İnmeli Hastalarda Disfajinin Yönetiminde Geliştirilen Kanıta Dayalı Rehberin Hasta Çıktılarına Etkisi

Abstract

Özer Küçük, E., The Effect of Developed Evidence-Based Guideline for Management of Dysphagia in Stroke on Patient Outcomes, Hacettepe University, Institute of Health Sciences, Internal Medical Nursing Program PhD Thesis, Ankara, 2018This study was conducted to develop an evidence-based guide to the management of post-stroke dysphagia for nurses, to evaluate of the developed guide effects on and the satisfaction, nutritional status and length of hospital stay, the Nursing Outcomes Classification (swallowing and prevention of aspiration) and to garner the opinions of nurses on the use of this guide. The study was conducted in five stages, involving methodologic, experimental and qualitative phases. The first two stages of the research were conducted methodologically, involving the development of an evidence-based guide and tested the validity of the Turkish version of the NOC of swallowing disorders. An “Advanced Research and Clinical Practice Model Based on Close Collaboration” was used to encourage nurses to put the evidence-based information in the guides into practice. In the experimental phase of the research (time series design), the effects of the guide on nursing outcomes, satisfaction, nutritional status and length of hospital stay were evaluated. The study sample included 60 patients (30 in the experimental group, 30 in the control group) who were admitted to the neurology clinics of ANEAH hospital between October 2016 and June 2018 with a diagnosis of acute stroke, and who met the study inclusion criteria. The results of the study revealed that the evidence-based guide has a positive effect on the nursing outcomes of prevention of aspiration and patient satisfaction (p<0,05), but had no effect on the length of hospital stay, nutritional and swallowing status of nursing outcome (p>0,05). The final phase of the research, designed as a qualitative study, evaluated the opinions of the participating nurses on the use of the evidence-based guide. The study found that the use of the guide by the nurses improved patient safety, care quality, professional competence, and patient and nurse satisfaction. Furthermore, this recently developed guide was defined as a valuable source, facilitating access to evidence-based knowledge. Based on these findings, it is suggested using the evidence-based guide developed for nurses in the management of dysphagia in stroke patients. Keywords: stroke, dysphagia, evidence-based, nursing, guideline