| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 3.18 MB | Adobe PDF |
Advisor(s)
Abstract(s)
Enquadramento: A disfagia no apĂłs acidente vascular cerebral (AVC) tem sido atribuĂda Ă
disfunção e incoordenação muscular farĂngea e Ă perda de controlo do sistema nervoso central. As
lesÔes do tronco encefålico são comumente citadas como tendo uma associação com a presença
de disfagia. No entanto, também tem sido sugerido que as lesÔes em locais corticais podem ser
mais comuns em doentes com disfagia ou naqueles com risco de aspiração.
Objetivos: Determinar a prevalĂȘncia da disfagia em doentes pĂłs acidente vascular cerebral;
relacionar a influĂȘncia de fatores sociodemogrĂĄficos e clĂnicos na ocorrĂȘncia de disfagia em
doentes pĂłs AVC.
MĂ©todos: Estudo quantitativo, com corte transversal, descritivo analĂtico-correlacional. Os dados
foram colhidos junto 60 doentes em situação de pós AVC internados no Serviço de Medicina de
um Centro Hospitalar da zona centro do paĂs. O diagnĂłstico de internamento de AVC no Serviço.
O instrumento de recolha de dados foi um questionårio com questÔes de caracterização
sociodemogrĂĄfica e clĂnica e a Escala GUSS de Stroke (2007).
Resultados: Trata-se de uma amostra constituĂda maioritariamente por mulheres (55,6%), com
uma média de idades de 79,37 anos (±10,12 anos). Grande parte dos doentes (85,0%) tem a sua
doença associada a algum fator risco, dos quais 66,7% tĂȘm hipertensĂŁo arterial, 30% fibrilhação
auricular, 31,7% dislipidémia, 16,7% diabetes mellitus, 10,0% alcoolismo, 23,3% sofrem de
obesidade. Prevalece o AVC isquémico (83,3%), sendo que 55,0% apresentam como local da
lesão o hemisfério direito e 45,0% o hemisfério esquerdo. A maioria dos doentes apresenta lesão
na artĂ©ria cerebral mĂ©dia (54,5%); 48 doentes que tiveram dĂ©fices evidenciados, com prevalĂȘncia
da disartria (31,7%) e hemiparesia (38,3%); 22,0% tiveram um AVC anterior. Apenas 3 doentes
apresentam sequelas na deglutição (23,1%), com 11,8% a ter reabilitação dirigida à disfagia, dos
quais 3 deles o programa foi realizado pelo terapeuta da fala (75,0%), com duas secçÔes para 2
doentes (40,0%) e cinco sessÔes para 3 doentes (60,0%), com uma duração de 10 minutos para 2
doentes (66,7%) e de 20 minutos no caso de 1 doente (33,3%). Apenas em 5,2% dos doentes foi
contemplada a continuidade da reabilitação da disfagia na alta; em 36,8% dos doentes foi
realizado ensino formal de preparação para a alta, tendo o mesmo sido dirigido, na maioria dos
casos, ao doente (47,6%). Em grande parte dos casos, o ensino foi planeado pelo enfermeiro
generalista (57,1%).
ConclusĂ”es: O grau de dependĂȘncia Ă© preditor da disfagia nas primeiras 24 horas, nas 48 horas e
na alta. Assim, os doentes com maior grau de dependĂȘncia mais disfagia apresentam nos trĂȘs
momentos de avaliação.
Abstract Background: Post stroke dysphagia has been attributed to pharyngeal muscle dysfunction and incoordination and loss of central nervous system control. Brainstem injuries are commonly cited as having an association with the presence of dysphagia. However, it has also been suggested that lesions at cortical sites may be more common in patients with dysphagia or those at risk of aspiration. Objectives: To determine the prevalence of dysphagia in stroke patients; to relate the influence of sociodemographic and clinical factors on the occurrence of dysphagia in stroke patients. Methods: Quantitative, cross-sectional, descriptive-correlational study. Data were collected from 60 post-stroke patients admitted to the Medical Service of a Hospital Center in the center of the country diagnosis of stroke admission to the Service. The data collection instrument was a questionnaire with questions of sociodemographic and clinical characterization and the Stroke GUSS Scale (2007). Results: This is a sample composed mainly of women (55.6%), with a mean age of 79.37 years (± 10.12 years). Most patients (85.0%) have their disease associated with some risk factor, of which 66.7% have hypertension, 30% atrial fibrillation, 31.7% dyslipidemia, 16.7% diabetes mellitus, 10, 0% alcoholism, 23.3% suffer from obesity. Ischemic stroke prevails (83.3%), with 55.0% presenting as lesion site the right hemisphere and 45.0% the left hemisphere. Most patients have damage to the middle cerebral artery (54.5%); 48 patients with evident deficits, with prevalence of dysarthria (31.7%) and hemiparesis (38.3%); 22.0% had a previous stroke. Only 3 patients had swallowing sequelae (23.1%), with 11.8% undergoing rehabilitation directed to dysphagia, of which 3 were programmed by the speech therapist (75.0%), with two sections for 2 40.0%) and five sessions for 3 patients (60.0%), lasting 10 minutes for 2 patients (66.7%) and 20 minutes for 1 patient (33.3%). Only 5.2% of patients contemplated the continuation of dysphagia rehabilitation at discharge; 36.8% of the patients were formally prepared for discharge preparation and in most cases they were directed to the patient (47.6%). In most cases, the teaching was planned by the generalist nurse (57.1%). Conclusions: The degree of dependence is a predictor of dysphagia in the first 24 hours, at 48 hours and at hospital discharge. Thus, patients with the highest degree of dependence plus dysphagia present at the three assessment times.
Abstract Background: Post stroke dysphagia has been attributed to pharyngeal muscle dysfunction and incoordination and loss of central nervous system control. Brainstem injuries are commonly cited as having an association with the presence of dysphagia. However, it has also been suggested that lesions at cortical sites may be more common in patients with dysphagia or those at risk of aspiration. Objectives: To determine the prevalence of dysphagia in stroke patients; to relate the influence of sociodemographic and clinical factors on the occurrence of dysphagia in stroke patients. Methods: Quantitative, cross-sectional, descriptive-correlational study. Data were collected from 60 post-stroke patients admitted to the Medical Service of a Hospital Center in the center of the country diagnosis of stroke admission to the Service. The data collection instrument was a questionnaire with questions of sociodemographic and clinical characterization and the Stroke GUSS Scale (2007). Results: This is a sample composed mainly of women (55.6%), with a mean age of 79.37 years (± 10.12 years). Most patients (85.0%) have their disease associated with some risk factor, of which 66.7% have hypertension, 30% atrial fibrillation, 31.7% dyslipidemia, 16.7% diabetes mellitus, 10, 0% alcoholism, 23.3% suffer from obesity. Ischemic stroke prevails (83.3%), with 55.0% presenting as lesion site the right hemisphere and 45.0% the left hemisphere. Most patients have damage to the middle cerebral artery (54.5%); 48 patients with evident deficits, with prevalence of dysarthria (31.7%) and hemiparesis (38.3%); 22.0% had a previous stroke. Only 3 patients had swallowing sequelae (23.1%), with 11.8% undergoing rehabilitation directed to dysphagia, of which 3 were programmed by the speech therapist (75.0%), with two sections for 2 40.0%) and five sessions for 3 patients (60.0%), lasting 10 minutes for 2 patients (66.7%) and 20 minutes for 1 patient (33.3%). Only 5.2% of patients contemplated the continuation of dysphagia rehabilitation at discharge; 36.8% of the patients were formally prepared for discharge preparation and in most cases they were directed to the patient (47.6%). In most cases, the teaching was planned by the generalist nurse (57.1%). Conclusions: The degree of dependence is a predictor of dysphagia in the first 24 hours, at 48 hours and at hospital discharge. Thus, patients with the highest degree of dependence plus dysphagia present at the three assessment times.
Description
Keywords
Acidente vascular cerebral Disfagia Factores de risco PerturbaçÔes de deglutição PrevalĂȘncia Deglutition disorders Prevalence Risk factors Stroke