Swallowing-related quality of life in hospitalized elderly patients: A cross-sectional analytical study

Ferreira, Ronivaldo Pinto; Alves, Luana Marsicano; Mangilli, Laura Davison

doi:10.37689/acta-ape/2023AO015022

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Original Article • Acta Paul Enferm 36 • 2023 • https://doi.org/10.37689/acta-ape/2023AO015022 copy

Swallowing-related quality of life in hospitalized elderly patients: A cross-sectional analytical study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To evaluate swallowing-related quality of life in hospitalized elderly patients.

Methods

Cross-sectional analytical and observational approach was used in our study. Fifty-two elderly patients in a medical clinic of a public hospital in Distrito Federal [Federal District] participated. In addition to collecting sociodemographic and health condition data, the Eating Assessment Tool and the swallowing-related quality of life Questionnaire were applied.

Results

Of the elderly participants, 30.8% had a self-reported risk of dysphagia. The elderly at risk for dysphagia had lower scores in the “eating duration” domain and higher scores in the “mental health” domain. The only domain in which there was no statistical difference in the response pattern of the participants who were, or were not at risk for dysphagia was the “sleep domain.” Among the variables of the 11 domains of the Swallowing Quality of Life Questionnaire, mostly positive correlations were found, with different degrees.

Conclusion

The swallowing-related quality of life of hospitalized elderly patients is directly manifested as decreased social interaction, increased eating time, fear to eat, and swallowing as a burden.

Dysphagia; Quality of life; Deglutition disorders; Aging; Nurses improving care for health system elders; Frail elderly; Age factors

Variables	Mean	Standard Deviation	Minimum	Maximum
Age (years)	73.17	8,38	61.00	94.00
Hospitalization time (days)	5.50	3.86	1.00	15.00

Variables	Classification	n = 52 n(%)
Sex	Female	28(53.85)
Sex	Male	24(46.15)
Race/Color	East Asian	1(1.92)
	White	32(61.54)
	Brown	18(34.62)
	Black	1(1.92)
Marital status	Married	21(40.38)
	Divorced	5(9.62)
	Single	5(9.62)
	Stable Union	5(9.62)
	Widow/Widower	16(30.77)
Education	Illiterate	7(13.46)
	SE-Comp.	8(15.38)
	SE-Incomp.	1(1.92)
	EE-Comp.	6(11.54)
	EE-Incomp.	26(50.00)
	HE-Comp.	4(7.70)
Coming from another health unit	No	17(32.69)
Coming from another health unit	Yes	35(67.31)
Reason for hospitalization	Surgical	12(23.08)
Reason for hospitalization	Respiratory	40(76.92)
Covid-19	No	13(25.00)
Covid-19	Yes	39(75.00)
Systemic arterial hypertension	No	18(34.62)
Systemic arterial hypertension	Yes	34(65.38)
Diabetes mellitus	No	30(57.69)
Diabetes mellitus	Yes	22(42.31)
Other comorbidities	No	18(34.62)
Other comorbidities	Yes	34(65.38)
Number of medications in continuous use	1	5(9.62)
	2	6(11.54)
	3	10(19.23)
	4	8(15.38)
	5	5(9.62)
	More than 5	9(17.31)
	No use of medication	9(17.31)
Complaints	Choking	5(9.62)
	Lack of appetite	1(1.92)
	Cough	13(25.00)
	No complaints	33(63.46)
Dentition	Permanent dentition	2(3.85)
	Dentulism	4(7.69)
	Partial Dentures	12(23.08)
	Full Dentures	34(65.38)
Type of diet	Soft/Mushy	6(11.54)
	Soft	28(53.85)
	Enteral/Mushy	3(5.77)
	Liquid	2(3.85)
	Mushy	13(25.00)
Dietary path	Oral	49(94.23)
Dietary path	Nasoenteral/oral tube	3(5.77)
Changes in taste	Absent	2(3.85)
	Decreased	18(34.62)
	Normal	30(57.69)
	Complaint of changes in tastes	2(3.85)
Frequency of oral hygiene	1	8(15.38)
	2	20(38.46)
	3	6(11.54)
	More than 3	18(34.62)
Mobility	Bedridden	4(7.69)
	With assistance	15(28.85)
	Normal	33(63.46)
Smoking/Alcoholism	Alcoholism	6(11.54)
	Smoking	1(1.92)
	Former alcoholic	5(9.62)
	Former smoker	11(21.15)
	Former smoker/Former Drinker	11(21.15)
	Never smoked or consumed alcohol	18(34.62)

Classification EAT-10 / Domains of the SWAL-QOL	Risk of dysphagia n = 16	No risk of dysphagia n = 36	p-value
Swallowing as a burden	75.00 ± 7.74	100.00 ± 0.00	0.00*
Desire to eat	86.44 ± 5.74	96.06 ± 1.71	0.02*
Eating duration	47.66 ± 9.90	78.82 ± 5.00	0.01*
Frequency of symptoms	75.88 ± 4.14	93.03 ± 1.08	0.00*
Food Selection	80.47 ± 5.35	96.53 ± 1.54	0.00*
Communication	78.13 ± 6.70	96.18 ± 1.48	0.00*
Fear to eat	62.48 ± 6.56	88.88 ± 2.47	0.00*
Mental Health	89.69 ± 2.98	99.86 ± 0.14	0.00*
Social function	88.44 ± 4.56	100.00 ± 0.00	0.00*
Sleep	79.94 ± 6.73	88.89 ± 2.85	0.39
Fatigue	75.47 ± 4.60	88.61 ± 1.88	0.01*

Variables		Fatigue	Sleep	Function social	Mental Health	Fear to eat	Communication	Food selection	Frequency of symptoms	Eating duration	Desire to eat	Swallowing as a burden
Swallowing as a burden	Coef. of Correlation	0.45	0.20	0.53	0.52	0.39	0.59	0.40	0.47	0.38	0.17	1.00
Swallowing as a burden	p-Value	0.00*	0.15	0.00*	0.00*	0.00*	0.00*	0.00*	0.00*	0.01*	0.22	-
Desire to eat	Coef. of Correlation	0.20	0.21	0.47	0.32	0.44	0.13	0.34	0.26	0.15	1.00
Desire to eat	p-Value	0.16	0.14	0.00*	0.02*	0.00*	0.37	0.01*	0.07	0.30	-
Eating duration	Coef. of Correlation	0.23	0.02	0.26	0.42	0.56	0.26	0.36	0.50	1.00
Eating duration	p-Value	0.11	0.86	0.06	0.00*	0.00*	0.07	0.01*	0.00*	-
Frequency of symptoms	Coef. of Correlation	0.45	0.16	0.38	0.64	0.68	0.50	0.43	1.00
Frequency of symptoms	p-Value	0.00*	0.25	0.01*	0.00*	0.00*	0.00*	0.00*	-
Food Selection	Coef. of Correlation	0.31	0.28	0.42	0.54	0.42	0.09	1.00
Food Selection	p-Value	0.03*	0.04*	0.00*	0.00*	0.00*	0.55	-
Communication	Coef. of Correlation	0.40	0.01	0.37	0.43	0.48	1.00
Communication	p-Value	0.00*	0.95	0.01*	0.00*	0.00*	-
Fear to eat	Coef. of Correlation	0.53	0.30	0.36	0.68	1.00
Fear to eat	p-Value	0.00*	0.03*	0.01*	0.00*	-
Mental Health	Coef. of Correlation	0.41	0.25	0.54	1.00
Mental Health	p-Value	0.00*	0.07	0.00*	-
Social function	Coef. of Correlation	0.26	0.27	1.00
Social function	p-Value	0.07	0.05	-
Sleep	Coef. of Correlation	0.42	1.00
Sleep	p-Value	0.00*	-
Fatigue	Coef. of Correlation	1.00
Fatigue	p-Value	-

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author: Ronivaldo Pinto Ferreira Email: ronny.pinto@hotmail.com