| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 2.48 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
A disfagia pós-extubação tem elevada incidência em doentes
entubados, submetidos a ventilação mecânica invasiva, o que dificulta a ingestão
segura de alimentos e líquidos, aumentando o risco de aspiração. Um rastreio precoce
após a extubação é fundamental para a prevenção das consequentes complicações.
Objetivo: Testar a fiabilidade e validade da versão em português europeu do
instrumento de rastreio da disfagia Gugging Swallowing Screen for Intensive Care
Units.
Métodos: Foram incluídos 51 doentes, internados num Serviço de Medicina Intensiva,
a quem o Gugging Swallowing Screen for Intensive Care Units foi aplicado, no
mínimo, 1 hora após a extubação. Para determinação da validade de critério, foi
utilizado o resultado da avaliação clínica, efetuada por um enfermeiro especialista em
enfermagem de reabilitação, num período inferior a 24 horas relativamente ao
primeiro rastreio. Para determinar a fiabilidade inter-observadores, foi realizada uma
segunda aplicação do instrumento, por outro enfermeiro, cego para a primeira
avaliação, num período inferior a 24 horas.
Resultados: A incidência de disfagia avaliada com recurso ao Gugging Swallowing
Screen for Intensive Care Units foi de 74,5%, e de 66,7%, avaliada com recurso à
avaliação clínica, estabelecendo-se uma associação estatisticamente significativa
entre ambas (χ2 = 29,6; p <0.001). Os valores da sensibilidade, especificidade e área
sob a curva foram, respetivamente, 93,3%, 53,3% e 0.766. Foi obtida uma moderada
fiabilidade inter-observadores (k = 0.530).
Conclusão: Os resultados sugerem que a versão portuguesa gera resultados
idênticos aos da versão original, é um método rápido e de aplicação simples à
cabeceira do leito do doente, para identificar doentes pós-extubados em risco de
disfagia e aspiração aumentados. Este instrumento de rastreio é uma ferramenta
simples e válida, com sensibilidade adequada para guiar os profissionais na avaliação
da necessidade de uma avaliação diferenciada.
Post-extubation dysphagia presents a high incidence in intubated patients undergoing invasive mechanical ventilation, complicating the safe ingestion of food and liquids and increasing the risk of aspiration. Early post-extubation screening is crucial to prevent subsequent complications. Aim: To test the reliability and validity of the European Portuguese version of the dysphagia screening tool Gugging Swallowing Screen for Intensive Care Units. Methods: 51 patients admitted to the Intensive Care Unit were enrolled, and the Gugging Swallowing Screen for Intensive Care Units was applied at least 1 hour after extubation. The criterion validity was determined using the clinical assessment performed by a nurse specialized in rehabilitation nursing within less than 24 hours of the initial screening. To determine inter-rater reliability, a second screening was performed by another nurse, blind to the results of the initial screening, in less than 24 hours. Results: The incidence of dysphagia assessed using the Gugging Swallowing Screen for Intensive Care Units was 74.5%, and 66.7%, when assessed using clinical evaluation, establishing a statistically significant association between the two (χ2 = 29.6; p < 0.001). The sensitivity, specificity and area under the curve values were, 93.3%, 53.3% and 0.766, respectively. A moderate inter- rater reliability was obtained (k = 0.530). Conclusion: The results suggest that the portuguese version produces identical results to the original version, is a quick, and simple bedside tool to apply, to identify post- extubated patients with increased risk of dysphagia and aspiration. This screening tool is a simple and valid instrument, with adequate sensitivity to guide professionals in assessing the need for a differentiated assessment.
Post-extubation dysphagia presents a high incidence in intubated patients undergoing invasive mechanical ventilation, complicating the safe ingestion of food and liquids and increasing the risk of aspiration. Early post-extubation screening is crucial to prevent subsequent complications. Aim: To test the reliability and validity of the European Portuguese version of the dysphagia screening tool Gugging Swallowing Screen for Intensive Care Units. Methods: 51 patients admitted to the Intensive Care Unit were enrolled, and the Gugging Swallowing Screen for Intensive Care Units was applied at least 1 hour after extubation. The criterion validity was determined using the clinical assessment performed by a nurse specialized in rehabilitation nursing within less than 24 hours of the initial screening. To determine inter-rater reliability, a second screening was performed by another nurse, blind to the results of the initial screening, in less than 24 hours. Results: The incidence of dysphagia assessed using the Gugging Swallowing Screen for Intensive Care Units was 74.5%, and 66.7%, when assessed using clinical evaluation, establishing a statistically significant association between the two (χ2 = 29.6; p < 0.001). The sensitivity, specificity and area under the curve values were, 93.3%, 53.3% and 0.766, respectively. A moderate inter- rater reliability was obtained (k = 0.530). Conclusion: The results suggest that the portuguese version produces identical results to the original version, is a quick, and simple bedside tool to apply, to identify post- extubated patients with increased risk of dysphagia and aspiration. This screening tool is a simple and valid instrument, with adequate sensitivity to guide professionals in assessing the need for a differentiated assessment.
Description
Keywords
Transtornos da deglutição Unidades cuidados intensivos Sensibilidade Especificidade Cuidados de enfermagem