J Korean Acad Nurs.  2015 Feb;45(1):1-13. 10.4040/jkan.2015.45.1.1.

Dysphagia Screening Measures for Use in Nursing Homes: A Systematic Review

Affiliations
  • 1College of Nursing, Seoul National University, Seoul, Korea.
  • 2The Research Institute of Nursing Science, Seoul National University, Seoul, Korea. luvlucie@snu.ac.kr
  • 3School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
  • 4Seoul Women's College of Nursing, Seoul, Korea.

Abstract

PURPOSE
The purpose of this study was to evaluate the psychometric quality and feasibility of measurements for screening dysphagia in older adults to identify the 'right tool' for nurses to use in nursing homes.
METHODS
A systematic review was done. Electronic databases were searched for studies related to dysphagia screening measurements. A checklist was used to evaluate the psychometric quality and applicability. Tools were evaluated for feasible incorporation into routine care by nurses.
RESULTS
29 tools from 31 studies were identified. Dysphagia screening tools with an acceptable validity and reliability had sensitivity between 68% and 100% and specificity between 52% and 100%. The Gugging Swallowing Screen (GUSS) and the Standardized Swallowing Assessment (SSA) were the tools with high psychometric quality, especially with high sensitivity, that nurses could perform feasibly to identify the risk and to grade the severity of dysphagia and aspiration of nursing home residents.
CONCLUSION
Results show that GUSS and SSA are reliable and sensitive tools for screening dysphagia which nurses can use in nursing homes. Further research is needed to examine feasibility of screening with identified tools, and also, to establish effective and standardized protocols for these tools so they can be effectively incorporated into routine care.

Keyword

Deglutition disorders; Nursing; Nursing homes; Screening; Systematic review

MeSH Terms

Databases, Factual
Deglutition
Deglutition Disorders/*diagnosis
Humans
Nursing Homes
Sensitivity and Specificity

Figure

  • Figure 1 Flowchart of document identification and selection process.


Reference

1. Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest. 2003; 124(1):328–336. DOI: 10.1378/chest.124.1.328.
2. Tanner DC. Lessons from nursing home dysphagia malpractice litigation. J Gerontol Nurs. 2010; 36(3):41–46. DOI: 10.3928/00989134-20100202-06.
3. Park YH, Han HR, Oh BM, Lee J, Park JA, Yu SJ, et al. Prevalence and associated factors of dysphagia in nursing home residents. Geriatr Nurs. 2013; 34(3):212–217. DOI: 10.1016/j.gerinurse.2013.02.014.
4. Murry T, Carrau RL. Clinical manual of swallowing disorders. 2nd ed. San Diego, CA: Plural Publishing;2006.
5. Krueger W, Conlon B. Comparison of dysphagia competency procedures in medical and school settings. In : The annual Convention of the American Speech-Language-Hearing Association; 2006 November 16-18; Miami, FL.
6. Beverly C, Burger SG, Maas ML, Specht JK. Aging issues: Nursing imperatives for healthcare reform. Nurs Adm Q. 2010; 34(2):95–109. DOI: 10.1097/NAQ.0b013e3181d91718.
7. Werner H. The benefits of the dysphagia clinical nurse specialist role. J Neurosci Nurs. 2005; 37(4):212–215.
8. Bours GJ, Speyer R, Lemmens J, Limburg M, de Wit R. Bedside screening tests vs. videofluoroscopy or fibreoptic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: Systematic review. J Adv Nurs. 2009; 65(3):477–493. DOI: 10.1111/j.1365-2648.2008.04915.x.
9. Travers PL. Poststroke dysphagia: Implications for nurses. Rehabil Nurs. 1999; 24(2):69–73. DOI: 10.1002/j.2048-7940.1999.tb01839.x.
10. Hawker S, Payne S, Kerr C, Hardey M, Powell J. Appraising the evidence: Reviewing disparate data systematically. Qual Health Res. 2002; 12(9):1284–1299. DOI: 10.1177/1049732302238250.
11. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007; 60(1):34–42. DOI: 10.1016/j.jclinepi.2006.03.012.
12. Martino R, Silver F, Teasell R, Bayley M, Nicholson G, Streiner DL, et al. The Toronto bedside swallowing screening test (TOR-BSST): Development and validation of a dysphagia screening tool for patients with stroke. Stroke. 2009; 40(2):555–561. DOI: 10.1161/strokeaha.107.510370.
13. Burns N, Grove SK. The practice of nursing research: Appraisal, synthesis, and generation of evidence. 7th ed. St. Louis, MO: Saunders;2013.
14. Bot SD, Terwee CB, van der Windt DA, Bouter LM, Dekker J, de Vet HC. Clinimetric evaluation of shoulder disability questionnaires: A systematic review of the literature. Ann Rheum Dis. 2004; 63(4):335–341. DOI: 10.1136/ard.2003.007724.
15. Westergren A. Detection of eating difficulties after stroke: A systematic review. Int Nurs Rev. 2006; 53(2):143–149. DOI: 10.1111/j.1466-7657.2006.00460.x.
16. Marques CH, de Rosso AL, André C. Bedside assessment of swallowing in stroke: Water tests are not enough. Top Stroke Rehabil. 2008; 15(4):378–383. DOI: 10.1310/tsr1504-378.
17. Antonios N, Carnaby-Mann G, Crary M, Miller L, Hubbard H, Hood K, et al. Analysis of a physician tool for evaluating dysphagia on an inpatient stroke unit: The modified mann assessment of swallowing ability. J Stroke Cerebrovasc Dis. 2010; 19(1):49–57. DOI: 10.1016/j.jstrokecerebrovasdis.2009.03.007.
18. Hiss SG, Postma GN. Fiberoptic endoscopic evaluation of swallowing. Laryngoscope. 2003; 113(8):1386–1393. DOI: 10.1097/00005537-200308000-00023.
19. Perry L, Love CP. Screening for dysphagia and aspiration in acute stroke: A systematic review. Dysphagia. 2001; 16(1):7–18. DOI: 10.1007/pl00021290.
20. Ramsey DJ, Smithard DG, Kalra L. Early assessments of dysphagia and aspiration risk in acute stroke patients. Stroke. 2003; 34(5):1252–1257. DOI: 10.1161/01.str.0000066309.06490.b8.
21. Intercollegiate Stroke Working Party. National clinical guidelines for stroke. 4th ed. London, UK: Royal College of Physicians;2012.
22. Lindsay P, Bayley M, Hellings C, Hill M, Woodbury E, Phillips S. Canadian best practice recommendations for stroke care (updated 2008). CMAJ. 2008; 179(12):S1–S25. DOI: 10.1503/cmaj.081148.r2.
23. Han TR, Paik NJ, Park JW. Quantifying swallowing function after stroke: A functional dysphagia scale based on videofluoroscopic studies. Arch Phys Med Rehabil. 2001; 82(5):677–682. DOI: 10.1053/apmr.2001.21939.
24. Trapl M, Enderle P, Nowotny M, Teuschl Y, Matz K, Dachenhausen A, et al. Dysphagia bedside screening for acute-stroke patients: The Gugging swallowing screen. Stroke. 2007; 38(11):2948–2952. DOI: 10.1161/strokeaha.107.483933.
25. Perry L. Screening swallowing function of patients with acute stroke. Part one: Identification, implementation and initial evaluation of a screening tool for use by nurses. J Clin Nurs. 2001; 10(4):463–473. DOI: 10.1046/j.1365-2702.2001.00501.x.
26. Logemann JA, Veis S, Colangelo L. A screening procedure for oropharyngeal dysphagia. Dysphagia. 1999; 14(1):44–51.
27. Lambert HC, Gisel EG. The assessment of oral, pharyngeal and esophageal dysphagia in elderly persons. Phys Occup Ther Geriatr. 1997; 14(4):1–25.
28. Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. QUADAS-2: A revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011; 155(8):529–536. DOI: 10.7326/0003-4819-155-8-201110180-00009.
29. Smithard DG, O'Neill PA, England RE, Park CL, Wyatt R, Martin DF, et al. The natural history of dysphagia following a stroke. Dysphagia. 1997; 12(4):188–193.
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