2021 Volume 24 Issue 2 Pages 91-99
Objectives: Appropriate meal forms and the provision of thickeners for liquid have been recommended for patients with dysphagia. The dysphagia diet committee of the Japanese Society of Dysphagia Rehabilitation issued a three-level standard for thickened water, but there is no standard for liquid nutrition. The thickening of liquid nutrition differs depending on the variety of nutrients and the thickness is often evaluated subjectively. This study aimed to establish a standard for the thickening of liquid nutrition in our hospital, and to create an adjustment manual based on subjective and objective evaluations of thickening viscosity. Therefore, we examined the method of adjusting the thickening of liquid nutrition and thickeners adopted in hospitals. Methods: The thickened water using softia®S was compared subjectively and using objective methods such as the Flow test and Line Spread Test (LST). We also examined the stirring method for thickening enteral nutrition and the duration of standing, and conducted subjective evaluation by multiple occupations and objective evaluation by the Flow test. A manual on thickening was prepared and distributed, and a questionnaire survey covering eight items was conducted ten months later. Results: Although there was a tendency to overestimate the amount of thickened water subjectively, the Flow test and LST values accurately reflected the standard amount of softia®S added. There were differences in the amount of softia®S added depending on the type of liquid nutrition and the degree of thickening increased with the amount of time left standing after mixing. The subjective evaluation varied among the examiners, but the Flow test demonstrated a consistent trend and was a useful evaluation method. There was a difference in the frequency of use of thickening agents in the questionnaire survey and 63% of the respondents complied with the precautions. Conclusion: The Flow test, a simple objective evaluation method, can be used to review the ambiguity of subjective evaluation when developing a hospital standard method for thickening liquid nutrition products. As the viscosity of liquid nutrition varies depending on the method of thickening, it is necessary to provide information and education to the ward nursing staff on the employed adjustment method.
