Akut inmeli hastalarda disfaji yönetiminde hemşirelere yönelik geliştirilen klinik rehber kullanımının aspirasyonun önlenmesi, beslenme ve memnuniyet durumu üzerine etkisi

Abstract

Amaç: Çalışmada, inme sonrası disfaji yönetiminde hemşirelere yönelik geliştirilen kanıta dayalı rehber kullanımının hastada aspirasyonun önlenmesi, beslenme ve memnuniyet durumu üzerine etkisinin değerlendirilmesi amaçlanmıştır. Yöntem: Bu çalışma randomize olmayan kontrollü deneysel yöntem kullanılarak yapılmıştır. Hemşirelerin araştırmacılar tarafından geliştirilen kanıta dayalı klinik rehberi uygulayabilmesi için “Yakın İşbirliğine Dayalı İleri Araştırma ve Klinik Uygulama Modeli” kullanılmıştır. Araştırmanın örneklemini, bir devlet hastanesinin nöroloji kliniklerine akut inme tanısı ile başvuran 60 hasta (30 deney, 30 kontrol) oluşturmuştur. Örneklemin evreni temsil etme gücü %95 güvenirlik ve %5 yanılgı düzeyi ile güç analizi sonucu %80.7’dir. Veriler, Hasta Bilgi Formu, Yatak Başı Su İçme Değerlendirme Testi, Amerikan Ulusal Sağlık Enstitüsü İnme Skalası, Aspirasyonun Önlenmesi Hemşirelik Çıktıları Sınıflaması Ölçeği (NOC), Mini Nutrisyonel Değerlendirme (MND) Testi Kısa Formu, Newcastle Hemşirelik Bakımından Memnuniyet Ölçeği kullanılarak yüz yüze araştırmacı tarafından toplanmıştır. Bulgular: Deney grubundaki hastaların aspirasyonun önlenmesine yönelik NOC ölçeği puan ortalaması, kontrol grubuna göre yüksek bulunmuştur (p<0.05). Deney grubundaki hastaların MND puan ortalamaları, kontrol grubundaki hastalara göre düşüktür (p>0.05). Her iki grubun MND puanı ortalama puanın altında olup, malnütrisyon riskinin olduğunu göstermektedir. Deney grubundaki hastaların memnuniyet puan ortalamaları, kontrol grubundan yüksek olup, iki grubun puan ortalamaları arasındaki fark istatistiksel olarak anlamlı bulunmuştur (p< 0.05). Sonuç: İnme sonrası disfajinin yönetiminde kanıta dayalı rehber ile bakım verilmesi, aspirasyonun önlenmesinde ve hasta memnuniyet düzeyini artırmada etkili bulunmuştur.

Keywords

• Disfaji
• kanıta dayalı rehber
• hemşirelik bakımı
• inme

The effect of using clinical guidelines developed for nurses in the management of post-stroke dysphagia on prevention of aspiration, nutritional status and patient satisfaction

Abstract

Objective: To evaluate the effect of using an evidence-based clinical guidelines developed for nurses in the management of post-stroke dysphagia on prevention of aspiration, nutritional status and patient satisfaction. Method: This study was conducted using a non-randomized controlled experimental method. “Advanced Research and Clinical Practice Model Based on Close Collaboration” was used to enable nurses to apply the evidence-based clinical guideline developed by the researchers. The sample of the study consisted of 60 patients (30 experimental, 30 control) who applied to the neurology clinics of a state hospital with the diagnosis of acute stroke. The power of the sample to represent the universe was 80.7% as a result of power analysis with 95% confidence and 5% error level. The data of the study were collected by the researcher through face-to-face interviews using the Patient Information Form, Bedside Water Drinking Assessment Test, American National Institutes of Health Stroke Scale, Aspiration prevention scale (NOC), Mini Nutritional Assessment (MNA) Test Short Form, and Newcastle Nursing Satisfaction Scale. Results: The mean score of the NOC scale for aspiration prevention in the experimental group was found to be higher than the control group (p<0.05). The mean MNA scores of the patients in the experimental group were lower than the patients in the control group (p>0.05). The MNA scores of both groups were below the average score, indicating a risk of malnutrition. The mean satisfaction scores of the experimental group was higher than that of the control group, and the difference between the mean scores of the two groups was statistically significant (p<0.05). Conclusion: Providing care with evidence-based guidelines in the management of post-stroke dysphagia was found to be effective in preventing aspiration and increasing patient satisfaction levels.

Keywords

• Dysphagia
• evidence-based guideline
• nursing care
• stroke

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