4.2.2 PflePhagie–Scale: A screening tool to identfiy the risk of dysphagia (237)
Mario Simon, Student of Science in Nursing (MScN), Institute of Nursing Science, University Witten/Herdecke, Witten, Germany Co authors: Sven Reuther, Andreas Liesch, Maria Magdalena Schreier & Sabine Bartholomeyczik mario.simon1@gmx.de
Abstract:
Background:
Although nurses are the first to identify problems with swallowing, but usually they do not use assessment instruments for a systematic nursing diagnostic. Therefore, German students of nursing science developed a screening instrument based on current literature for the identification of elderly at risk for dysphagia: the PflePhagie-Scale.
Aims:
Aims of this study were to investigate the criterion-related validity and practicability of the PflePhagie - Scale.
Methods:
Trained nurses screend a convenience sample of 57 patients/ residents in May 2007 with the PflePhagie-Scale. Inclusion criteria were patients in geriatric rehabilitation wards or residents of a nursing home facility, who were able for oral food intake. The criterion was a diagnosed dysphagia or the confirmation of the dysphagia risk by an in-house speech therapist. A descriptive analysis was performed using odds ratios for each Item, sensitivity and specifity as well as predictive values to find the best cut-off score. Finally the nurses discussed their experience with the instrument in a moderated group meeting. Ethical clearance was given by the university's ethic committee.
Results:
24 of 57 participants were at risk for dysphagia. The average age of the total sample is 72.1 years. Odds ratios of the items vary from 3,9 (95% CI: 1,2 - 12.6) to 31.0 (95% CI: 5,9 - 163.5). With a cut-off score of 4 points sensivity is 96%; specificity is 88%; positive predictive value is 85% and negative predictive value is 97%. The average time for the screening was 6.67 minutes.
Discussion:
External validity cannot be warranted because of the small convenience sample. However, results show a good validity for this sample and a good practicability.
Conclusion:
The validity of the instrument, as well as the interrater - reliability should be investigated in a larger and representative sample, before the instrument can be implemented into practice.
Source of Funding: N/A
Level of funding: N/A
Biography:
Professional biography Mr. Mario Simon Since Nov. 2006 Postgraduate Student in the Master – Programm (Master of Science in Nursing) at the Private University Witten/ Herdecke, Department of Nursing Science, Germany Nov. 2006 Bachelor´s Degree Science in Nursing (BScN) 2003 – 2006 Undergraduate student in the Bachelor – Programm (Bachelor of Science in Nursing) at the Private University Witten/ Herdecke, Department of Nursing Science, Germany since Jan. 1998 registered nurse on an internal medicine ward in a hospital in Karlsruhe, Germany 1994 – 1997 Education to a registered nurse in Rodalben, Germany Professional biography Mr. Sven Reuther Since Nov. 2006 Postgraduate Student in the Master – Programm (Master of Science in Nursing) at the Private University Witten/ Herdecke, Department of Nursing Science, Germany Nov. 2006 Bachelor´s Degree Science in Nursing (BScN) 2003 – 2006 Undergraduate student in the Bachelor – Programm (Bachelor of Science in Nursing) at the Private University Witten/ Herdecke, Department of Nursing Science, Germany 2000 – 2003 Education to a registered nurse for the elderly in Munich, Germany.