Validation of a multiprofessional instrument for screening the risk of bronchoaspiration in a hospital environment

Authors

DOI:

https://doi.org/10.33448/rsd-v11i1.24847

Keywords:

Validation study; Deglutition disorders; Mass screening; Bronchopneumonia.

Abstract

Objective: To develop and content-validate a multidisciplinary instrument for screening the risk of bronchoaspiration. Method: This is a cross-sectional, quantitative content validation study that followed the following steps: development of an instrument for screening the risk of bronchoaspiration based on a literature review and validation of this instrument according to agreement and relevance among judges. For this phase, 6 specialists in the field were invited (1 physician, 1 physiotherapist, 1 speech therapist, and 3 nurses) to evaluate the instrument and report agreement based on a Likert-type questionnaire. For the analysis of agreement between the judges, the Content Validity Index was used for each item (CVI-I) and total (CVI-T). Results: The instrument consisted of 10 items: age (≥60 years); past illness; Glasgow scale <13; orotracheal intubation; orotracheal intubation time (≥24hours); tracheostomy; feeling dyspneia, inadequate oral hygiene; via alternative feeding and coughing/choking. There is agreement between judges regarding each item (CVI-I 1.0) and also in the entirety (CVI-T 1.0) of the instrument. Conclusion: The multiprofessional instrument for screening the risk of bronchoaspiration in the hospital environment was developed and has content validity, provided by a team of experienced professionals in the field.

References

Almeida, T. M., Cola, P. C., Pernambuco, L. de A., Magalhães, H. V., Magnoni, C. D., & Silva, R. G. da. (2017). Instrumento de rastreio para disfagia orofaríngea no Acidente Vascular Encefálico - Parte I: evidências de validade baseadas no conteúdo e nos processos de resposta. CoDAS, 29(4), 1–9. https://doi.org/10.1590/2317-1782/20172017009

Bassi, D. (2014). Doença pulmonar obstrutiva cônica: considerações sobre deglutição e qualidade de vida (Issues 1–112). UNIVERSIDADE FEDERAL DE SANTA CATARINA.

Behera, A., Read, D., Jackson, N., Saour, B., Alshekhlee, D., & Mosier, A. K. (2018). A Validated Swallow Screener for Dysphagia and Aspiration in Patients with Stroke. Journal of Stroke and Cerebrovascular Diseases, 27(7), 1897–1904. https://doi.org/10.1016/j.jstrokecerebrovasdis.2018.02.037

Belafsky, P. C., Mouadeb, D. A., Rees, C. J., Pryor, J. C., Postma, G. N., Allen, J., & Leonard, R. J. (2008). Validity and reliability of the eating assessment tool (EAT-10). Annals of Otology, Rhinology and Laryngology, 117(12), 919–924. https://doi.org/10.1177/000348940811701210

Butcher, H. K., Bulechek, Gloria M. Dochterman, J., & Wagner, C. M. (2016). NIC - Classificação das Intervenções de Enfermagem. Elsevier.

Carmo, L. F. dos S., Santos, F. A. A. dos, Mendonça, S. C. B. de, & Araújo, B. C. L. (2018). Management of the risk of bronchoaspiration in patients with oropharyngeal dysphagia. Revista CEFAC, 20(4), 532–540. https://doi.org/10.1590/1982-021620182045818

Cavalcante, L. da S., & Matos, M. do P. S. de O. (2015). Práticas de higienização oral ao paciente da UTI e efeitos benéficos na análise de 30 enfermeiros no Pronto Socorro e Hospital 28 de Agosto em Manaus/AM. J. Health Sci. Inst, 33(3), 239–242. https://www.unip.br/comunicacao/publicacoes/ics/edicoes/2015/03_jul-set/V33_n3_2015_p239a242.pdf

Chaves, R. de D. (2014). Achados clínicos e da análise videofluoroscópica da deglutição em pacientes com doença pulmonar obstrutiva crônica [Universidade de São Paulo]. https://www.teses.usp.br/teses/disponiveis/5/5162/tde-26052014-104709/pt-br.php

Cho, S. Y., Choung, R. S., Saito, Y. A., Schleck, C. D., Zinsmeister, A. R., Locke III, G. R., & Talley, N. J. (2015). Prevalence and risk factors for dysphagia: a U.S. community study. Neurogastroenterol Motil, 27(2), 212–219. https://doi.org/10.1111/nmo.12467.

Clavé, P., & Shaker, R. (2015). Dysphagia: Current reality and scope of the problem. Nature Reviews Gastroenterology and Hepatology, 12(5), 259–270. https://doi.org/10.1038/nrgastro.2015.49

Dedivitis, R. A., Santoro, P. P., & Arakawa-Sugueno, L. (2017). Manual prático de disfagia - diagnóstico e tratamento (1a edição). Reviter. https://doi.org/10.1017/CBO9781107415324.004

DeLegge, M. H. (2002). Aspiration Pneumonia: Incidence, Mortality, and At-Risk Populations. In Journal of Parenteral and Enteral Nutrition (Vol. 26, Issue 6_suppl, pp. S19–S25). https://doi.org/10.1177/014860710202600604

DiBardino, D. M., & Wunderink, R. G. (2015). Aspiration pneumonia: A review of modern trends. Journal of Critical Care, 30(1), 40–48. https://doi.org/10.1016/j.jcrc.2014.07.011

Fernandes, K., & Oda, S. (2017). Manual Prático de disfagia - diagnóstico e tratamento. (1a).

Ferrucci, J. L., Sassi, F. C., de Medeiros, G. C., & de Andrade, C. R. F. (2019). Comparison between the functional aspects of swallowing and clinical markers in ICU patients with Traumatic Brain Injury (TBI). Codas, 31(2), 1–11. https://doi.org/10.1590/2317-1782/20182017278

Fritz, M. A., Suiter, D. M. & Postma, G. (2019). Chronic Cough. In Dysphagia in Chronic Cough. Plural Publishing, Inc.

Furmann, N., & Costa, F. M. (2015). Critérios clínicos utilizados por profissionais para liberação de dieta via oral em pacientes adultos hospitalizados. Revista CEFAC, 17(4), 1278–1287. https://doi.org/10.1590/1982-0216201517413614

Global strategy for the diagnosis, managemente, and prevention of chronic obstructive pulmonary disease. GOLD, Global Obstructive Lung Disease, (2018), 1–44. http://www.goldcopd.org/uploads/users/files/GOLD_Report_2015_Apr2.pdf

Lee Titsworth, W., Abram, J., Fullerton, A., Hester, J., Guin, P., Waters, M. F., & Mocco, J. (2013). Prospective quality initiative to maximize dysphagia screening reduces hospital-acquired pneumonia prevalence in patients with stroke. In Stroke (Vol. 44, Issue 11, pp. 3154–3160). https://doi.org/10.1161/STROKEAHA.111.000204

Loivos, L. (2009). DPOC - definição e conceitos - as bases clínicas. Pulmão RJ - Atualizações Temáticas, 1(1), 34–37. http://www.sopterj.com.br/atualizacoes_tematicas/2009/05.pdf

Madhavan, A., Carnaby, G. D., Chhabria, K., & Crary, M. A. (2018). Preliminary development of a screening tool for pre-clinical dysphagia in community dwelling older adults. Geriatrics (Switzerland), 3(4), 1–12. https://doi.org/10.3390/geriatrics3040090

Maeda, K., & Akagi, J. (2014). Oral care may reduce pneumonia in the tube-fed elderly: A preliminary study. Dysphagia, 29(5), 616–621. https://doi.org/10.1007/s00455-014-9553-6

Marik, P. (2001). Aspiration Syndromes. In Handbook of Evidence-Based Critical Care. Springer-Verlag. https://doi.org/10.1016/B978-0-323-01199-0.50216-4

Marvin, S., Thibeault, S., & Ehlenbach, W. J. (2019). Post-extubation Dysphagia: Does Timing of Evaluation Matter? In Dysphagia (Vol. 34, Issue 2, pp. 210–219). https://doi.org/10.1007/s00455-018-9926-3

Medeiros, G. C. de, Sassi, F. C., Zambom, L. S., & Andrade, C. R. F. de. (2016). Correlação entre a gravidade de pacientes críticos e preditores clínicos de risco para a broncoaspiração. J Bras Pneumol, 2(42), 114–120. https://doi.org/10.1590/S1806-37562015000000192

Nascimento, N. P. G. do, Gonçalves, P. F., Douglas-de-Oliveira, W. D., & Flecha, O. D. (2018). Aspiration Pneumonia and oral health: a critical review of literature. Revista Brasileira de Odontologia, 75, 1–7.

Oliveira, A. C. M. de, Friche, A. A. de L., Salomão, M. S., Bougo, G. C., & Vicente, L. C. C. (2018). Predictive factors for oropharyngeal dysphagia after prolonged orotracheal intubation. Brazilian Journal of Otorhinolaryngology, 84(6), 722–728. https://doi.org/10.1016/j.bjorl.2017.08.010

Paine, M. A. (2017). Dysphagia: A New Geriatric Syndrome. Journal of the American Medical Directors Association. 18(7):555-557. doi: 10.1016/j.jamda.2017.03.017.

Pereira, A.S., Shitsuka D.M., Parreira, F.J., Shitsuka, R. Metodologia da pesquisa cietífica. 1ªed. (2018). Santa Maria/RS.

Porto, A. L., & Porto, C. C. (2019). Semiologia médica. Guanabara Koogan.

Schrock, J. W., Bernstein, J., Glasenapp, M., Drogell, K., & Hanna, J. (2011). A novel emergency department dysphagia screen for patients presenting with acute stroke. Academic Emergency Medicine, 18(6), 584–589. https://doi.org/10.1111/j.1553-2712.2011.01087.x

See, K. C., Peng, S. Y., Phua, J., Sum, C. L., & Concepcion, J. (2016). Nurse-performed screening for postextubation dysphagia: A retrospective cohort study in critically ill medical patients. In Critical Care (Vol. 20, Issue 1). https://doi.org/10.1186/s13054-016-1507-y

Toh Yoon, E. W. (2018). A novel semi-solidifying liquid formula via the nasogastric route to maintain enteral nutrition in the event of recurrent aspiration pneumonia: A case report. Clinical Case Reports, 6(9), 1708–1712. https://doi.org/10.1002/ccr3.1668

Weinhardt, J., Hazelett, S., Barrett, D., Lada, R., Enos, T., & Keleman, R. (2008). Accuracy of a bedside dysphagia screening: A comparison of registered nurses and speech therapists. Rehabilitation Nursing, 33(6), 247–252. https://doi.org/10.1002/j.2048-7940.2008.tb00236.x

Yeo, H., & Rosenthal, R. (2018). Cirurgia no paciente geriátrico (S. T. de Cirurgia (Ed. 20a edição). Elsevier Editora Ltda,.

Published

06/01/2022

How to Cite

SARTORI, A. P. de A. .; COLTRO, P. H.; BOUMER, T. C.; ZANATA, I. de L. .; SANTOS, R. S. . Validation of a multiprofessional instrument for screening the risk of bronchoaspiration in a hospital environment. Research, Society and Development, [S. l.], v. 11, n. 1, p. e27111124847, 2022. DOI: 10.33448/rsd-v11i1.24847. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/24847. Acesso em: 26 dec. 2024.

Issue

Section

Health Sciences