Concordância entre a avaliação clínica e videofluoroscópica em pacientes disfágicos
Autor(a) principal: | |
---|---|
Data de Publicação: | 2014 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional Manancial UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/6573 |
Resumo: | The current conception of speech therapy in dysphagia requires the use of a clinical assesment protocol that can provide sensitive and specific answers as to the degree of swallowing disorders. Objective: The objective of this research was to establish the correlation between the Dysphagia Risk Evaluation Protocol (DREP) and videofluoroscopy in patients with swallowing disorders as well as checking the level of oral intake after their assessment. Method: This research is exploratory, quantitative, longitudinal and retrospective in database. The sample consisted of 91 patients, 55 men and 36 women, aged between 18 and 89 years old. It was performed the clinical evaluation of dysphagia with the use of the Dysphagia Risk Evaluation Protocol - DREP (PADOVANI et al, 2007), use of the Functional Oral Intake Scale for Dysphagia in Stroke Patients - FOIS (CRARY et al, 2005), videofluoroscopic swallowing exam (VFSE) and use of the penetration/aspiration scale (ROSENBECK et al., 1996). The VFSE images were evaluated individually by three judges with expertise in dysphagia Results: The analysis of concordance of objective evaluation diagnosis between the judges according to the ICC was substantial and second Kappa index was considered moderate. The correlation between clinical (DREP) and objective assessment was moderate, it was found that the VFSE detected specific features of swallowing not identified in the clinical evaluation. The agreement between FOIS / DREP and FOIS / VFSE calculated by Kappa test was moderate, but the overall correlation was strong. Out of the 24 patients who received indication for total alternative feeding, that means, nothing orally, 13 (54%) received indication of at least one feeding consistency after completion of the VFSE. Furthermore, according to the clinical evaluation, 35 patients also needed an alternative feeding means and after the VFSE 25 patients still had indication for alternative feeding means. Conclusion: The DREP proved to be a satisfactory tool for establishing the presence of dysphagia in patients with different pathologies, but does not identify characteristics that are subject to analysis only with videofluoroscopy, confirming the necessary support of an objective method of assesment for a complete evaluation of the cases of dysphagia. There was strong correlation between the FOIS after clinical assessment by the DREP protocol and the videofluoroscopy of swallowing, the latter providing more accurate indication for the use of alternative feeding and liberation of oral feeding. Besides that, it was observed that the FOIS is an effective marker for determining the level of oral intake in dysphagia cases which were originated from neoplasms, diseases of the circulatory and respiratory systems. |
id |
UFSM-20_d705c6b7e4aea96078836631101753b0 |
---|---|
oai_identifier_str |
oai:repositorio.ufsm.br:1/6573 |
network_acronym_str |
UFSM-20 |
network_name_str |
Repositório Institucional Manancial UFSM |
repository_id_str |
3913 |
spelling |
2015-03-042015-03-042014-03-31COSTA, Cintia da Conceição. AGREEMENT BETWEEN CLINICAL EVALUATION IN PATIENTS AND VIDEOFLUOROSCOPIC DYSPHAGIA. 2014. 109 f. Dissertação (Mestrado em Fonoaudiologia) - Universidade Federal de Santa Maria, Santa Maria, 2014.http://repositorio.ufsm.br/handle/1/6573The current conception of speech therapy in dysphagia requires the use of a clinical assesment protocol that can provide sensitive and specific answers as to the degree of swallowing disorders. Objective: The objective of this research was to establish the correlation between the Dysphagia Risk Evaluation Protocol (DREP) and videofluoroscopy in patients with swallowing disorders as well as checking the level of oral intake after their assessment. Method: This research is exploratory, quantitative, longitudinal and retrospective in database. The sample consisted of 91 patients, 55 men and 36 women, aged between 18 and 89 years old. It was performed the clinical evaluation of dysphagia with the use of the Dysphagia Risk Evaluation Protocol - DREP (PADOVANI et al, 2007), use of the Functional Oral Intake Scale for Dysphagia in Stroke Patients - FOIS (CRARY et al, 2005), videofluoroscopic swallowing exam (VFSE) and use of the penetration/aspiration scale (ROSENBECK et al., 1996). The VFSE images were evaluated individually by three judges with expertise in dysphagia Results: The analysis of concordance of objective evaluation diagnosis between the judges according to the ICC was substantial and second Kappa index was considered moderate. The correlation between clinical (DREP) and objective assessment was moderate, it was found that the VFSE detected specific features of swallowing not identified in the clinical evaluation. The agreement between FOIS / DREP and FOIS / VFSE calculated by Kappa test was moderate, but the overall correlation was strong. Out of the 24 patients who received indication for total alternative feeding, that means, nothing orally, 13 (54%) received indication of at least one feeding consistency after completion of the VFSE. Furthermore, according to the clinical evaluation, 35 patients also needed an alternative feeding means and after the VFSE 25 patients still had indication for alternative feeding means. Conclusion: The DREP proved to be a satisfactory tool for establishing the presence of dysphagia in patients with different pathologies, but does not identify characteristics that are subject to analysis only with videofluoroscopy, confirming the necessary support of an objective method of assesment for a complete evaluation of the cases of dysphagia. There was strong correlation between the FOIS after clinical assessment by the DREP protocol and the videofluoroscopy of swallowing, the latter providing more accurate indication for the use of alternative feeding and liberation of oral feeding. Besides that, it was observed that the FOIS is an effective marker for determining the level of oral intake in dysphagia cases which were originated from neoplasms, diseases of the circulatory and respiratory systems.Introdução: A concepção atual de atuação fonoaudiológica na disfagia exige o uso de protocolo de avaliação clínica que possa fornecer respostas sensíveis e específicas quanto ao grau da alteração da deglutição. Objetivo: O objetivo desta pesquisa foi estabelecer a concordância entre o protocolo clínico de avaliação de disfagia (PARD) e avaliação objetiva através da videofluoroscopia em pacientes com distúrbio da deglutição assim como verificar o nível de ingestão oral após as respectivas avaliações em diferentes patologias. Método: Esta pesquisa tem caráter exploratório, quantitativo, transversal e retrospectivo em banco de dados. A amostra foi constituída por 91 pacientes, 55 homens e 36 mulheres com idades entre 18 e 89 anos. Foi realizada a avaliação clínica da disfagia com o uso do Protocolo de Avaliação do Risco para a Disfagia - PARD (PADOVANI et al, 2007), aplicação da escala Functional Oral Intake Scale for Dysphagia in Stroke Patients FOIS (CRARY et al, 2005), avaliação videofluoroscópica da deglutição e aplicação da escala de penetração/aspiração (ROSENBECK et al., 1996). Para atingir os objetivos desta pesquisa e garantir a confiabilidade do diagnóstico de disfagia todos os exames de VFD foram reanalisados por três juízas a fim de se estabelecer a concordância entre elas. Resultados: A análise da concordância do diagnóstico na avaliação objetiva entre as juízas segundo o ICC foi substancial e segundo índice Kappa foi considerada moderada. A concordância entre avaliação clínica (PARD) e objetiva foi moderada e verificou-se que a VFD detectou características específicas da deglutição não identificadas na avaliação clínica. A concordância entre FOIS/PARD e FOIS/VFD calculada através do teste de Kappa foi moderada, já a correlação geral foi forte. Dos 24 pacientes que receberam indicação de via alternativa total de alimentação, ou seja, nada por via oral, 13 (54%) receberam indicação de pelo menos uma consistência de alimentação após a realização da VFD. Pode-se constatar que segundo a avaliação clínica 35 pacientes necessitavam de via alternativa de alimentação enquanto que após a VFD 25 pacientes ainda tinham indicação de via alternativa de alimentação. Conclusão: O PARD demonstrou ser uma ferramenta capaz de estabelecer a presença de disfagia em pacientes portadores de diferentes patologias, porém não identifica características que são passíveis de análise somente com a videofluoroscopia, ratificando a necessidade de um método de avaliação objetiva para complementar o diagnóstico de disfagia. Houve concordância forte entre a FOIS após avaliação clínica por meio do protocolo PARD e a videofluroscopia da deglutição. A VFD conferiu maior precisão na indicação do uso de vias alternativas de alimentação e liberação da via oral. Além disso, observou-se que a FOIS é um marcador eficaz para determinação do nível de ingestão oral para os casos de disfagia cuja origem foi as neoplasias, as doenças do aparelho circulatório e do aparelho respiratório.Coordenação de Aperfeiçoamento de Pessoal de Nível Superiorapplication/pdfporUniversidade Federal de Santa MariaPrograma de Pós-Graduação em Distúrbios da Comunicação HumanaUFSMBRFonoaudiologiaTranstorno de deglutiçãoVideofluoroscopiaMétodosSwallowing disordersVideofluoroscopyMethodsCNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIAConcordância entre a avaliação clínica e videofluoroscópica em pacientes disfágicosAgreement between clinical evaluation in patients and videofluoroscopic dysphagiainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisMancopes, Renatahttp://lattes.cnpq.br/9897341072714640Silva, Ana Maria Toniolo dahttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4777172E1Mezzomo, Carolina Lisbôahttp://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4779654H0Almeida, Sheila Tamanini dehttp://lattes.cnpq.br/0133108539506684http://lattes.cnpq.br/5766714041934838Costa, Cintia da Conceição400700000003400300500500300300d7ce0251-a99c-477a-baaf-6ed8e04d61560903e539-4c1a-4ea5-b09f-fb7821b396dc3dbd68ee-26bc-45c2-9c9b-d474d48a3b5c5eb13dba-ee48-42f4-82d4-cc61309d8b4240ac8271-b58d-41df-85dc-8c978a0a6e1binfo:eu-repo/semantics/openAccessreponame:Repositório Institucional Manancial UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALCOSTA, CINTIA DA CONCEICAO.pdfapplication/pdf1206641http://repositorio.ufsm.br/bitstream/1/6573/1/COSTA%2c%20CINTIA%20DA%20CONCEICAO.pdf438e69b278bcbda38fce961de38a8c81MD51TEXTCOSTA, CINTIA DA CONCEICAO.pdf.txtCOSTA, CINTIA DA CONCEICAO.pdf.txtExtracted texttext/plain194726http://repositorio.ufsm.br/bitstream/1/6573/2/COSTA%2c%20CINTIA%20DA%20CONCEICAO.pdf.txt884e4c2e83aca82ed4e8adb30cec67bbMD52THUMBNAILCOSTA, CINTIA DA CONCEICAO.pdf.jpgCOSTA, CINTIA DA CONCEICAO.pdf.jpgIM Thumbnailimage/jpeg4957http://repositorio.ufsm.br/bitstream/1/6573/3/COSTA%2c%20CINTIA%20DA%20CONCEICAO.pdf.jpgb8a4a454c830386fe73d4e2eb7b4694bMD531/65732022-03-08 16:59:35.51oai:repositorio.ufsm.br:1/6573Repositório Institucionalhttp://repositorio.ufsm.br/PUBhttp://repositorio.ufsm.br/oai/requestouvidoria@ufsm.bropendoar:39132022-03-08T19:59:35Repositório Institucional Manancial UFSM - Universidade Federal de Santa Maria (UFSM)false |
dc.title.por.fl_str_mv |
Concordância entre a avaliação clínica e videofluoroscópica em pacientes disfágicos |
dc.title.alternative.eng.fl_str_mv |
Agreement between clinical evaluation in patients and videofluoroscopic dysphagia |
title |
Concordância entre a avaliação clínica e videofluoroscópica em pacientes disfágicos |
spellingShingle |
Concordância entre a avaliação clínica e videofluoroscópica em pacientes disfágicos Costa, Cintia da Conceição Transtorno de deglutição Videofluoroscopia Métodos Swallowing disorders Videofluoroscopy Methods CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
title_short |
Concordância entre a avaliação clínica e videofluoroscópica em pacientes disfágicos |
title_full |
Concordância entre a avaliação clínica e videofluoroscópica em pacientes disfágicos |
title_fullStr |
Concordância entre a avaliação clínica e videofluoroscópica em pacientes disfágicos |
title_full_unstemmed |
Concordância entre a avaliação clínica e videofluoroscópica em pacientes disfágicos |
title_sort |
Concordância entre a avaliação clínica e videofluoroscópica em pacientes disfágicos |
author |
Costa, Cintia da Conceição |
author_facet |
Costa, Cintia da Conceição |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Mancopes, Renata |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/9897341072714640 |
dc.contributor.advisor-co1.fl_str_mv |
Silva, Ana Maria Toniolo da |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4777172E1 |
dc.contributor.referee1.fl_str_mv |
Mezzomo, Carolina Lisbôa |
dc.contributor.referee1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4779654H0 |
dc.contributor.referee2.fl_str_mv |
Almeida, Sheila Tamanini de |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/0133108539506684 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/5766714041934838 |
dc.contributor.author.fl_str_mv |
Costa, Cintia da Conceição |
contributor_str_mv |
Mancopes, Renata Silva, Ana Maria Toniolo da Mezzomo, Carolina Lisbôa Almeida, Sheila Tamanini de |
dc.subject.por.fl_str_mv |
Transtorno de deglutição Videofluoroscopia Métodos |
topic |
Transtorno de deglutição Videofluoroscopia Métodos Swallowing disorders Videofluoroscopy Methods CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
dc.subject.eng.fl_str_mv |
Swallowing disorders Videofluoroscopy Methods |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::FONOAUDIOLOGIA |
description |
The current conception of speech therapy in dysphagia requires the use of a clinical assesment protocol that can provide sensitive and specific answers as to the degree of swallowing disorders. Objective: The objective of this research was to establish the correlation between the Dysphagia Risk Evaluation Protocol (DREP) and videofluoroscopy in patients with swallowing disorders as well as checking the level of oral intake after their assessment. Method: This research is exploratory, quantitative, longitudinal and retrospective in database. The sample consisted of 91 patients, 55 men and 36 women, aged between 18 and 89 years old. It was performed the clinical evaluation of dysphagia with the use of the Dysphagia Risk Evaluation Protocol - DREP (PADOVANI et al, 2007), use of the Functional Oral Intake Scale for Dysphagia in Stroke Patients - FOIS (CRARY et al, 2005), videofluoroscopic swallowing exam (VFSE) and use of the penetration/aspiration scale (ROSENBECK et al., 1996). The VFSE images were evaluated individually by three judges with expertise in dysphagia Results: The analysis of concordance of objective evaluation diagnosis between the judges according to the ICC was substantial and second Kappa index was considered moderate. The correlation between clinical (DREP) and objective assessment was moderate, it was found that the VFSE detected specific features of swallowing not identified in the clinical evaluation. The agreement between FOIS / DREP and FOIS / VFSE calculated by Kappa test was moderate, but the overall correlation was strong. Out of the 24 patients who received indication for total alternative feeding, that means, nothing orally, 13 (54%) received indication of at least one feeding consistency after completion of the VFSE. Furthermore, according to the clinical evaluation, 35 patients also needed an alternative feeding means and after the VFSE 25 patients still had indication for alternative feeding means. Conclusion: The DREP proved to be a satisfactory tool for establishing the presence of dysphagia in patients with different pathologies, but does not identify characteristics that are subject to analysis only with videofluoroscopy, confirming the necessary support of an objective method of assesment for a complete evaluation of the cases of dysphagia. There was strong correlation between the FOIS after clinical assessment by the DREP protocol and the videofluoroscopy of swallowing, the latter providing more accurate indication for the use of alternative feeding and liberation of oral feeding. Besides that, it was observed that the FOIS is an effective marker for determining the level of oral intake in dysphagia cases which were originated from neoplasms, diseases of the circulatory and respiratory systems. |
publishDate |
2014 |
dc.date.issued.fl_str_mv |
2014-03-31 |
dc.date.accessioned.fl_str_mv |
2015-03-04 |
dc.date.available.fl_str_mv |
2015-03-04 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
COSTA, Cintia da Conceição. AGREEMENT BETWEEN CLINICAL EVALUATION IN PATIENTS AND VIDEOFLUOROSCOPIC DYSPHAGIA. 2014. 109 f. Dissertação (Mestrado em Fonoaudiologia) - Universidade Federal de Santa Maria, Santa Maria, 2014. |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufsm.br/handle/1/6573 |
identifier_str_mv |
COSTA, Cintia da Conceição. AGREEMENT BETWEEN CLINICAL EVALUATION IN PATIENTS AND VIDEOFLUOROSCOPIC DYSPHAGIA. 2014. 109 f. Dissertação (Mestrado em Fonoaudiologia) - Universidade Federal de Santa Maria, Santa Maria, 2014. |
url |
http://repositorio.ufsm.br/handle/1/6573 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.cnpq.fl_str_mv |
400700000003 |
dc.relation.confidence.fl_str_mv |
400 300 500 500 300 300 |
dc.relation.authority.fl_str_mv |
d7ce0251-a99c-477a-baaf-6ed8e04d6156 0903e539-4c1a-4ea5-b09f-fb7821b396dc 3dbd68ee-26bc-45c2-9c9b-d474d48a3b5c 5eb13dba-ee48-42f4-82d4-cc61309d8b42 40ac8271-b58d-41df-85dc-8c978a0a6e1b |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Distúrbios da Comunicação Humana |
dc.publisher.initials.fl_str_mv |
UFSM |
dc.publisher.country.fl_str_mv |
BR |
dc.publisher.department.fl_str_mv |
Fonoaudiologia |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional Manancial UFSM instname:Universidade Federal de Santa Maria (UFSM) instacron:UFSM |
instname_str |
Universidade Federal de Santa Maria (UFSM) |
instacron_str |
UFSM |
institution |
UFSM |
reponame_str |
Repositório Institucional Manancial UFSM |
collection |
Repositório Institucional Manancial UFSM |
bitstream.url.fl_str_mv |
http://repositorio.ufsm.br/bitstream/1/6573/1/COSTA%2c%20CINTIA%20DA%20CONCEICAO.pdf http://repositorio.ufsm.br/bitstream/1/6573/2/COSTA%2c%20CINTIA%20DA%20CONCEICAO.pdf.txt http://repositorio.ufsm.br/bitstream/1/6573/3/COSTA%2c%20CINTIA%20DA%20CONCEICAO.pdf.jpg |
bitstream.checksum.fl_str_mv |
438e69b278bcbda38fce961de38a8c81 884e4c2e83aca82ed4e8adb30cec67bb b8a4a454c830386fe73d4e2eb7b4694b |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 MD5 |
repository.name.fl_str_mv |
Repositório Institucional Manancial UFSM - Universidade Federal de Santa Maria (UFSM) |
repository.mail.fl_str_mv |
ouvidoria@ufsm.br |
_version_ |
1808854719210192896 |