[Objective] Tongue cleaning plays an important role in the prevention of aspiration pneumonia and halitosis. Although tongue brushes of various shapes and materials are available, there are few reports that compare the tongue cleaning effect of different brushes, so it is difficult for nonprofessional dental staff to select the optimal tongue brush. The purpose of this study was to set up criteria for selecting the optimal tongue brush.
[Methods] Thirty-nine dependent elderly in a nursing home were divided into three groups. A tongue brush with double-sided fine nylon brushes (group A), a tongue brush with arch wire-torsion brush (group B), and a foam brush (group C) were used by groups A, B, and C, respectively. Tongue cleaning was implemented by caregivers (nonprofessional dental staff) for 14 days. Tongue coating was evaluated by a dentist and dental hygienist. Caregivers filled out questionnaires about oral hygiene.
[Results and discussion] The thickness of the tongue coating showed a significant improvement in all groups (p＜0.05). In particular, the elderly with a thick tongue coating at the beginning of the study showed a significant improvement in group A (p＜0.05). The pain was less in groups A and C, and stickiness of secretion was improved in groups B and C, although there was no statistically significant difference. There were cases in which tongue cleaning was interrupted because of pain in group B. The less pain with brush A might have resulted in more effective tongue cleaning.
[Conclusion] The tongue brush with double-sided fine nylon brushes was effective for a thick tongue coating, while the tongue brush with arch wire-torsion brush and the foam brush reduced the stickiness. Selection of the optimal tongue brush may result in more effective cleaning of the tongue coating.
[Purpose] The purpose of this study is to focus on the “nursing process” and develop a quality assessment scale of dysphagia nursing （QASDN） for both certified nurses（CNs）in the dysphagia nursing field and hospital nurses.
[Methods] The study was approved by the Ethics Committee of the Aichi Prefectural College of Nursing ＆Health. A QASDN was developed based on a literature review and assessed by thirteen experts in dysphagia rehabilitation. The QASDN of CNs and hospital nurses contained 76 and 70 items, respectively. A questionnaire survey regarding the QASDN was conducted among 58 CNs registered in 2006 and 2007, and 1002 nurses at a hospital where CNs work seven months after completion of the regular CN course.
[Results] 1. Valid responses to the QASDN of hospital nurses were obtained from 438 hospital nurses. Sixty-four items were selected from considering the results of mean and rate of practice. Construct validity was analyzed by factor analysis. Six factors were obtained, “assessment of swallowing function,” “assessment and practice for discharge planning,” “risk management and practice of dysphgia rehabilitation,” “practice of dysphgia rehabilitation for pharyngeal dysphagia” “evaluation and coordination,” and “assessment of risk management.” Reliability was analyzed by internal consistency. Cronbach's α was 0.92 for overall scores.
2. Valid responses to the QASDN of CNs were obtained from 47 CNs. Sixty-nine items were selected from considering the results of mean and rate of practice. Construct validity was analyzed by factor analysis of 17 items except for 52 items（5 factors）in common with the QASDN of hospital nurses above. Two factors were obtained, “evaluation, leadership, consultation and coordination to nursing team” and “coordination to rehabilitation team.” QASDN of CNs consisted of 69 items, seven factors. Reliability was analyzed by internal consistency. Cronbach's a was 0.98 for overall scores.
[Conclusion] These results suggested that the QASDN of both CNs and hospital nurses developed have high validity and reliability.
[Purpose] The purpose of this study was to clarify the educational effectiveness of a regular curriculum for certified nurses in dysphagia nursing.
[Methods] The study was approved by the Ethics Committee of the Aichi Prefectural College of Nursing ＆ Health. Using a quality assessment scale of dysphagia nursing (QASDN) for certified nurses (CNs), a questionnaire survey by mail was conducted on CNs registered in 2006 seven months and one year seven months, respectively, after completion of the regular CN course. Similarly, the survey was conducted among CNs registered in 2007 at one month after admission, three months and seven months after completion of the regular CN course, respectively. The QASDN for CNs consisted of 69 items and seven factors: “Ⅰ: assessment of swallowing function”; “Ⅱ: assessment and practice for discharge planning”; “Ⅲ: risk management and practice of dysphagia rehabilitation”; “Ⅳ: practice of dysphagia rehabilitation for pharyngeal dysphagia”; “Ⅴ: assessment of risk management”; “Ⅵ: evaluation, leadership, consultation and coordination of nursing team”; and “Ⅶ: coordination with rehabilitation team.” The QASDN were rated on a scale of five by CNs. Statistical analysis was performed using Wilcoxon signed-ranks test.
[Results] 1. The mean scores of six QASDN factors of 22 CNs registered in 2007 seven months after completion of the regular CN course were as follows: factor Ⅰ 2.95, Ⅲ 2.81, Ⅳ 2.28, Ⅴ 3.08, Ⅵ 2.42, and Ⅶ 1.89, respectively. They were significantly higher than at admission (p＜0.05).
2. The mean scores of 3 QASDN factors of CNs registered in 2006 and 2007 seven months after completion of the regular CN course were around 3.0 for factor Ⅰ, Ⅲ and Ⅴ.
3. The mean scores of 5 QASDN factors of 26 CNs registered in 2006 one year seven months after completion of the regular CN course were factor Ⅱ 2.50, Ⅲ 3.02, Ⅴ 3.29, Ⅵ 2.69 and Ⅶ 2.00, respectively. They also increased significantly compared with the score after seven months (p＜0.05).
[Conclusion] These results suggested that the mean score one year seven months after completion of the regular CN course was at the level of “almost always provide such care” for risk management, assessment of swallowing function and dysphagia rehabilitation. They thus were educationally effective. The findings suggested the necessity to reinforce the curriculum so as to include discharge planning and coordination with the rehabilitation team.
Vacuum infusion of enzymes into freeze-thaw food materials (FI) is a technique for softening food materials while retaining their shape. This technique enhances the infusion efficiency of a degradative enzyme under reduced pressure by using thawed materials.
This study aimed to develop a technique using a vacuum packaging machine instead of a vacuum pump. Bamboo shoots, lotus roots and burdock were used as the food materials.
The method of FI using a vacuum packaging machine was as follows. Frozen food materials were thawed in an enzyme solution so that the enzyme was absorbed onto their surface. They were then taken out of the solution and placed into packaging film. The enzyme was infused using a vacuum packaging machine. The enzyme reaction proceeded at 50℃ for 1 h.
The enzyme infusing efficiency was examined using the enzyme solution while food was being thawed and as enzyme was being infused. We also examined the degree of reduced pressure, concentration of degradative enzyme, and holding time under reduced pressure.
The bamboo shoots and lotus roots, which were thawed in the enzyme solution and then infused with enzymes without the solution, were significantly softer than when thawed into buffer solution and infused with enzyme in the enzyme solution. Burdock was not affected differently by the two methods. The softening effect on bamboo shoots and lotus roots was increased by reducing the pressure (15.30–5.10 kPa). Burdock was not affected by the degree of pressure. Softness that was equivalent to the conventional method was accomplished using 1.25–1.67 times the concentration of enzyme, and holding for 3–5 min under reduced pressure.
These results suggested it was possible to use a vacuum packaging machine for FI. This technique will help improve foods for the elderly or those with disorders, thus improving their quality of life.
Purpose: The transition between the oral and pharyngeal phases is one of the times when mis-swallowing of a low-viscosity liquid like water occurs. Adequate regulation of the velopharyngeal value for swallowing, in which the velum is primarily involved, is essential for preventing aspiration of the airway. The purpose of this study was to examine electromyographically whether differences in the viscosity of low-viscosity liquids could influence regulation of the velopharyngeal valve with levator veli palatini (LVP) muscle activity.
Method: Ten healthy subjects (age: 21–32, average age: 24.0, SD: 2.9) without any clinical history of dysphagia were enrolled in this study. Smoothed EMG signals of the LVP muscle were collected. Each subject swallowed water and milk of a certain volume 10 times. The swallowing volume was individually determined on the basis of the optimum volume for swallowing for each subject.
Result: LVP muscle activity was significantly smaller for milk than for water for seven of the ten subjects (paired t-test, p＜0.01). As a group, EMG activity was also significantly greater for water than for milk.
Conclusion: It was clarified that velopharyngeal function for swallowing depended on the viscosity for liquids having a viscosity close to that of water.