ml/d（OR=2.600,95％CI：1.253～5.396,P=0.010）、BMI〈18.5 kg/m^2（OR=4.576,95％CI：1.220～17.172,P=0.024）、年龄（OR=1.048,95％CI：1.004～1.095,P=0.032）、帕金森病史（OR=2.505,95％CI：1.015～6.180,P=0.046）是社区老人吞咽障碍的影响因素.结论 北京市东城区社区老人吞咽障碍状况值得重视,应通过关注相关因素、有效筛查等积极措施以做到对老年人吞咽障碍的早发现、早预防、早干预.Objective To understand the current status of dysphagia among community elderly of Dongcheng District of Beijing Municipality and to explore its related factors.Methods From May 2016 to February 2017, the International Resident Assessment Instrument Home Care （InterRAI HC） was used for data of home care needs assessment of community elderly （≥60 years old） to carry out the focused analysis of dysphagia. The evaluation result of the term ＂nutrition intake patterns＂ of InterRAI HC was taken as the standard to determine whether to be with or without dysphagia. The chi-square test and Logistic regression were used to analyze the influencing factors of dysphagia among community elderly.Results Among 229 community elderly, there were 49 cases with dysphagia with 21.4% for the incidence. The related factors of dysphagia among community elderly included the impaired balanced capacity （OR=4.913, 95%CI： 1.772-13.618, P=0.002）, yield of drinking water〈1000 ml/d （OR=2.600, 95%CI： 1.253-5.396,P=0.010）, ages （OR=1.048, 95%CI： 1.004-1.095,P=0.024）, body mass index〈18.5 kg/m^2 （OR=4.576, 95%CI： 1.220-17.172,P=0.024） and history of Parkinson＇s disease （OR=2.505, 95%CI： 1.015-6.180,P=0.046）.Conclusions The current status of dysphagia in community elderly of Dongcheng District of Beijing Municipality is worth attaching importance to. The dysphagia of the aged should be prevented, discovered and treated early by active measures such as paying close attention to related factors and effective screening.

关 键 词：老年人 吞咽障碍 社区 影响因素 

分 类 号：R473.2[医药卫生—护理学]