老年护理中老年人食物偏好评估工具的适应与评价：DYSPHAGING偏好研究方案

文献信息

中文摘要

引言： 营养不良是老年人的一个主要问题，因其多因素起源及其对发病率和死亡率的影响。口咽性吞咽困难在衰弱老年患者中常见，并通过促使个体逐步从饮食中撤除食物而导致营养不良，进而引起饮食失衡和潜在并发症。尽管质地调整和营养策略在临床实践中广泛实施，但对住院老年吞咽困难患者的实际食物偏好知之甚少。现有的食物偏好评估工具稀缺，且对该人群的异质性和感觉障碍适应性差。DYSPHAGING偏好研究旨在开发一种专门针对住院老年人的食物偏好评估工具，评估其重测信度，并描述使用该适应工具测量的食物偏好。
方法与分析： DYSPHAGING偏好研究设计为一项前瞻性、多中心、非比较性方案，包括三个步骤。步骤1将通过评估预选食物的视觉和词汇识别，将最初为儿科人群开发的强制选择问卷适应于年龄≥70岁、住院于老年病房的成年人。步骤2将在一个新的老年人队列中评估偏好问卷的重测信度和实际可行性。步骤3将是一项横断面研究，描述食物偏好，并使用进食评估工具-10比较筛查阳性和筛查阴性吞咽困难参与者之间的偏好指数。问卷将包括六类食物（酸性、质地、甜味、酱汁、乳制品和熟食）。总共将纳入209名参与者，涵盖急性老年、康复和长期护理单元（步骤1纳入35名参与者，步骤2纳入35名参与者，步骤3纳入174名参与者，其中步骤2的35名参与者纳入步骤3人群）。描述性和比较性分析将根据预定义的统计分析计划进行。
伦理与传播： 该研究方案于2025年9月11日获得法国法兰西岛III个人保护委员会（CPP）批准（批准号：25.02467.000911-2025-A00795-44），符合法国立法。所有参与者将根据国家法规提供知情不反对。主要和次要目标的结果将通过同行评审出版物、会议报告和与临床利益相关者的沟通进行传播。
试验注册号： NCT05734586。

英文摘要

INTRODUCTION: Undernutrition is a major concern in older adults due to its multifactorial origins and its impact on morbidity and mortality. Oropharyngeal dysphagia is common in frail geriatric patients and contributes to undernutrition by prompting individuals to progressively withdraw foods from their diet, leading to dietary imbalance and potential complications. Although texture adaptation and nutritional strategies are widely implemented in clinical practice, little is known about the actual food preferences of hospitalised older adults with dysphagia. Existing tools to assess food preferences are scarce and poorly adapted to the heterogeneity and sensory impairments of this population. The DYSPHAGING Preferences study aims to develop a food-preference assessment tool specifically tailored to hospitalised older adults, assess its test-retest reliability and describe food preferences measured using this adapted instrument.
METHODS AND ANALYSIS: The DYSPHAGING Preferences study is designed as a prospective, multicentre, non-comparative protocol consisting of three steps. Step 1 will adapt a forced-choice questionnaire-initially developed for paediatric populations-to adults aged≥70 years hospitalised in geriatric wards, by assessing visual and lexical recognition of pre-selected food items. Step 2 will evaluate the test-retest reliability and practical feasibility of administering the preference questionnaire in a new cohort of older adults. Step 3 will be a cross-sectional study describing food preferences and comparing Preference Indexes between participants screening positive and screening negative for dysphagia using the Eating Assessment Tool-10. The questionnaire will include six categories of food (acidic, textured, sweet, in sauce, dairy and cooked). A total of 209 participants will be included across acute geriatric, rehabilitation and long-term care units (35 participants in step 1, 35 participants in step 2 and 174 participants in step 3, with the 35 participants from step 2 included in the step 3 population). Descriptive and comparative analyses will be performed according to a predefined statistical analysis plan.
ETHICS AND DISSEMINATION: The study protocol was approved by the Comité de Protection des Personnes (CPP) Île-de-France III on 11 September 2025 (approval number: 25.02467.000911-2025-A00795-44), in accordance with French legislation. All participants will provide informed non-opposition in accordance with national regulations. The results of the primary and secondary objectives will be disseminated through peer-reviewed publications, conference presentations and communication with clinical stakeholders.
TRIAL REGISTRATION NUMBER: NCT05734586.