연하장애(dysphagia)란 음식물을 삼키는 데 어려움이 있는 상태를 말하며, 목구멍의 경한 불편감에서부터 심한 경우 음식물을 전혀 삼키지 못하는 상태까지 다양하게 나타난다. 연하과정은 6개의 뇌신경과 55개의 근육이 관련되는 복잡한 현상으로, 뇌졸중, 다발성 경화증, 뇌종양, 파킨슨, 치매 등 다양한 질환에서 흔하게 나타나는 문제이다(Cornwell, Murdoch, Ward, & Morgan, 2003; Westergren, Hallberg, & Isson, 1999). 이 중 뇌졸중은 연하장애의 가장 일반적인 원인으로, 뇌졸중 후 25-65%의 환자에서 연하장애가 나타나는 것으로 알려져 있다(Mann, Hankey, & Cameron, 1999; Teasell, Bach, & McRae, 1994). 연하장애의 증상으로는 침흘림, 씹기 장애, 입속에 음식물 주머니 형성(food pocketing), 삼킴 지연, 기침, 질식, 습한 목소리(wet-sound voice), 인두에 음식물이 달라붙는 느낌(food sticking), 체중감소, 가슴쓰림, 비강 역류, 흡인성 폐렴 등이 보고되어 있다(Perry, 2001).
Purpose: The purposes of this study were to reveal the nutritional status and symptoms related to dysphagia and to identify the information needs of the patient with post-stroke dysphagia for self care. Methods: Fifty one subjects were selected among patients being admitted from 3 tertiary hospitals. Data were collected using questionnaires, interview, and medical record. Data analysis was done using descriptive statistics with SPSS. Results: 1) The mean hemoglobin, serum albumin, and hematocrit level of the subjects were 11.2±1.8 g/dL, 3.2±0.6 g/dL, and 33.5±2.3%, respectively. 2) The most common symptom due to dysphagia was ‘slurred speech (86.3%)’, followed by ‘less flexible in tongue and mouth movement (80.4%)’, ‘difficulty chewing and swallowing (74.5%)’. 3) The highest score of information needs for patients/caregivers was to know which foods are suitable for dysphagic patients or not (2.67±0.48 of 3.0 score). They also want to know how to swallow safely (2.65±0.59), to administer medication safely (2.63±0.59), and to learn rehabilitative techniques (2.61±0.57). Conclusion: These findings would be useful information for staffs to do multidisciplinary approach and they would be necessary for stroke patients to manage their symptoms.
서 론 연구 방법 연구 결과 논 의 결론 및 제언
