“一发艺”这一简短心理社会互动与居家吞咽康复中自发活动及不良事件的关联：一项回顾性队列研究
Association of "Ippatsu-Gei," a Brief Psychosocial Interaction, with Spontaneous Activity and Adverse Events in Home-Visit Dysphagia Rehabilitation: A Retrospective Cohort Study.
文献信息
| PMID | 42882204 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Chizuko Kameda |
| 作者单位 | Division of Gerontology and Gerodontology, Department of Dysphagia Rehabilitation, Institute of Science Tokyo, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. |
| 期刊 | Journal of clinical medicine |
| SCI 分区 | Q1 |
| IF | 3.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景/目的： 直接训练和间接训练在吞咽康复中已得到充分确立，但简短心理社会互动在居家照护中的作用仍不明确。本回顾性队列研究考察了提供者层面接触“一发艺”是否与居家吞咽康复期间的自发活动和不良事件相关。方法：回顾了2019年1月至6月期间至少接受过一次治疗的患者临床记录。暴露定义为由常规将一发艺纳入患者沟通的牙科医生提供照护。自发活动分析要求完成180天完整随访（N = 148）；不良事件分析纳入完成随访或在180天内发生预设事件的患者（N = 150）。结果：148例患者中有18例（12.2%）记录了自发活动。一发艺暴露与自发活动几率较高相关（校正比值比5.42；95%置信区间1.62-18.18；p = 0.006），但该估计仍不精确。150例患者中有31例（20.7%）发生不良事件，且与一发艺暴露无显著关联（校正比值比0.53；95%置信区间0.20-1.39；p = 0.195）。结论：提供者层面的一发艺暴露与回顾性记录的自发活动相关，但因果解释受时间不确定性、提供者相关效应和残余混杂的限制。未观察到与不良事件有统计学显著关联。
英文摘要
Background/Objectives: Direct and indirect training are well established in dysphagia rehabilitation, but the role of brief psychosocial interactions in home-based care remains unclear. This retrospective cohort study examined whether provider-based exposure to "Ippatsu-gei" was associated with spontaneous activity and adverse events during home-visit dysphagia rehabilitation. Methods: Clinical records were reviewed for patients who received at least one session between January and June 2019. Exposure was defined as care from dentists who routinely incorporated Ippatsu-gei into patient communication. Spontaneous-activity analysis required complete 180-day follow-up (N = 148); adverse-event analysis included patients with complete follow-up or a predefined event within 180 days (N = 150). Results: Spontaneous activity was documented in 18 of 148 patients (12.2%). Ippatsu-gei exposure was associated with higher odds of spontaneous activity (adjusted odds ratio 5.42; 95% confidence interval 1.62-18.18; p = 0.006), although the estimate remained imprecise. Adverse events occurred in 31 of 150 patients (20.7%) and were not significantly associated with Ippatsu-gei exposure (adjusted odds ratio 0.53; 95% confidence interval 0.20-1.39; p = 0.195). Conclusions: Provider-based Ippatsu-gei exposure was associated with retrospectively documented spontaneous activity, but causal interpretation is limited by temporal uncertainty, provider-related effects, and residual confounding. No statistically significant association with adverse events was observed.