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Abstract(s)
A disfagia é um problema comum, que afeta uma percentagem significativa de doentes e pode resultar numa alta incidência de complicações por aspiração. O estudo da deglutição e da eventual disfagia é importante do ponto de vista clínico. O rastreio precoce dos distúrbios da deglutição pode evitar grandes riscos ao doente, como o desenvolvimento de pneumonia, diminuir o tempo de internamento hospitalar e os custos associados. A escala Gugging Swallowing Screen (GUSS) é considerada uma ferramenta promissora para avaliação clínica precoce da deglutição, que avalia o potencial risco de aspiração pulmonar. Objetivo: Esta tese tem como finalidade obter um corpo de evidência científica que reúna um conjunto de informações acerca da utilização da Gugging Swallowing Screen (GUSS) em meio hospitalar e, através desta ferramenta avaliar a prevalência da disfagia assim como os fatores de risco que influenciam a deglutição nos doentes internados no serviço de Medicina de Lagos. Metodologia: O tema abordado baseia-se em dois artigos, sendo um deles uma revisão sistemática da literatura e outro um estudo quantitativo, do tipo prospetivo correlacional, realizado num serviço de medicina. Resultados: Quatro estudos primários evidenciam dados relevantes acerca da utilidade da escala GUSS no âmbito hospitalar. A mesma foi testada numa amostra de 174 indivíduos, dos quais 52,87% não apresentaram disfagia, 14,37% apresentaram disfagia ligeira, 17,24% disfagia moderada e 15,52% disfagia grave. Fatores como sexo, doença oncológica, quadro respiratório, uso de medicamentos, tipo de medicamentos e frequência da medicação não apresentam correlação estatisticamente significativa. Idade, história prévia de disfagia, doença neurológica, doença neuromuscular e comprometimento motor apresentam uma correlação estatisticamente significativa negativa fraca. O nível de consciência apresenta uma correlação estatisticamente negativa e moderada. E a cooperação apresenta uma correlação estatisticamente positiva e moderada. Conclusão: A introdução de novas ferramentas na avaliação clínica da deglutição para despiste de disfagia proporciona uma oportunidade substancial para definir estratégias de melhoria contínua, de forma a reduzir o risco de danos aos doentes internados. Para tal, são necessários mais estudos com a aplicação da mesma ferramenta noutros serviços e hospitais.
ABSTRACT - The dysphagia is a common problem which affects a large percentage of patients and may result in high incidents of complications by aspiration. The study of deglutition and of the eventual dysphagia is important from the clinical point of view. The early detection of deglutition disorders can avoid great risks to patients, such as the development of pneumonia, the reduction of hospitalization and its associated costs. The Gugging Swallowing Screen scale (GUSS) is considered a promising tool for early clinical evaluation of deglutition, which assesses the potential risk of pulmonary aspiration. Objective: The aim of this thesis is to obtain a body of scientific evidence, bringing together a range of information about the use of the GUSS methodology in hospitals, and through this tool assess the predominance of dysphagia as well as the factors of risk that influence the deglutition in hospitalized patients in Lagos medical service. Methodology: The analysis of the subject of this thesis is based on two articles. One of them is a systematic literature review, and the other is a quantitative, prospective and correlational study, carried out in a medical service. Results: Four primary studies have shown relevant data on the usefulness of GUSS methodology in hospitals. The GUSS scale was tested in a total of 174 individuals, of whom 52,87% did not present dysphagia, 14,37% presented light dysphagia, 17,24% moderated dysphagia and 15,52% serious dysphagia. Factors such as gender, oncological and respiratory diseases, the use of medicines, the type and frequency of medication do not show statistically significant correlation. Age, previous history of dysphagia, neurological disease, neuromuscular disease and motor impairment, show a weak negative statistically significant correlation. The level of awareness shows a statistically negative and moderate correlation. And the cooperation shows a statistically positive and moderate correlation. Conclusion: The introduction of new tools in the clinical assessment of deglutition for detection of dysphagia provides a substantial opportunity to define strategies for further improvement in order to reduce the risk of damages to hospitalized patients. To do this, more studies are needed using this tool in other services and hospitals.
ABSTRACT - The dysphagia is a common problem which affects a large percentage of patients and may result in high incidents of complications by aspiration. The study of deglutition and of the eventual dysphagia is important from the clinical point of view. The early detection of deglutition disorders can avoid great risks to patients, such as the development of pneumonia, the reduction of hospitalization and its associated costs. The Gugging Swallowing Screen scale (GUSS) is considered a promising tool for early clinical evaluation of deglutition, which assesses the potential risk of pulmonary aspiration. Objective: The aim of this thesis is to obtain a body of scientific evidence, bringing together a range of information about the use of the GUSS methodology in hospitals, and through this tool assess the predominance of dysphagia as well as the factors of risk that influence the deglutition in hospitalized patients in Lagos medical service. Methodology: The analysis of the subject of this thesis is based on two articles. One of them is a systematic literature review, and the other is a quantitative, prospective and correlational study, carried out in a medical service. Results: Four primary studies have shown relevant data on the usefulness of GUSS methodology in hospitals. The GUSS scale was tested in a total of 174 individuals, of whom 52,87% did not present dysphagia, 14,37% presented light dysphagia, 17,24% moderated dysphagia and 15,52% serious dysphagia. Factors such as gender, oncological and respiratory diseases, the use of medicines, the type and frequency of medication do not show statistically significant correlation. Age, previous history of dysphagia, neurological disease, neuromuscular disease and motor impairment, show a weak negative statistically significant correlation. The level of awareness shows a statistically negative and moderate correlation. And the cooperation shows a statistically positive and moderate correlation. Conclusion: The introduction of new tools in the clinical assessment of deglutition for detection of dysphagia provides a substantial opportunity to define strategies for further improvement in order to reduce the risk of damages to hospitalized patients. To do this, more studies are needed using this tool in other services and hospitals.
Description
Mestrado em Gestão e Avaliação de Tecnologias em Saúde
Keywords
Deglutição Distúrbio da deglutição Disfagia Escala Gugging Swallowing Screen Deglutition Deglutition disorder Dysphagia Gugging Swallowing Screen Scale
Citation
Ventura IM. Gugging Swallowing Screen na avaliação clínica da deglutição [Dissertation]. Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; 2018.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa