被诊断为口咽吞咽困难的患者坚持吞咽治疗的相关因素

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2024-09-14 DOI:10.1002/lio2.1318

Uche C. Ezeh MD, MS, Matina Balou PhD, Tyler Crosby MD, Paul E. Kwak MD, Milan R. Amin MD

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引用次数: 0

摘要

目的本研究旨在评估临床诊断为口咽吞咽困难（OD）的患者在坚持吞咽治疗方面的差异。方法对 600 名口咽吞咽困难患者的数据进行分析，这些患者在视频荧光吞咽研究中证实存在吞咽安全性和/或效率障碍。根据患者对治疗疗程的依从性（即参加吞咽治疗疗程的次数）对患者进行分类。治疗依从性结果分为两组：参加规定治疗次数少于50%的患者和参加治疗次数达到或超过50%的患者。连续变量以均数±标准差或中位数±四分位距表示。分类变量的比较采用皮尔逊卡方检验（Pearson chi-square tests）和费雪精确检验（Fisher's exact test）。采用单变量和多变量二元逻辑回归模型来确定与成功坚持治疗相关的因素。结果约 79% 的患者坚持了吞咽治疗。我们发现，坚持治疗与年龄、性别、种族、民族、主要语言、婚姻状况、保险状况、职业、收入中位数、距离、教育程度、OD 严重程度和诊断年份之间没有明显关系（p > 0.05）。在单变量和多变量二元回归模型中，我们没有发现任何协变量可显著预测吞咽治疗的不依从性（p > 0.05）。结论本研究分析的变量与不坚持吞咽治疗无明显关联。尽管如此，我们的研究仍填补了一项重要的知识空白，未来的研究将从探索其他相关的社会经济和疾病相关因素中获益。证据等级 4 级。

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Factors associated with adherence to swallowing therapy among patients diagnosed with oropharyngeal dysphagia

Objective

The objective of this study is to assess disparities in adherence to swallowing therapy for clinically diagnosed oropharyngeal dysphagia (OD) patients.

Methods

Analysis was conducted on data from 600 patients with OD and confirmed impairments in swallowing safety and/or efficiency on a videofluoroscopic swallow study. Patients were classified based on their adherence to treatment sessions, defined as the number of swallow treatment sessions attended. The outcome of treatment adherence was categorized into two groups: those who attended fewer than 50% of the prescribed treatment sessions and those who attended 50% or more of the sessions. Continuous variables were presented as mean ± standard deviation or median ± interquartile range. Categorical variables were compared using Pearson chi-square tests and Fisher's exact test when appropriate. Univariable and multivariable binary logistic regression models were employed to identify factors associated with successful adherence.

Results

Approximately 79% adhered to swallowing treatment. We found no significant relationship between adherence and age, sex, race, ethnicity, primary language, marital status, insurance status, occupation, median income, distance, education, OD severity, and diagnosis year (p > 0.05). We found no covariables to be significant predictors to swallowing treatment nonadherence in both univariable and multivariable binary regression models (p > 0.05).

Conclusion

The variables analyzed in this study were not significantly associated with nonadherence to swallow therapy. Nevertheless, our study still addressed an important knowledge gap and future studies would benefit from exploring other relevant socioeconomic and disease-related factors.