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Assessing patients with multiple sclerosis for dysphagia: Is a simple nursing neurological screening test the answer?

Authors: Mandysová Petra | Ehler Edvard | Škvrňáková Jana

Year: 2015

Type of publication: ostatní - přednáška nebo poster

Page from-to: nestránkováno

Titles:

Language	Name	Abstract	Keywords
eng	Assessing patients with multiple sclerosis for dysphagia: Is a simple nursing neurological screening test the answer?	Objectives: The aim was to develop a simple neurological dysphagia screening test for nurses that could be used for a variety of neurological conditions including MS. The study was based on comparing the results of physical examination (PE) with flexible endoscopic examination of swallowing (FEES) as the gold standard. Methodology: Study participants included patients with a neurological diagnosis (including MS) and a potential risk of dysphagia (n = 112). The patients underwent PE (32 items) by a trained nurse and FEES by a physician. The results were dichotomized (normal versus abnormal) and compared using the phi coefficient. PE items demonstrating a statistically significant relationship with FEES (p-value < 0.05) were included in the screening test if they contained < 5% of missing values. The diagnostic parameters of the test were calculated for all possible cut-off scores. Results: Of the 112 patients, six were excluded in the data analysis phase as their PE and FEES were completely normal. For the remaining 106 patients, eight PE items met the established criteria; they were combined into a simple nursing dysphagia screening test. The best cut-off score was 1 as it produced the highest sensitivity (95.5%; 95% confidence interval [CI] = 84.9–98.7) and NPV (88.9%; 95% CI = 67.2–96.9). Conclusions: Sensitivity and NPV of the developed screening test are high and are comparable with other screening tests described in the literature. However, most other screening tests are for patients with stroke, and nurses are involved in their development quite rarely. The size of our sample was sufficiently large as it permitted a sufficiently narrow estimation of the 95% CI. In this respect, the test is better than many other screening tests. The developed test is simple and is suitable for nurse-led dysphagia screening in patients with neurological conditions, including MS. Further research on its use in MS patients is recommended.	assessment; dysphagia; FEES; multiple sclerosis; neurological nursing; screening test; swallowing.