Multiple skleroz hastalarında disfaji ve disfajiye yönelik hemşirelik yaklaşımları

Yıl 2020, Cilt: 13 Sayı: 3, 437 - 443, 05.12.2020

Gülşah Kesik Leyla Özdemir

https://doi.org/10.26559/mersinsbd.682854

Cited By: 2

Öz

Disfaji; multiple skleroz hastalarında sıklıkla görülen ve hayati komplikasyonlara neden olabilen bir bulgudur. Literatürde, disfajinin multiple skleroz hastalarında görülme sıklığının %33 ile %43 aralığında olduğu bildirilmektedir. Disfajinin; multiple sklerozun alevlenme dönemlerinde 2-3 haftadan 2-4 aya kadar sürebileceği, kronikleşerek remisyon dönemlerinde de devam edebileceği bildirilmiştir. Disfaji, hastada beslenmeyi olumsuz etkiler ve yaşam kalitesini düşürür. Aspirasyon pnömonisi, dehidratasyon, malnütrisyon, yutma kaygısı multiple skleroz hastalarında disfajiye bağlı gelişen önemli beslenme komplikasyonlarıdır. Bozulan beslenme örüntüsü, bu hastalarda mortalite ve morbiditeyi artıran nedenler arasında ilk sıralarda yer almaktadır. Multiple skleroz hastalarında disfajinin noninvaziv ve nonfarmakolojik hemşirelik yaklaşımları ile kontrol altına alınması mümkündür. Bu derlemede, Multiple Skleroz hastalarında önemli bir bulgu olan disfaji ve disfajinin tanılanması, tedavisi ve bakımı aşamalarında hemşirenin rolü tartışılmıştır.

Anahtar Kelimeler

multiple skleroz, disfaji, Yutma bozuklukları, hemşirelik, hemşirelik bakımı

Destekleyen Kurum

Yoktur

Proje Numarası

Yoktur

Teşekkür

Yoktur

Nursing approaches to dysphage and dysphage in multiple sclerosiz

Öz

Dysphagia is a common symptom in multiple sclerosis patients and can cause life-threatening complications. In the literature, the incidence of dysphagia in patients with multiple sclerosis is reported to be 33% to 43%. Dysphagia: It has been reported that multiple sclerosis can last from 2-3 weeks to 2-4 months in relapsing periods and may continue in remission periods by becoming chronic. Dysphagia negatively affects nutrition and decreases the quality of life in the patient. Aspiration pneumonia, dehydration, malnutrition, swallowing anxiety are important nutritional complications due to dysphagia in patients with multiple sclerosis. Disrupted nutritional pattern is among the leading causes of increased mortality and morbidity in these patients. It is possible to control dysphagia in patients with multiple sclerosis with noninvasive and nursing approaches. In this review, the role of the nurse in the diagnosis, treatment and care stages of dysphagia is discussed.

Anahtar Kelimeler

Multiple sclerosis, dysphagia, swallowing disorders, nursing, nursing care

Proje Numarası

Yoktur

Kaynakça

• 1. Arvedson J, Clark H, Lazarus C, Schooling T, Frymark T. The effects of oral-motor exercises on swallowing in children: an evidence-based systematic review. Dev Med Child Neurol 2010; 52: 1000-1013.
• 2. Tenekeci E, Kara B, Çetiz A, Demirkaya Ş, Demir N, Açıkel C. Multipl Sklerozda Disfaji Değerlendirme Ölçeği Türkçe Formunun Geçerlik ve Güvenirliği. Arch Neuropsychiatr 2016; 53
• 3. Sayaca Ç. Yutma Bozukluklarının Rehabilitasyonunda Propriyoseptif Nöromusküler Fasilitasyon Tekniğinin Etkisinin Araştırılması. (Doktora Tezi) Ankara, 2010.
• 4. Bergamaschi R, Crivelli P, Rezzani C, Patti F, Solaro C, Rossi P, et al. The DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. J Neuro Sci 2008; 269:49-53.
• 5. Plowman EK, Tabor LC, Robison R, et al. Discriminant ability of the Eating Assessment Tool-10 to detect aspiration in individuals with amyotrophic lateral sclerosis. Neurogastroenterol Motil. 2016;28:85–90. doi:10.1111/nmo.12700.
• 6. Rofes L, Arreola V, Mukherjee R, Clave P. Sensitivity and specificity of the Eating Assessment Tool and the volume-viscosity swallow test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;26:1256–65. doi:10. 1111/nmo.12382.
• 7. Wiesner W, Wetzel S, Kappos L, Hoshi M, Witte U, Radue E, et al. Swallowing abnormalities in multiple sclerosis: correlation between videofluoroscopy and subjective symptoms. Eur Radiol 2002; 12:789-792.
• 8. Cheney DM, Siddiqui MT, Litts JK, Kuhn MA, Belafsky PC. The ability of the 10-Item Eating Assessment Tool (EAT-10) to predict aspiration risk in persons with dysphagia. Ann Otol Rhinol Laryngol. 2015;124:351–4. doi:10.1177/0003489414558107.
• 9. Kaspar K, Ekberg O. Identifying vulnerable patients: role of the EAT-10 and the multidisciplinary team for early intervention and comprehensive dysphagia care. Nestle Nutr Inst Workshop Ser. 2012;72:19–31. doi:10.1159/000339977.
• 10. Carrión S, Cabré S, Monteis R. Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital. Clin Nutr. 2015;4:36–42. doi:10.1016/j.clnu.2014.04.014
• 11. Ayanoğlu AE, Öz F. Yutma bozukluklarında tanı. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2012; 3:1-6.
• 12. Budak E, Taymur İ, Önen S, Kanat B, Akdeniz Ö, Demirci H. Symptoms of swallowing anxiety in panic disorder patients and associated psychopathologic factors. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 2017;1-11.
• 13. Teismann K, Steinsträter O, Warnecke T, Suntrup S, Rngelstein E, Pantev C, et al. Tactile thermal oral stimulation increases the cortical representation of swallowing. BMC Neurosci. 2009; 10: 71.
• 14. Arsava E, Aydoğdu İ, Güngör L, Togay Işıkay C, Yaka C İnme Hastalarında Nütrisyonel Yaklaşım ve Tedavi, Türkiye için Uzman Görüşü. Turk J Neurol 2018;24:226-242. DOI:10.4274/tnd.92603
• 15. Umay E, Gürçay E, Ünlü E, Ekşioğlu E, Çakçı A. Erken Dönem İnmeli Hastalarda Disfajinin Fonksiyonel ve Nutrisyonel Etkisi. Turkiye Klinikleri J Med Sci 2010;30(3):925-31.
• 16. Finestone HM, Greene-Finestone LS, Wilson ES, Teasell RW. Malnutrition in stroke patients on the rehabilitation service and at follow-up: prevalence and predictors. Arch Phys Med Rehabil 1995;76(4):310-6.
• 17. Dávalos A, Ricart W, Gonzalez-Huix F, Soler S, Marrugat J, Molins A, et al. Effect of malnutrition after acute stroke on clinical outcome. Stroke 1996; 27(6):1028-32.
• 18. De Lucas Taracena TN, Montanes Rada F. Swallowing phobia: symptoms, diagnosis and treatment. Actas Esp Psiquiatr 2006;34:309–316.
• 19. Çakır Edis E. Aspirasyon Pnömonisi. Güncel Göğüs Hastalıkları Serisi 2014; 2 (1): 52-58.
• 20. Selçuk B. Dysphagia in Stroke. Turk J Phys Med Rehab 2006;52(Suppl B):B38-B44
• 21. Martin-Harris B, Logemann JA, McMahon S, Schleicher M, Sandidge J. Clinical utility of the modified barium swallow. Dysphagia 2000; 15: 136-141.
• 22. Janssen, I, Katzmarzyk PT, Ross R. Bodymass index, waist circumference, and healt risk: evidence in support of current. Arch Intern Med, 2002;14:74-79.
• 23. Logeman JA. Swallowing disorders caused by neurologic lesions from which some recovery can be anticipated. In: Logeman JA, editor. Evaluation and treatment of swallowing disorders. Second Edition. Austin, Texas: Pro Ed.; 1998.
• 24. Verdonschot RJ, Baijens LW, Serroyen JL, Leue C, Kremer B. Symptoms of anxiety and depression assessed with the Hospital Anxiety and Depression Scale in patients with oropharyngeal dysphagia. J Psychosom Res 2013;75:451–457. doi:10.1016/j.jpsychores.2013.08.021
• 25. Demir, N. Reliability and Validity of the Turkish Eating Assessment Tool (T-EAT-10) Dysphagia 2016;31:644–649.
• 26. O’Rourke, A, Morgan, LB, Coss-Adame, E. The Effect of Voluntary Pharyngeal Swallowing Maneuvers on Esophageal Swallowing Physiology. Dysphagia 2014;29, 262–268. doi:10.1007/s00455-013-9505-6
• 27. Karaali E, Özcan Ö, Ilgın D. Investigation of rehabilitation methods used in dysphagia following head and neck cancer. Turkısh Journal Of Physiotherapy And Rehabilitation 2017;28(1):57-58.
• 28. Bogaardt H, van Dam D, Wever N, Bruggeman C, Koops J, Fokkens W. Use of Neuromuscular Electrostimulation in the Treatment of Dysphagia in Patients With Multiple Sclerosis. Annals of Otology, Rhinology & Laryngology 2009;118(4):241-246.
• 29. Restivo D, Casabona A, Centonze D, Marchese-Ragona R, Maimone D, Pavone A. Pharyngeal Electrical Stimulation for Dysphagia Associated with Multiple Sclerosis: A Pilot Study. Brain Stimulation 2013;6:418-423.