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題 名 | 應用實證護理方法探討腦中風後病人執行下巴下壓抗阻力運動改善吞嚥困難之成效=Exploring the Efficacy of Chin Tuck against Resistance Exercise for Improving Swallowing Difficulties in Post-Stroke Patients Using an Evidence-Based Nursing Practice Approach |
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作 者 | 王雅秀; 張福凌; 蘇祝慧; 林麗嬋; 簡慧雯; | 書刊名 | 臺灣健康照顧研究學刊 |
卷 期 | 29 2024.01[民113.01] |
頁 次 | 頁1-17 |
分類號 | 419.82 |
關鍵詞 | 腦中風; 下巴下壓抗阻力運動; 吞嚥困難; Stroke; Chin tuck against resistance exercise; Dysphagia; |
語 文 | 中文(Chinese) |
中文摘要 | 腦中風病人因疾病因素引起喉部肌肉活動不協調,將產生吞嚥障礙,導致吸入性肺炎、營養不良、脫水及死亡率增加,即使經過治療,約有11-50%腦中風病人於出院後6個月內仍有持續性吞嚥障礙,因此需要持續返回醫院執行傳統吞嚥治療。下巴下壓抗阻力運動是近年來新發展的一種吞嚥訓練方式,故本文運用實證護理方法,探討腦中風後病人執行下巴下壓抗阻力運動是否能改善其吞嚥困難之成效。依主題確立關鍵字,搜尋實證資料庫,檢索條件限定符合主題關鍵字,研究設計限定系統性文獻回顧、統合分析、隨機對照試驗之中文、英文文獻,排除非實驗性研究與臨床實驗之文獻,共搜尋23篇文獻,最終納入符合條件為2篇隨機對照試驗,採用嚴謹實證評讀工具進行評讀。經文獻綜整結果為下巴下壓抗阻力運動每天執行30次動作,1週五天,至少持續4週後其可增加下巴、舌骨上肌到咽喉部的肌肉力量進而改善腦中風病人之咽喉期吞嚥困難。此外,下巴下壓抗阻力運動相關設備成本低,於病人無相關禁忌下,建議未來可推廣於傳統吞嚥治療腦中風病人上,使吞嚥能力盡快改善或恢復,增加生活品質,減少嗆咳頻率及吸入性肺炎之醫療支出。 |
英文摘要 | Stroke patients experience swallowing difficulties due to factors related to the disease, which result in discoordination of throat muscle activities. This condition can lead to aspiration pneumonia, malnutrition, dehydration, and increased mortality. Even with treatment, approximately 11-50% of stroke patients still have persistent swallowing difficulties within six months of discharge, necessitating a return to the hospital for traditional swallowing therapy. Chin tuck against resistance exercise is a relatively recent approach to swallowing training. This study applied evidence-based nursing methods to evaluate the effectiveness of chin tuck against resistance exercise in alleviating swallowing difficulties among post-stroke patients. By identifying key terms related to the topic, a search was conducted in evidence-based databases, with retrieval criteria limited to studies that matched the topic keywords. The study design encompassed systematic literature reviews, integrated analyses, and randomized controlled trials published in both Chinese and English languages. Non-experimental and clinical studies were excluded. A total of 23 articles were identified, with the final inclusion of two randomized controlled trials. Rigorous evidence appraisal tools were used for the evaluation. The synthesis of the literature revealed that performing chin tuck against resistance exercise 30 times a day, five days a week, for at least four weeks, can increase muscle strength from the chin and suprahyoid muscles to the pharynx. This, in turn, improves swallowing difficulties in stroke patients. Equipment for chin tuck against resistance exercise-related is cost-effective and, barring contraindications, recommended for incorporation into traditional swallowing therapy protocols for stroke patients. This approach can help improve or restore swallowing ability, enhance the quality of life, reduce the frequency of penetration or aspiration, and decrease healthcare expenditures related to aspiration pneumonia. |
本系統中英文摘要資訊取自各篇刊載內容。