Status of Utilization and Issues of the Japanese Dysphagia Diet 2018 for Persons Acquiring Dysphagia in the Developmental Period

Abstract

　To extract issues of the Japanese Dysphagia Diet 2018 (JDD2018), which classifies texture modified diets for persons acquiring dysphagia in the developmental period, the status of utilization of the classification was surveyed. The scope of the questionnaire survey was 136 facilities and 75 national hospitals with wards for persons with severe motor and intellectual disabilities. The valid response rate was 34.6%. Few facilities were using the classification for meal services, nutrition and dietary counseling, or informationsharing with other facilities; even for meal services, which was the most utilized system, only 38.4% of the facilities were using it. More than half of the facilities that did not use this classification in their meal services used the Japanese Dysphagia Diet 2021 for midlife disorders (JDD2021). Although JDD2021 was indicated as the reason for not using the JDD2018 classification, it could not be clarified whether this was the result of a close examination of both classifications. It is possible that they did not actively consider introducing the JDD2018 classification. In order to encourage the use of this classification, it is important to reiterate the target and objectives, and promote its usefulness based on practical examples. In addition, it was also suggested that anxiety about the finished product, selection, cooking methods, etc. was a disincentive to introducing the system, and it was considered necessary to improve supplementary materials and training programs. Even if the system was used in meal services, few facilities used it for dietary and nutritional counseling and information-sharing with other facilities. It was inferred that there were few opportunities to share information because of the small number of transfers of food service recipients between facilities. Many of the nutritional challenges faced by meal recipients were inadequate energy, protein, and water intake due to insufficient oral intake and limited food intake, weight loss, and undernutrition. There was no difference in nutritional problems depending on usage of this classification, indicating that supplemental nutrition should be considered in conjunction with a texture modified diet for this category of patients.