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Abstract：
BACKGROUND: Stroke frequently results in oropharyngeal dysfunction (OD), leading to difficulties in swallowing and eating, as well as triggering negative emotions, malnutrition, and aspiration pneumonia, which can be detrimental to patients. However, routine nursing interventions often fail to address these issues adequately. Systemic and psychological interventions can improve dysphagia symptoms, relieve negative emotions, and improve quality of life. However, there are few clinical reports of systemic interventions combined with psychological interventions for stroke patients with OD.
OBJECTIVE: To explore the effects of combining systemic and psychological interventions in stroke patients with OD.
METHODS: This retrospective study included 90 stroke patients with OD, admitted to the Second Affiliated Hospital of Qiqihar Medical College (January 2022-December 2023), who were divided into two groups: regular and coalition. Swallowing function grading (using a water swallow test), swallowing function [using the standardized swallowing assessment (SSA)], negative emotions [using the self-rating anxiety scale (SAS) and self-rating depression scale (SDS)], and quality of life (SWAL-QOL) were compared between groups before and after the intervention; aspiration pneumonia incidence was recorded.
RESULTS: Post-intervention, the coalition group had a greater number of patients with grade 1 swallowing function compared to the regular group, while the number of patients with grade 5 swallowing function was lower than that in the regular group (P < 0.05). Post-intervention, the SSA, SAS, and SDS scores of both groups decreased, with a more significant decrease observed in the coalition group (P < 0.05). Additionally, the total SWAL-QOL score in both groups increased, with a more significant increase observed in the coalition group (P < 0.05). During the intervention period, the total incidence of aspiration and aspiration pneumonia in the coalition group was lower than that in the control group (4.44% vs 20.00%; P < 0.05).
CONCLUSIONS: Systemic intervention combined with psychological intervention can improve dysphagia symptoms, alleviate negative emotions, enhance quality of life, and reduce the incidence of aspiration pneumonia in patients with OD.
OBJECTIVE: To explore the effects of combining systemic and psychological interventions in stroke patients with OD.
METHODS: This retrospective study included 90 stroke patients with OD, admitted to the Second Affiliated Hospital of Qiqihar Medical College (January 2022-December 2023), who were divided into two groups: regular and coalition. Swallowing function grading (using a water swallow test), swallowing function [using the standardized swallowing assessment (SSA)], negative emotions [using the self-rating anxiety scale (SAS) and self-rating depression scale (SDS)], and quality of life (SWAL-QOL) were compared between groups before and after the intervention; aspiration pneumonia incidence was recorded.
RESULTS: Post-intervention, the coalition group had a greater number of patients with grade 1 swallowing function compared to the regular group, while the number of patients with grade 5 swallowing function was lower than that in the regular group (P < 0.05). Post-intervention, the SSA, SAS, and SDS scores of both groups decreased, with a more significant decrease observed in the coalition group (P < 0.05). Additionally, the total SWAL-QOL score in both groups increased, with a more significant increase observed in the coalition group (P < 0.05). During the intervention period, the total incidence of aspiration and aspiration pneumonia in the coalition group was lower than that in the control group (4.44% vs 20.00%; P < 0.05).
CONCLUSIONS: Systemic intervention combined with psychological intervention can improve dysphagia symptoms, alleviate negative emotions, enhance quality of life, and reduce the incidence of aspiration pneumonia in patients with OD.
摘要：
背景：中风经常导致口咽功能障碍（OD），导致吞咽和进食困难，以及引发负面情绪，营养不良,和吸入性肺炎,这可能对患者有害。然而,常规护理干预措施往往无法充分解决这些问题。系统和心理干预可以改善吞咽困难的症状，缓解负面情绪，提高生活质量。然而,关于脑卒中伴OD患者的系统干预结合心理干预的临床报道较少。
目的：探讨结合系统和心理干预对脑卒中患者OD的影响。
方法：这项回顾性研究包括90例脑卒中患者，齐齐哈尔医学院第二附属医院（2022年1月至2023年12月），他们分为两组:常规和联盟。吞咽功能分级（使用水吞咽测试），吞咽功能[使用标准化吞咽评估（SSA）]，负面情绪[使用焦虑自评量表（SAS）和抑郁自评量表（SDS）]，比较两组干预前后的生活质量(SWAL-QOL);记录吸入性肺炎发生率.
结果：干预后，与常规组相比，联盟组有更多的1级吞咽功能患者，而吞咽功能5级的患者人数低于常规组（P<0.05）。干预后，SSA,SAS,两组SDS评分均下降,在联合组中观察到更显著的下降(P<0.05)。此外,两组SWAL-QOL总分均升高,在联合组中观察到更显著的增加(P<0.05)。干预期间,联合组吸入性和吸入性肺炎的总发生率低于对照组（4.44％vs20.00％；P<0.05）。
结论：系统干预联合心理干预可改善吞咽困难症状，缓解负面情绪,提高生活质量，降低OD患者吸入性肺炎的发生率。
目的：探讨结合系统和心理干预对脑卒中患者OD的影响。
方法：这项回顾性研究包括90例脑卒中患者，齐齐哈尔医学院第二附属医院（2022年1月至2023年12月），他们分为两组:常规和联盟。吞咽功能分级（使用水吞咽测试），吞咽功能[使用标准化吞咽评估（SSA）]，负面情绪[使用焦虑自评量表（SAS）和抑郁自评量表（SDS）]，比较两组干预前后的生活质量(SWAL-QOL);记录吸入性肺炎发生率.
结果：干预后，与常规组相比，联盟组有更多的1级吞咽功能患者，而吞咽功能5级的患者人数低于常规组（P<0.05）。干预后，SSA,SAS,两组SDS评分均下降,在联合组中观察到更显著的下降(P<0.05)。此外,两组SWAL-QOL总分均升高,在联合组中观察到更显著的增加(P<0.05)。干预期间,联合组吸入性和吸入性肺炎的总发生率低于对照组（4.44％vs20.00％；P<0.05）。
结论：系统干预联合心理干预可改善吞咽困难症状，缓解负面情绪,提高生活质量，降低OD患者吸入性肺炎的发生率。
