[The Determinants of Dysphagia in Patients With Stroke During Hospitalized Rehabilitation].

BACKGROUND: Stroke was the third leading cause of death in Taiwan in 2014. A study found that 53.61% of stroke patients suffered from dysphagia disorder during the rehabilitation phase, which may result in lung aspiration and death. The determinants of dysphagia among nationally hospitalized-rehabilitation stroke patients have not been explored comprehensively.

PURPOSE: To explore the incidence of dysphagia among hospitalized-rehabilitation stroke patients and the related determinants of dysphagia.

METHODS: This descriptive and correlational research design employed a convenience sample of 130 hospitalized stroke patients from rehabilitation wards at a northern regional hospital in Taiwan. A questionnaire and functional assessment were used to collect data. Instruments used included personal and clinical characteristics data questionnaire, the National Institute of Health Stroke Scale (NIHSS), Barthel Index, Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Standardization Swallowing Assessment (SSA), and Acute Stroke Dysphagia Screening (ASDS). Data analyses contained descriptive statistics and logistic regression.

RESULTS: The incidence of stroke dysphagia was 63.8% (SSA) and 64.6% (ASDS), respectively. Age, marital status, stroke site, stroke severity (NIHSS), and cognitive status (MMSE) were identified as significant determinants of dysphagia in bivariate logistic regression, whereas stroke severity and cognitive status were identified as significant independent determinants of dysphagia in multivariate logistic regression.

CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Two-thirds of the participant sample were affected by dysphagia, for which NIHSS and cognitive status were identified as significant determinants. Thus, nurses may conduct early screening for high risk populations based on patients' clinical characteristics in order to reduce aspiration pneumonia problems and to improve the quality of clinical care for dysphagia patients.