吞嚥困難飲食的發展及國際間差異的比較

Development of Dysphagia Diets and a Comparison of International Differences

黃萾芬(Ying-Fen Huang) ； 張惠萍(Hui-Ping Chang)

《臺灣膳食營養學雜誌》 9卷2期 (2017/12) Pp. 1-14

https://doi.org/10.6709/TJD.201712_9(2).0001

摘要

吞嚥困難是目前全球關注的議題，尤其在人口快速老化的臺灣，預期面臨吞嚥困難問題的患者將快速增加。吞嚥困難易引發患者吸入性肺炎、體重減輕、營養不良、脫水等風險，嚴重影響生活品質，甚至對生命構成威脅，而藉由調整食物的質地及液體的稠度，可以減少上述問題、增加進食安全，避免不必要的管灌餵食，更可維護病人的舒適及尊嚴，這對於有吞嚥問題的病人來說極為重要。目前世界各國皆致力於發展吞嚥困難飲食，然而各國對於吞嚥困難飲食的分級名稱、定義、特性卻仍缺乏一致性的標準，因此建立國際性的標準專業術語和定義正積極倡議中，此將可提升醫院、長照機構及居家照顧者間的溝通，更甚者擴展至食品業者開發吞嚥困難餐點，以期改善病人進食上的安全、降低家屬照顧上的負擔、提升生活品質。本文將比較美國、英國、澳洲、日本、臺灣及國際吞嚥困難飲食標準化推動委員會對吞嚥困難飲食質地分級上的差異，以提供醫療團隊照護時的參考。

關鍵字

吞嚥困難 ； 老化 ； 食物質地 ； 液體稠度 ； 增稠劑 ； 吸入性肺炎

並列摘要

Dysphagia is a global problem, especially in rapidly aging Taiwan. Characterized by difficulty in swallowing, the prevalence of this condition is rapidly increasing among older people. Patients with dysphagia face numerous problems, including aspiration pneumonia, weight loss, malnutrition, and dehydration. Altering food particle size, food texture properties, and liquid thickness have been observed to reduce the aforementioned complications, promote safe swallowing, maintain patient comfort, and protect the dignity of patients by preventing unnecessary tube feeding. However, the current classifications, definitions, and characteristics lack consistent standards among countries, which increases the risks to patient safety. Therefore, standard international terminology and definitions are being established, thereby enhancing communication between hospitals, long-term care facilities, and home caregivers. This trend may even extend to the food industry, which could develop dysphagia diets, thereby promoting safe eating and increasing quality of life for patients with dysphagia. This study compares the classifications of dysphagia diets in the United States, the United Kingdom, Australia, Japan, and Taiwan, as well as those of the International Dysphagia Diet Standardisation Initiative (IDDSI), to provide a treatment reference for medical teams.

並列關鍵字

dysphagia ； aging ； food texture ； liquid thickness ； thickening agent ； aspiration pneumonia