Syftet med studien var att göra en litteraturstudie vilken beskriver hur sjuksköterskans omvårdnadsåtgärder förebygger komplikationer vilka kan uppstå vid måltidssituationer för patienter drabbade av dysfagi till följd av stroke. Studien genomfördes som litteraturstudie med beskrivande design, 12 vetenskapliga artiklar granskades och sammanställdes under tre huvudrubriker; Åtgärder för att förebygga aspirationspneumoni, Nutritionsstöd samt Kvalitetsgranskning av artiklar. Resultatet visade att många av sjuksköterskans omvårdnadsåtgärder kunde minska risken att patienter med dysfagi drabbas av aspirationspneumoni. Det framkom en rad olika kompensationsstrategier och åtgärder sjuksköterskan kunde bidra med, bland annat intensiv munhygien samt stimulering av tunga och mun med is eller annat kallt föremål vilket stimulerar sväljreflexen. Andra åtgärder var rätt sittposition och anpassad konsistens på mat och vätska samt kosttillskott. Resultatet i föreliggande studie visade att utbildning inom förebyggande omvårdnadsåtgärder var nödvändiga för att rätt matningsteknik användes och att kostrekommendationer följdes, samt att det fanns ett lämpligt instrument för sjuksköterskans kompetens vid screening av dysfagi. Vidare påvisade resultatet att emotionellt stöd från sjuksköterskan var viktigt vid måltidssituationer. Slutsatsen var att kunskap om sjuksköterskans omvårdnadsåtgärder vid måltidssituationen leder till färre komplikationer hos patienter med dysfagi. / The aim of this study was to conduct a literature review that describes how nurses care measures can help prevent complications that can occur at mealtime situations for patients suffering from dysphagia following stroke. The study was conducted as a literature review with descriptive design, 12 scientific articles were reviewed and summarized under three main headings: Measures to prevent aspiration pneumonia, Nutrition Support and Quality review of articles.The results demonstrate that many of the nurses care strategies decreased the risk of patients with dysphagia experience aspiration pneumonia. It was found a series of compensation strategies and interventions nurses could contribute, including intensive oral hygiene as well as stimulation of the tongue and mouth with ice or other cold objects which stimulate swallowing reflex. Other measures were correct sitting position and custom texture of food and fluid and dietary supplements. The results of the present study indicated that nurse training was necessary for proper feeding technique and the dietary recommendations were followed, it also demonstrated there was a suitable instrument for nursing skills in screening for dysphagia. Furthermore, the result indicated that emotional support from the nurse was important at mealtime situations. The conclusion was that knowledge about nursing care measures in eating habits resulting in fewer complications in patients with dysphagia.

A total of 188 patients completed data at twelve months (attrition rate: 29% over 12 months). The path coefficients show low functional ability (beta=0.51), more depressive symptoms (beta=-0.27), low state self-esteem (beta3=0.20), female gender (beta=0.13), older age (beta=-0.11) and living in a residential care facility (beta=-0.12) have a direct effect on participation restriction, and these variables accounted for 71% of the variance in explaining participation restrictions at 12 months. Repeated measures revealed significant decreases in overall levels of participation restriction and depressive symptoms from baseline to one year. However, no significant early changes in the levels of state self-esteem and depressive symptoms (from baseline to six months) and no significant late changes in both depressive symptoms and LHS scores were found (between six months and 12 months). / A total of 210 stroke survivors completed data at six months. Functional ability, state self-esteem, and number of strokes significantly accounted for 57% of the variance in participation restriction. Lower levels of functional ability, state self-esteem and social support satisfaction were associated with an increased likelihood of having depressive symptoms (z = 5.30, 34.12, and 5.51). / Aims. To gain understanding about the social, psychological and physical outcomes following inpatient stroke rehabilitation; to determine the variables predicting the level of participation and depressive symptoms of stroke survivors at baseline, six and 12 months following discharge from a rehabilitation hospital; to test a theoretical model of predictors of participation restriction at 12 months; and to determine the level over time for each of the outcomes. / Conclusion and implications. The findings in this study indicate that identification of stroke survivors at risk of high levels of participation restriction and low self-esteem will assist health professionals to devise appropriate interventions that target improving the psychological well being amongst person with stroke. Rehabilitation services need to continue to focus on restoring functional independence but also need to diagnose and treat depressive symptoms in order to minimise the restriction to participation in society. Assisting stroke survivors in redefining their identity after stroke could be an important aspect in stroke rehabilitation. (Abstract shortened by UMI.) / Chau, Pak Chun Janita. / Adviser: Shelia Twinn. / Source: Dissertation Abstracts International, Volume: 70-06, Section: B, page: 3426. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 237-276). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.