Understanding Dysphagia Diets among Nurses at Advanced Treatment Hospitals and the Difficulty and Anxiety Associated with Food Type Assessment

Abstract

Objective:　 The objective of this study was to determine how nurses at advanced treatment hospitals understand dysphagia diets, as well as the difficulty and anxiety associated with food type assessment.　 Methods:　 A survey form was distributed to 540 ward nurses at advanced treatment hospital A. The 367 nurses from whom responses were obtained were treated as experimental subjects. In addition, for patients who had used dysphagia diets within the past year, data such as their age and the ward to which they belonged when they started the diet were collected from medical records.　 Results:　 A total of 53.2% of the patients who had used a dysphagia diet were aged 60 years or older. Patients belonged to all wards except for the intensive care unit. In the nurses’ survey, the percentage of nurses who had studied the “Japanese Dysphagia Diet 2013 by the Japanese Society of Dysphagia Rehabilitation dysphagia diet committee” was significantly higher among ward nurses with many patients using dysphagia diets (p＝ 0.017). Understanding of aspects, such as the definition of “dysphagia diet,” and the difference between codes 3 and 4 was also significantly higher among ward nurses with many patients using dysphagia diets (p＜ 0.001). Moreover, among the 132 nurses with experience in caring for patients using dysphagia diets, approximately 70% had difficulty or anxiety regarding food type assessment; no significant difference was observed between ward nurses with many patients using dysphagia diets and ward nurses with few such patients.　 Discussion:　 As the aging rate has increased, many hospital wards demand practical nursing skills for elderly individuals with dysphagia. The difficulty and anxiety among nurses regarding food type assessment may be due to insufficient knowledge regarding dysphagia diets and other aspects of ingestion and swallowing, as well as insufficient practical nursing skills tailored to individual patients; these issues suggest that it is necessary to provide learning opportunities regarding dysphagia.　 Conclusions:　 Ward nurses with many patients using dysphagia diets had a greater understanding of the diet compared to ward nurses with few such patients. However, regardless of the degree of involvement with patients using dysphagia diets, nurses had difficulty and anxiety regarding food type assessment.