- 期刊
吞嚥困難與飲食食物質地標準
Food Texture Standard and Its Clinical Applications in Dysphagia Diet
摘要
台灣已經進入高齡社會，咀嚼吞嚥障礙的人口即將隨著人口的老化而急速增長。目前各先進的國家都已發展咀嚼困難飲食，本文獻整理美國的國家吞嚥困難飲食（National Dysphagia Diet: Standardization for Optimal Care, NDD），日本嚥下調整食學會分類2013（The Japanese Society of Dysphagia Rehabilitation 2013, JSDR 2013）與國際吞嚥困難飲食標準（International Dysphagia Diet Standardisation Initiative, IDDSI）在咀嚼吞嚥困難飲食中對食物質地標準及檢測方式。NDD及IDDSI對固體質地標準包含食物尺寸、軟嫩度與凝聚狀況等，液體則使用食物的流動速度來規範液體食物的黏稠度。NDD對檢測工具沒有具體的建議，IDDSI建議使用一定規格的叉子、湯匙、針筒等工具，檢測方式準確、快速、簡單且經濟，JSDR 2013主要是以精密儀器為檢測工具。近年美國、澳洲、歐盟等國家已經逐漸將IDDSI的質地分類方式及檢測方法運用在臨床上。不同於歐美，日本咀嚼吞嚥困難飲食使用精準的儀器來測試食物質地，在食物在硬度、黏度、內聚力等物理特性有具體的規範，雖然精準但是需使用較昂貴的儀器，臨床的方便性較低。IDDSI的檢測方法適合吞嚥困難病人且符合臨床上簡易快速準確的需求。
並列摘要
With Taiwan officially becoming an aged society, its dysphagia population is expected to escalate along the pace of population aging, indicating a crucial need to develop a national dysphagia diet standard as many advanced countries have done in recent years. The article reviewed the standard dysphagia diets and the testing methods prescribed in the National Dysphagia Diet (NDD) of the Japanese Society of Dysphagia Rehabilitation (JSDR 2013) and the International Dysphagia Diet Standardisation Initiative (IDDSI). Both standards measure adhesiveness of liquid by flow rate and food texture by particle size, tenderness, and cohesiveness. Testing tools, such as viscometers, forks, spoons, and syringes, should be easily obtainable for clinical workers and caregivers. Compared to IDDSI, the NDD descriptions for solid food are more specific on the texture of foods with hardness, adhesiveness, and cohesiveness tested by high-tech instruments which are more precise but also more expensive. In light of their easier accessibility, IDDSI testing methods are considered more compatible with clinical practice for patients with dysphagia.