Dysphagia comes any time when the individual experienced difficulty moving food or liquid from mouth to stomach, or experienced choking or throat clearing during or following meal time. But the risk of dysphagia is susceptible to aging physical troubles such as change in head and neck anatomy that supports the swallowing operation, decrease in the number of teeth, weakening saliva plays, dry mouth, weakening of tongue and sphincteral muscles. Chronic disease coupled with aging and medication or other treatment process can increase the risk of dysphagia .
Dysphagia can be a fatal threat for human life as the principal cause for aspiration pneumonia, which is ranked the number one fatal disease for the elderly and also incurs malnutrition, dehydration, asphyxia and death and other serious medical problems. In addition, main symptoms for the risk of dysphagia such as slobbering, coughing, throat clearing can drag eating meal and cause anxiety with meals and avoidance of public eating. Furthermore, it may discourage social activity and inhibit psychological well-being and downgrade the dysphagia- specific quality of life. Nevertheless, in reality, the previous studies on dysphagia mainly focused on prevalence of dysphagia rather than on dysphasia risk confining its horizon to clinical approach without regards to dysphagia specific socio-psychological well-being status.
Consequently, in an effort to prevent dysphagia and its relevant complications, this research is intended to alert the risk of dysphagia of community?dwelling elderly and find dysphagia specific impact on quality life to perceive socio-psychological well-being status including functional status comprehensively.
The sampling population of this research consists of 260 Community-Dwelling Elderly aged 65 years or older who live Jong-No district in Seoul and Sung Nam City, Gyunggi province. Data collection was made during February 15- February 28, 2013. SPSS Window 18.0 was adopted to give descriptive statistics t-test and verification of x2, Logistic regression analysis, Pearson’s correlation analysis to the collected data.
The average age of the 260 sample population was 75.8 inclusive of 175 women which accounts for 67.3%. 162 respondents which accounts for 62.3% subject to dysphagia risk as majority group. Neurology disease(OR=10.125, CI=1.092-93.899), gastritis(OR=5.731, CI=1.482-22.173), perceived natural teeth discomfort(OR=0.947, CI=1.311-5.196), perceived denture discomfort(OR=2.969, CI=1.016-8.677), dry mouth ‘severe’(OR=15.677, CI=2.986-82.297), ‘very severe’(OR=9.047, CI=1.680-48.726), ‘A little’(OR=4.147, CI=2.075-8.286), number of natural teeth(OR=0.947, CI=0.903-0.993) were significant factors predicting dysphagia risk in elderly. Lastly the higher dysphasia risk, the dysphagia-specific quality of life significantly lowered.
The conclusion in this study are below.
First, this study shows that the elderly are inclined to be ignorant of dysphagia lacking accurate knowledge of it. To prevent complication and downgrade the quality of life, it is essential to give proper education for the community-dwelling elderly to have right understanding of dysphagia and take countermeasure and prevention of complications
Second, effective nursing intervention programs should be developed for those elderly who are determined to have dysphagia risk on the basis of this study result. In particular, dysphagia cannot be viewed as the simple physical trouble but it must be perceived and taken into consideration, from the psycho-sociological perspectives, the functional status and dysphagia specific downgrade of quality life, and social activities should be taken into account
Third, this study has limitation to generalize the analytical conclusion to the entire national level since the elderly group sampling is taken locally only two provinces such as Seoul and Kyunggi areas. Therefore, it is encouraging to pursue ensuing study in the future to upgrade this study encompassing the elderly samples in a variety of wide community level.