Japanese

Title	地域高齢者の口腔機能の実態調査と摂食機能の健康管理に関する意識の変化
Subtitle	原著
Authors	河村敦子1), 篠木由樹1), 田村ひかり1), 堀田真帆1), 米村礼子2), 堤雅恵1)
Authors (kana)
Organization	1)山口大学大学院医学系研究科保健学専攻, 2)宇部リハビリテーション病院
Journal	日本摂食嚥下リハビリテーション学会雑誌
Volume	24
Number	1
Page	26-37
Year/Month	2020 / 4
Article	原著
Publisher	日本摂食嚥下リハビリテーション学会
Abstract	「要旨」 【目的】現在高齢化率は27.7%と過去最高となり, 高齢者の誤嚥性肺炎による死亡率が高いことが問題視されている. 本研究の目的は, 地域に在住する65歳以上の高齢者の口腔ケアおよび摂食機能の実態を明らかにし, 嚥下体操の研修会の前後で, 自ら摂食機能を健康管理することへの意識の変化を明らかにすることである. 【方法】老年看護学教員と看護学生3名とが, 地域の5ヵ所の老人クラブを訪問し, 口腔ケアの重要性, 嚥下体操・唾液腺マッサージおよびパタカラ口腔体操の指導の介入を実施した. 介入の前後で, 口腔・摂食機能, 口腔ケアの状況, 加齢に伴う口腔機能低下への認識および自己健康管理方法に関して, 自記式質問紙調査を行った. 【結果】アンケート調査において有効回答が得られた77名(平均年齢76.3±6.1歳: 男性33名, 女性44名)を研究対象とした. 参加者の21%は独居で, 1日の食事回数は90%の人が3回であった. 介入前の歯磨きの平均回数は2.4±1.1回/日で, 朝食後や就寝前に行われることが多かった. 研究参加者の62.3%に義歯があり, 約40%の参加者に食事中にむせる症状や口渇があることが示された. 介入前の嚥下体操の認知度は35.1%で, 摂食機能に対する健康管理への意識がある人は41.6%であった. 介入後に摂食機能に対する健康管理への意識が変化した人は74.0%で, 歯磨きを行おうとする回数が有意に増加した(p=.000). 参加者のうち31.2%の人が, 嚥下体操の継続の意志を示した. 【結論】口腔ケアおよび嚥下体操の指導は, 地域高齢者の約7割の人々に, 摂食機能に対する健康管理への意識の変化をもたらし, 歯磨きを実施しようとする回数を有意に増加させた. しかし, 一度では知識の定着は困難であるため, 継続して研修会の機会を設ける必要性が示唆された.
Practice	医療技術
Keywords	嚥下体操, 摂食機能, 健康管理, 地域高齢者, swallowing exercises, health care, older adults

English

Title	Survey on the Actual Situation of Oral Function and Change in Awareness of Health Management for Eating Function in Community-Dwelling Older Adults
Subtitle
Authors	Atsuko KAWAMURA1), Yuki SHINOKI1), Hikari TAMURA1), Maho HORITA1), Reiko YONEMURA2), Masae TSUTSUMI1)
Authors (kana)
Organization	1)Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, 2)Department of Nursing, Ube Rehabilitation Hospital
Journal	The Japanese Journal of Dysphagia Rehabilitation
Volume	24
Number	1
Page	26-37
Year/Month	2020 / 4
Article	Original article
Publisher	The Japanese Society of Dysphagia Rehabilitation
Abstract	[Abstract] Purpose: Japan is becoming a super-aged society and aspiration pneumonia is a major cause of death among older adults. We aimed to evaluate the oral care and eating function of community-dwelling older adults aged 65 years and over. Furthermore, we attempted to clarify whether the provision of educational guidance regarding oral care and swallowing exercises could change their awareness of health management for eating function. Methods: One hundred and seventeen older adults enrolled in this study. We provided the participants with guidance about methods for oral care, massage of the salivary glands, and exercises for the muscles around the oral cavity related to swallowing. Before and after the educational program, the participants completed a questionnaire about oral care, eating function, and awareness of management of oral health. Results: Seventy-seven participants (33 men, 44 women; mean age 76.3+-6.1 years) returned completed questionnaires (response rate 65.8%). Among the participants, 21.0% lived alone, 90% ate three meals per day, and 62.3% had dentures. Before the intervention, the participants brushed their teeth with toothpaste an average of 2.4+-1.1 times per day, most commonly after breakfast or before going to bed. Approximately 40% of participants showed some symptoms of impaired eating function, for example choking, taking a long time to eat, or having difficulty eating hard foods. Among the participants, 35.1% were aware of swallowing exercises and 41.6% were aware of health care for eating function. After the educational intervention, 74% of the participants showed an improvement in their awareness of health care for eating function and there was a significant increase in the average frequency of daily toothbrushing events among the participants (p=.000). 31.2% of participants expressed an intention to continue swallowing exercises. Conclusion: This guidance improved the awareness of the participants about health care for eating function. However, since it was difficult to establish knowledge through a single educational session, it would be preferable to provide regular guidance on oral care.
Practice	Medical technology
Keywords	swallowing exercises, health care, older adults

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