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      Fonoaudiologia e nutrição em ambiente hospitalar: análise de terminologia de classificação das consistências alimentares Translated title: Speech-Language and Nutritional Sciences in hospital environment: analysis of terminology of food consistencies classification

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          Abstract

          RESUMO Objetivos: Verificar se há concordância entre fonoaudiólogos e nutricionistas na classificação de consistências alimentares utilizadas em hospitais e as opiniões sobre as possíveis consequências das divergências nessa classificação. Métodos: Estudo descritivo transversal com 30 fonoaudiólogos e 30 nutricionistas que trabalhavam em 14 hospitais da rede pública e/ou privada de Belo Horizonte. Os profissionais responderam um questionário elaborado pelas pesquisadoras e classificaram cinco alimentos, com e sem direcionamento teórico. Empregaram-se os testes estatísticos Exato de Fisher e Z para comparação de proporções, com nível de significância de 5%. Resultados: Tanto fonoaudiólogos (100%) quanto nutricionistas (90%) percebem divergência nas classificações, sendo que, respectivamente, 86,2% e 100% acreditam que essa divergência pode prejudicar a recuperação dos pacientes. O risco de aspiração de alimento foi o prejuízo mais citado. Para a classificação geral das consistências alimentares, a maior parte dos profissionais (88,5%) sugeriu de quatro a seis termos. Quanto à terminologia utilizada na classificação dos alimentos apresentados sem direcionamento teórico, os profissionais citaram 49 termos e concordaram apenas na classificação do sólido e do líquido. Com o direcionamento teórico, os profissionais concordaram também na classificação do pastoso grosso e do pastoso fino. Conclusão: Tanto fonoaudiólogos quanto nutricionistas reconhecem divergências na classificação das consistências alimentares e o consequente risco de prejuízos à recuperação do paciente. A utilização do direcionamento teórico aumentou a concordância entre os profissionais.

          Translated abstract

          ABSTRACT Purpose To verify if there is an agreement between speech-language pathologists and nutritionists about the classification of food textures used in hospitals and their opinions about the possible consequences of differences in this classification. Methods This is a descriptive, cross-sectional study with 30 speech-language pathologists and 30 nutritionists who worked in 14 hospitals of public and/or private network in Belo Horizonte, Brazil. The professionals answered a questionnaire, prepared by the researchers, and classified five different foods, with and without theoretical direction. The data were analyzed using Fisher's exact and Z -tests to compare ratios with a 5% significance level. Results Both speech-language therapists (100%) and nutritionists (90%) perceive divergence in the classification and, 86.2% and 100% of them, respectively, believe that this difference may affect the patients' recovery. Aspiration risk was the most mentioned problem. For the general classification of food textures, most of the professionals (88.5%) suggested four to six terms. As to the terminology used in the classification of food presented without theoretical direction, the professionals cited 49 terms and agreed only in the solid and liquid classifications. With theoretical direction, the professionals also agreed in the classification of thick and thin paste. Conclusion Both the professionals recognized divergences in the classification of food textures and the consequent risk of damage to patient's recovery. The use of theoretical direction increased the agreement between these professionals.

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          Most cited references35

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          The effect of bolus viscosity on swallowing function in neurogenic dysphagia.

          To assess the pathophysiology and treatment of neurogenic dysphagia. 46 patients with brain damage, 46 with neurodegenerative diseases and eight healthy volunteers were studied by videofluoroscopy while swallowing 3-20 mL liquid (20.4 mPa s), nectar (274.4 mPa s) and pudding (3931.2 mPa s) boluses. Volunteers presented a safe and efficacious swallow, short swallow response ( or =0.33 mJ). Brain damage patients presented: (i) 21.6% aspiration of liquids, reduced by nectar (10.5%) and pudding (5.3%) viscosity (P or =806 ms) with a delay in laryngeal closure (> or =245 ms), and weak bolus propulsion forces (< or =0.20 mJ). Increasing viscosity did not affect timing of swallow response or bolus kinetic energy. Patients with neurogenic dysphagia presented high prevalence of videofluoroscopic signs of impaired safety and efficacy of swallow, and were at high risk of respiratory and nutritional complications. Impaired safety is associated with slow oropharyngeal reconfiguration and impaired efficacy with low bolus propulsion. Increasing bolus viscosity greatly improves swallowing function in neurological patients.
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              To report the results of the full clinical swallowing assessment in acute-care population in a large Brazilian teaching hospital.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                codas
                CoDAS
                CoDAS
                Sociedade Brasileira de Fonoaudiologia (São Paulo )
                2317-1782
                December 2015
                : 27
                : 6
                : 541-549
                Affiliations
                [1 ] Clínica Medicina Empresarial Brasil
                [2 ] Universidade Federal de Minas Gerais Brazil
                [3 ] Universidade Federal de Minas Gerais Brazil
                [4 ] Universidade Federal de Minas Gerais Brazil
                Article
                S2317-17822015000600541
                10.1590/2317-1782/20152015059
                b859f9ff-4f35-4514-9901-80614db02315

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=2317-1782&lng=en
                Categories
                AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
                REHABILITATION

                Audiology,Physiotherapy
                Food,Diet,Speech Language Pathology,Food Service Hospital,Deglutition Disorders,Alimentos,Dieta,Fonoaudiologia,Serviço Hospitalar de Nutrição,Transtornos de Deglutição

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