Clinical Validation of the Related Factors and Defining Characteristics of Impaired Swallowing for Patients with Stroke

腦中風患者吞嚥障礙相關因素和定義性特徵之臨床效度測定

鄭綺(Chii Jeng) ； 許寶鶯(Pao-Ying Sheu) ； 陳靜敏(Ching-Min Chen) ； 陳淑如(Su-Ru Chen) ； 曾櫻枝(Ing-Gy Tseng)

《The Journal of Nursing Research》 9卷4期 (2001/09) Pp. 105-115

摘要

This exploratory study was conducted to examine the reliability and validity of related factors and defining characteristics of impaired swallowing for stroke patients. Sample of the study included (1) 12 nursing experts, (2) 52 nurses who work in neurological wards, and (3) 107 stroke patients who were divided into a BDST (Burks Dysphagia Screening Test)-positive group (n = 51) and a BDST-negative group (n = 56). Data were collected and validated based on expert validity, diagnostic content validity (DCV), construct validity, and discriminate validity. Results showed that the DCV scores of 17 related factors and 12 defining characteristics were all greater than 0.5. The internal consistency of the 12 defining characteristics was demonstrated by a Cronbach alpha coefficient of 0.89. Two factors were extracted from the 12 defining characteristics after factor analysis; these were “high risk of aspiration with speech disorder” and “ineffectiveness of swallowing”. Five major defining characteristics, i.e. pocketing of food, signs of acute aspiration, burning or tickling at the back of the throat, spitting food or food leaking from the mouth, and weak or hoarse cough, were determined by logistic regression. The findings of this study suggest that the 17 related factors and 12 defining characteristics are reliable and valid in diagnosing the problem of impaired swallowing for stroke patients.

關鍵字

中風患者 ； 吞嚥障礙 ； 相關因素 ； 定義性特徵

並列摘要

This exploratory study was conducted to examine the reliability and validity of related factors and defining characteristics of impaired swallowing for stroke patients. Sample of the study included (1) 12 nursing experts, (2) 52 nurses who work in neurological wards, and (3) 107 stroke patients who were divided into a BDST (Burks Dysphagia Screening Test)-positive group (n = 51) and a BDST-negative group (n = 56). Data were collected and validated based on expert validity, diagnostic content validity (DCV), construct validity, and discriminate validity. Results showed that the DCV scores of 17 related factors and 12 defining characteristics were all greater than 0.5. The internal consistency of the 12 defining characteristics was demonstrated by a Cronbach alpha coefficient of 0.89. Two factors were extracted from the 12 defining characteristics after factor analysis; these were “high risk of aspiration with speech disorder” and “ineffectiveness of swallowing”. Five major defining characteristics, i.e. pocketing of food, signs of acute aspiration, burning or tickling at the back of the throat, spitting food or food leaking from the mouth, and weak or hoarse cough, were determined by logistic regression. The findings of this study suggest that the 17 related factors and 12 defining characteristics are reliable and valid in diagnosing the problem of impaired swallowing for stroke patients.

並列關鍵字

stroke patient ； impaired swallowing ； related factor ； defining characteristic

參考文獻

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Carpenito, L. J.(1997).Nursing diagnosis: Application to clinical practice.Philadelphia:Lippincott.

Comrey, A. L.(1978).Common methodological problems in factor analysis studies.Journal of Consulting and Clinical Psychology.46

DePippo, K. L., Holas, M. A., Reding, M. H.(1994).The Burke Dysphagia Screening Test: Validation of its use in patients with stroke.Archives Physical Medicine ＆ Rehabilitation.75