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http://www.codas.periodikos.com.br/article/doipath/10.1590/2317-1782/20202019061
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Development of the Pediatric Dysphagia Risk Screening Instrument (PDRSI)

Desenvolvimento do Instrumento de Rastreio Para o Risco de Disfagia Pediátrica (IRRD-Ped)

Camila Lucia Etges; Lisiane De Rosa Barbosa; Maria Cristina de Almeida Freitas Cardoso

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Abstract

Purpose: Develop a screening tool to identify children at risk of dysphagia within hospitals. Method: The Pediatric Dysphagia Risk Screening Instrument (PDRSI), which consists of 23 questions, was developed by speech therapists, based on a review of academic articles and was intended to be answered by those responsible for the children in the hospital. The PDRSI was sent for expert review, in addition to realizing a pilot study. To check the validity criteria, PDRSI was answered by those responsible for the hospitalized children. Subsequently, the children went through a clinical evaluation of deglutition applying the Pediatric Dysphagia Assessment Protocol (PDAP). Each child’s guardian signed a consent form. The subjects were divided into two groups (with dysphagia and those with normal swallowing). A relation between PDRSI questions and the PDAP outcome was observed, using the Person chi-square test or Fisher’s exact test. The cutoff point for the presence of risk was defined for dysphagia through the ROC curve. The reliability of PDRSI was verified by the Cronbach α coefficient. Results: The sample consisted of 40 children with a median age of 3.7 months. There was a statistically significant association in eight items of the questionnaire. The internal consistency of PDRSI was 0.828. The cutoff point for risk for dysphagia was five points (sensitivity = 100% and specificity = 80%). Conclusion: Due to the satisfactory results found, the validation process of PDRSI should continue.

Keywords

Deglutition, Deglutition Disorders, Mass Screening, Child, Child Health

Resumo

Objetivo: Desenvolver um instrumento de rastreio para a identificação de crianças com risco para disfagia, em ambiente hospitalar. Método: O Instrumento de Rastreio para o Risco de Disfagia Pediátrica (IRRD-Ped), constituído por 23 questões, foi desenvolvido por fonoaudiólogos, após revisão da literatura. Ele foi proposto para ser aplicado aos responsáveis por crianças em internação hospitalar. O IRRD-Ped foi enviado a juízes para análise, tendo sido também realizado um estudo piloto. Para verificar a validade de critério, aplicou-se o IRRD-Ped aos responsáveis por crianças internadas e, posteriormente, realizou-se, com estas crianças, avaliação clínica da deglutição, através do Protocolo de Avaliação da Disfagia Pediátrica (PAD-PED). Os responsáveis assinaram o Termo de Consentimento Livre e Esclarecido. Os sujeitos foram separados em dois grupos (com disfagia e com deglutição normal), sendo verificada a associação entre as questões do IRRD-Ped e o resultado do PAD-PED, através do teste qui-quadrado de Person ou exato de Fisher. Definiu-se o ponto de corte para presença de risco para disfagia através da Curva ROC. A confiabilidade do IRRD-Ped foi verificada pelo coeficiente α de Cronbach. Resultados: A amostra foi constituída por 40 crianças com mediana de idade de 3,7 meses. Verificou-se associação estatisticamente significativa em oito itens do instrumento. A consistência interna do IRRD-Ped foi de 0,828. O ponto de corte para o risco de disfagia foi de cinco pontos (sensibilidade = 100% e especificidade = 80%). Conclusão: Devido aos satisfatórios resultados encontrados, deve-se dar prosseguimento ao processo de validação do IRRD-Ped.

Palavras-chave

Deglutição, Transtornos de Deglutição, Programas de Rastreamento, Criança, Saúde da Criança

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Submetido em:
11/03/2019

Aceito em:
28/09/2019

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