Evaluation of a nurse-led swallowing risk assessment tool in care-home residents: a prospective diagnostic accuracy study.

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

European Geriatric Medicine Pub Date : 2025-05-03 DOI:10.1007/s41999-025-01194-z

Patricia Heaney, Deborah Annis-Marley, William Gray, Louise Jones, Julia Scott, Miles D Witham

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引用次数: 0

Abstract

Purpose: To develop and test a screening tool enabling care-home staff to identify residents with high-risk swallowing problems (dysphagia).

Methods: The Nurse Dysphagia Screening Tool (NDST) was developed via an iterative, participatory process. A diagnostic evaluation study was performed in North-East of England care homes. We compared NDST with gold-standard speech and language therapist swallowing assessment risk category to derive sensitivity, specificity, and positive and negative predictive values.

Results: One hundred and seventy two residents (101 women) were included from 14 care homes, mean age 82.1 years (SD 10.6). Residents known to SLT, or with Percutaneous Endoscopic Gastrostomy (PEG) were excluded. 18/172 (11%) had high-risk swallow by gold-standard assessment. NDST was completed successfully on all participants. Sensitivity, specificity, and positive and negative predictive values were 72%, 92%, 50%, and 97%, respectively. Sensitivity was higher (100%) in high-volume care homes and for those recruited late in the study, suggesting a learning curve.

Conclusion: NDST requires additional testing but can potentially identify high-risk dysphagia in care homes.

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护理院居民中护士主导的吞咽风险评估工具的评估：一项前瞻性诊断准确性研究。

目的：开发和测试一种筛选工具，使养老院的工作人员能够识别有高风险吞咽问题（吞咽困难）的居民。方法：护士吞咽困难筛查工具（NDST）是通过一个迭代的、参与式的过程开发的。一项诊断评估研究在英格兰东北部的护理院进行。我们将NDST与金标准言语和语言治疗师吞咽评估风险分类进行比较，得出敏感性、特异性以及阳性和阴性预测值。结果：共纳入来自14家养老院的172名住客（101名女性），平均年龄82.1岁（SD 10.6）。已知SLT或经皮内镜胃造口术（PEG）的居民被排除在外。根据金标准评估，18/172例（11%）为高危吞咽。所有参与者的无损检测均顺利完成。敏感性、特异性、阳性预测值和阴性预测值分别为72%、92%、50%和97%。在大容量护理院和研究后期招募的人中，敏感性更高（100%），这表明存在学习曲线。结论：NDST需要额外的检测，但可以潜在地识别养老院的高危吞咽困难。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Geriatric Medicine GERIATRICS & GERONTOLOGY-

CiteScore

6.70

自引率

2.60%

发文量

114

审稿时长

6-12 weeks

期刊介绍： European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine. The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.