| Objective:The purpose of this study is to understand the swallowing status,knowledge and behavior levels related to swallowing safety in elderly COPD patients,implement respiratory function training for elderly COPD patients with swallowing disorders,and explore the impact of this nursing measure on the swallowing function of patients,with a view to strengthening the patients’ swallowing safety awareness and self care ability,reducing the incidence of adverse events such as coughing and aspiration,and improving the quality of life.Methods:1.Current situation survey: 262 elderly patients with COPD from a Grade III comprehensive teaching hospital(four wards)in Shanxi Province were selected as the subjects of the survey by convenient sampling method.A cross-sectional survey was conducted through the general data questionnaire,the swallowing screening scale,the Wadian drinking water test and the related knowledge and behavior questionnaire of swallowing disorders.2.Empirical study: Using the convenient sampling method,the elderly patients with COPD who were admitted to the Department of Respiratory and Critical Care Medicine of a Class III general hospital in Shanxi Province were selected as the study subjects,and106 patients who met the inclusion and exclusion criteria were screened out.The control group(n=53)used routine nursing,and the test group(n=53)guided the patients to perform respiratory muscle training on this basis.After 8 weeks of intervention,the swallowing function,lung function,the difference between sports endurance and swallowing-related quality of life scores.Results:1.The results of the current survey:(1)The results of swallowing screening scale showed that 105 people had dysphagia,accounting for 40.08%;94 people(35.88%)had dysphagia according to the Wadian drinking water test.Therefore,through subjective and objective comprehensive evaluation,the swallowing ability of elderly patients with COPD was poor,suggesting the need for early screening and evaluation to provide guidance for early intervention.(2)The scores of swallowing-related knowledge dimension and swallowing behavior dimension of elderly patients with COPD were(5.20± 2.29)and(23.79 ± 11.50),respectively,and the qualification rate was lower than 60%.In short,most of the patients’ swallowing safety knowledge and behavior were at the middle or low level,suggesting that nursing staff should strengthen health education in clinical work to improve patients’ cognition and behavior,and then minimize the negative impact on patients.2.Empirical study results:(1)Before the intervention,the general data of patients in the two groups,Wada drinking water test,peak expiratory flow,six-minute walking distance,and swallowing-related quality of life scores were balanced and comparable,with no statistical difference(P>0.05).(2)After 8 weeks of intervention,the level of Wada drinking water test in the test group was lower than that in the control group,with a statistically significant difference(P<0.001);After 8 weeks of intervention,the peak expiratory flow and six-minute walking distance of patients in the test group were higher than those in the control group,with statistical difference(P<0.05);The quality of life related to swallowing in the test group was higher than that in the control group after 8weeks,with statistical significance(P<0.05).Conclusion:1.The incidence of swallowing disorders in elderly COPD patients is high,and their swallowing safety awareness and self-care ability are not up to the ideal level.It is urgent to have a scientific and effective nursing plan for swallowing disorders to manage the swallowing problems of patients and meet the basic physiological needs of patients’ eating safety.2.Respiratory muscle training can simultaneously improve the respiratory and swallowing functions of patients,enhance the coordination of the respiratory swallowing process,significantly improve the quality of life of patients,and provide theoretical reference for the patient’s home based swallowing rehabilitation. |
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