| Objectives:The purpose of this study is to understand the awareness of aged care workers in medical nursing combined institutions about dysphagia and the current situation of managing the elderly with dysphagia and to understand the attitudes of aged care workers toward the management of elderly with dysphagia based on the mobile medical platform.Based on this,we combined literature research to develop a scientific and practical mobile medical platform module content for the management of dysphagia in medical nursing combined institutions.Methods:1.Qualitative study A descriptive phenomenological method was used to conduct one-on-one,semi-structured in-depth interviews with 24 aged care workers using a purposive sampling method,and Colaizzi phenomenological analysis was applied to analyze the data to understand the current situation of aged care workers’ management of older adults with dysphagia and aged care workers’ acceptance of the mobile medical platform for dysphagia management,and to provide a basis for the development of the platform module content.2.Literature analysis Systematic search of literature related to the intervention of dysphagia in elderly institutions,summarizing the intervention methods of dysphagia in elderly institutions,and providing a reference for the construction of the platform module content.3.Delphi expert consultation Based on the results of qualitative research and literature analysis,the first draft of the module content of the mobile medical platform for the management of dysphagia in medical nursing combined institutions was developed through group discussion under the guidance of the caregiver skills model and the information-motivation-behavior skills model.The Delphi expert consultation method was used to consult the first draft of the module content,and the expert opinions were summarized and analyzed to improve the content and finalize the module content of the mobile medical platform for dysphagia management in medical nursing combined institutions.Results:1.Qualitative study results Based on the interviews,3 themes and 14 sub-themes were extracted,coping strategies of aged care workers in managing dysphagia(building a trusting relationship,food preparation,changing feeding positions,control of eating speed and bite-size,personalized eating environment,good communication);management of dysphagia by aged care workers was full of challenges(insufficient knowledge of dysphagia,heavy feeding task burden,high safety responsibilities,lack of confidence,negative emotional experiences);attitudes toward managing dysphagia based on m Health(strong willingness to accept,suggestions for platform construction,hindrances to platform use).2.Results of literature analysis A total of 17 papers with 1227 study cases were included,involving six types of interventions: Chinese medicine intervention,health education,rehabilitation training,oral care,nutritional management and comprehensive intervention,and the comprehensive interventions specifically included: psychological care,rehabilitation care,physiotherapy,functional training and feeding training.3.Delphi expert consultation results Based on the preliminary literature analysis and qualitative research,we used the caregiver skill model and the information-motivation-behavior skill model as the guiding basis,the content system of the mobile medical platform module for managing dysphagia in medical nursing combined institutions was initially constructed through group discussion,including 2primary indicators,11 secondary indicators,43 tertiary indicators and 19 quaternary indicators.After two rounds of expert consultation,the module content of mobile medical platform for dysphagia management in medical and nursing institutions was finalized,including 2 primary indicators,12 secondary indicators,52 tertiary indicators,and 23 quaternary indicators.The positive coefficients of experts in the two rounds of consultation were 85.00% and 88.24%,and the proportions of experts who gave opinions were 45.00% and 26.67%,and the coefficients of experts’ authority were 0.91 and 0.93,respectively;the coefficients of variation of importance of indicators at all levels after the two rounds of consultation fluctuated from 0.00 to 0.24,and the coefficients of Kendall’s harmony were 0.143 and 0.165,respectively(p < 0.05).Conclusions:1.The current situation of aged care workers managing older adults with dysphagia in medical nursing combined institutions is poor,and the management process faces multiple challenges,including insufficient relevant knowledge and a heavy caregiving burden,and there is a need to improve aged care workers’ ability to manage older adults with dysphagia.2.The study developed the content of the module of the mobile medical platform for dysphagia in medical nursing combined institutions through qualitative interviews,literature analysis,and Delphi expert correspondence,etc.The results are scientific and reliable,and provide a basis for the development and application of the platform in the next step. |
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