The introduction of a quantitative case conference form to record and evaluate swallowing improvement in dysphagic patients

• Published in: The Japanese Journal of Dysphagia Rehabilitation Vol. 11; no. 2; pp. 130 - 136
• Main Authors: KONISHI, Masanori, INAGAKI, Shuhei, HAGIWARA, Ryoji, MITSUMASU, Satoru, KOIKE, Sumiko, SAKAI, Namika, SAITO, Haruko, TAKEDA, Rihei
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Dysphagia Rehabilitation 31.08.2007; 一般社団法人 日本摂食嚥下リハビリテーション学会
• Subjects: assessment; conference; dysphagia; カンファレンス; 摂食・嚥下障害; 評価
• ISSN: 1343-8441; 2434-2254
• DOI: 10.32136/jsdr.11.2_130

【Purpose】We designed and constructed a standardized swallowing evaluation form to be used among professionals working with swallowing impaired patients. The purpose of the form was to enable accurate recording and dissemination of information between all people involved in the care process by recording and scoring swallowing function factors. Factors affecting swallowing ability were graded on a point scale for each patient, with a cumulative total providing a quantitative value reflecting the current swallowing status or level of improvement.【Subjects and methods】We evaluated 31 subjects diagnosed as having dysphagia resulting from CNS disorder. Multiple appraisals lead to a total of 92 forms being used, and fourteen factors associated with swallowing ability were identified and graded over the course of each assessment. These included cognition of food, motivation, palsy, ataxia, tracheotomy, tongue exercises, nasopharyngeal closure, elevation of the lingual root, glottis closure, elevation of the larynx, RSST (Repetitive Saliva Swallowing Test), swallowing reflex, voice disorder and understanding.【Results and Discussion】1. It was found that the cumulative point total of swallowing function factors from each evaluation correlated significantly with Fujishima's grading in dysphagic patients.2. Ten factors were additionally found to correlate significantly with Fujishima's grading. These included cognition of food, motivation, tongue exercises, nasopharyngeal closure, elevation of the lingual root, glottis closure, RSST, swallowing reflex, voice disorder and understanding. These factors, individually or in conjunction, thus appear to have importance in predicting swallowing ability. Multiple regression analysis revealed that the regression formula including motivation, ataxia, elevation of the lingual root, swallowing reflex, voice disorder can be predict Fujishima’s grading.3. In 26 cases which had undergone at least 2 swallowing evaluations, elevation of the lingual root correlated strongly with swallowing ability at the time of the last swallowing evaluation. Among fourteen factors, only elevation of the lingual root can be predict Fujishima's grading by multiple regression. Thus our case conference form is thought to be useful to evaluate swallowing function of dysphagic patients.