Journal of Korean Academy of Nursing

Development and Validation of the Self-Care for Aspiration Pneumonia Prevention Scale in the Community Dwelling Elderly with Risk of Dysphasia: Yang, Eun Young , Lee, Shin-Young; J Korean Acad Nurs 2020;50(3):474-486. Published online June 30, 2020; DOI: https://doi.org/10.4040/jkan.20041

Abstract PDF: Purpose
The purpose of this study was to develop and validate a Korean version of the Self-Care for Aspiration Pneumonia Prevention(SCAPP-K) scale in older adults at risk of dysphasia.
Methods
The Hertz and Baas model of scale development and validation was used. Inthe development stage, items were generated via literature review and interviews with medical experts, older adults, and caregivers. Tenexperts assessed the items for content validity. Subsequently, 12 older adults participated in a pilot test to determine the comprehensibilityand appropriateness of the SCAPP-K scale. The validation stage involved a cross-sectional survey with 203 older adults for exploratoryfactor analysis (EFA) and 200 older adults for confirmatory factor analysis (CFA) and to determine convergent and discriminant validity. Totest the validity and reliability of the scale, EFA using principal component analysis with varimax rotation and CFA were conducted, andconvergent and discriminant validity as well as internal consistency reliability were determined.
Results
As a result of EFA, three self-carefactors (knowledge, resources, behaviors) with 21 items were validated. The CFA and convergent and discriminant validity indicated theapplicability of the three-factor self-care scale. The reliability of the SCAPP-K scale was acceptable, with Cronbach’s a=.87~.91.
Conclusion
The SCAPP-K scale has acceptable validity and reliability and can contribute to clinical practice, research, and education to improveself-care for the prevention of aspiration pneumonia in older adults at risk of dysphasia.

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3 Web of Science

Clinical Implications of the Glucose Test Strip Method for Early Detection of Pulmonary Aspiration in Nasogastric Tube- Fed Patients: Hwa Soon Kim; Journal of Korean Academy of Nursing 2004;34(7):1215-1223. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2004.34.7.1215

Abstract PDF: Purpose
This study was performed to test the clinical usefulness of the glucose test strip method for early detection of pulmonary aspiration in tube fed patients.
Method
The subjects for the study were 36 patients who were receiving enteral feedings and 39 patients who were not given enteral feedings. For the analysis, the tube fed patients were divided into two groups (clinically significant aspiration and no aspiration) according to criteria.
Result
The mean glucose concentration of tracheal secretions from non enteral fed patients was 26.35mg/dl and were lower than those concentrations found in tube fed patients (32.75mg/dl). The mean glucose concentration of the aspiration group was 45.60mg/dl and the glucose concentration of the non aspiration group was 19.93mg/dl. The difference was statistically significant (t=2.163, p=. 038). More subjects in the no aspiration group (73%) than the aspiration group (56%) had glucose concentrations below 20mg/dl. After deleting the cases that had samples containing blood, glucose concentrations of tracheal aspirates were lower in both groups.
Conclusion
The glucose level of the aspiration group was significantly lower than the no aspiration group and more subjects in the aspiration group had a glucose level higher than 101mg/dl. Therefore, the glucose test of tracheal secretions in tube fed patients could be a desirable test for screening for tracheal aspiration. Especially the patient who is showing repeatedly high glucose levels should not be given feedings until reassessment is completed.

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Comparison for Risk Estimate of Aspiration between the Revised Dysphagia Assessment Tool and Videofluoroscopy in Post-Stroke Patients: Kyung Hee Moon, Hyun Sook Sohn, Eun Seok Lee, Eun Kyung Paek, Eun Ju Kang, Seung Hee Lee, Na Ri Han, Meen Hye Lee, Deog Young Kim, Chang Gi Park, Ji-Soo Yoo; J Korean Acad Nurs 2010;40(3):359-366. Published online June 30, 2010; DOI: https://doi.org/10.4040/jkan.2010.40.3.359

Abstract PDF: Purpose
The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool.
Methods
A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis.
Results
In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy.
Conclusion
The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.

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