小児専門病院における摂食外来のニ一ズと対応  [in Japanese] A Clinical Survey on the Feeding Therapy Clinic for Children  [in Japanese]

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Abstract

当院において月1回行われる摂食外来の実態について調査を行った.主な結果としては主訴の多くが「鼻注栄養から経口摂取に移行させたい」「離乳食が進まない」であったこと,指導回数は1回で終了したものが最も多かったこと,などであった.また本外来で指導した症例のうち,改善例と中断例を比較すると,疾患別では中断例に脳性麻痺児が多い傾向がみられた.初診時の食形態には顕著な差が認められなかったが,最終時の食形態について,中断例では食形態が不変または後退したものが多かった.また,他者に勧められて受診に至ったものが中断例には多かった.この調査を通じて,食事にまつわる援助が決して「訓練」的な位置づけだけでは解決しえないことが明らかとなった.こうした子どもにSTがどのようなサービスを提供するかについてST自身が自己の資質の限界吟味を主体的に行い,自己の臨床感や立場を明確にした上で指導に当たることが必要と思われた.

The aim of this study is to survey the activities of a feeding therapy clinic in children's hospital during a 10 year from 1987 to 1997. The clinic is available once a month for patients, and many specialists such as a pediatrician, pediatric dentists, physical therapists, occupational therapists, speech therapists (ST), and a dietitian are involved. 192 patients (99 males and 93 females) visited the clinic over a total of 110 clinic days during the 10 years. According to the analysis of the clinical charts, the main results are as follows; (1) The major complaints were “changing from tube feeding to mouth feeding” and “difficulty in weaning”. (2) Ninety-seven patients (50%) came once and about two thirds of the children quit the clinic within 3 visits. (3) 126 (65%) of the patient's families asked a staff member for help in feeding by themselves, however 53 patients were referred by others. (4) In comparing the improved group (25 patients) and the group who discontinued therapy (24 patients), cerebral palsy patients were found more in the latter. In terms of the feeding stage at the first meeting, there were not any differences between these two groups. However, there were significant differences in advancement between feeding stages and family motivation when measured by an Χ<sup>2</sup> test. It is speculated from these observation that children with feeding difficulties had a lot of problems. These included not only dysphagia, but also problems caused by their posture, poor weight gain, etc. For these various problems, it is important to use the team approach and to include individual specialists as described above.

Journal

  • THE JAPANESE JOURNAL OF COMMUNICATION DISORDERS

    THE JAPANESE JOURNAL OF COMMUNICATION DISORDERS 16(2), 80-86, 1999-08-30

    Japanese Association of Communication Disorders

References:  3

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008102021
  • NII NACSIS-CAT ID (NCID)
    AN10091280
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    09128204
  • NDL Article ID
    4855138
  • NDL Source Classification
    ZF1(教育) // ZS47(科学技術--医学--治療医学・看護学・漢方医学)
  • NDL Call No.
    Z7-1914
  • Data Source
    CJP  CJPref  NDL  J-STAGE 
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