語言治療師的吞嚥治療技術如何影響營養狀態：實用文獻回顧

Practical Review of Alteration of Nutrition Conditions Resulted From Treatments for Dysphagia Administered by Speech-Language Pathologists

陳雅凡(Ya-Fan Chen) ； 蔡子培(Tzu-Pei Tsai)

《台灣聽力語言學會雜誌》 47期 (2022/12) Pp. 27-41

https://doi.org/10.6143/JSLHAT.202212_(47).0003

摘要

吞嚥能力受損會影響進食的安全性及營養素的攝取。吞嚥機制複雜須仰賴多種專業的共同照護。語言治療師在吞嚥照護團隊中擔任吞嚥評估與治療的角色，但應注意部分治療技術可能會改變患者的營養狀態。本文針對成人吞嚥障礙患者，回顧並探討語言治療師與營養師於臨床決策的交互影響。本文以三面向呈現：一、語言治療師的吞嚥治療技術；二、影響患者營養狀況的吞嚥治療技術；三、吞嚥障礙患者的營養需求。綜合過去研究發現調整食物質地會對患者的營養狀態造成影響，如食物的營養密度降低，或適口性不佳導致患者的進食動機降低。專業的吞嚥照護應同時兼顧病理、生理、心理和營養，因此需要仰賴團隊合作方能完成。本文統整吞嚥治療技術與營養間的相關性，提供臨床工作參考。期望能強化吞嚥障礙患者的吞嚥照護品質，提供更完善的吞嚥照護。

關鍵字

吞嚥障礙 ； 吞嚥治療 ； 營養 ； 營養狀態

並列摘要

Problems in swallowing affect the safety and adequacy of nutrient ingestion. Swallowing mechanisms are complex and collaboration from various disciplines are needed for treating swallowing disorders. speech-language pathologists (SLPs)' role is to directly assess and treat patients with dysphagia. However, SLPs' plan might impact on nutritional conditions of these clients. The current study aimed to review recent findings in speech-language pathology and nutritional science. We emphasized on the juxtaposition of dysphagia treatment that might alter nutritional conditions of these clients. We organized the content into three main sections: (1) dysphagia treatment by the SLPs; (2) how impacts of swallowing treatment on nutrition, and (3) nutrition needs of clients with dysphagia. In summary of past studies, any alteration in the consistency has its corresponding impact on the nutrition of the food, e.g. dilution of nutrition, and impact on the sensation of food that, in turn, changes motivation of eating in the patients with dysphagia. Providing professional service to patients with dysphagia is a teamwork taking into account of the pathology, physiology, psychology and nutrition. The current review can be used as a reference for the clinical practice in swallowing disorders, and thus it will lead to provide a more thorough decision making.

並列關鍵字

Dysphagia ； Swallowing therapy ； Nutrition ； Nutritional status

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