A Study of Current Status of Oral Feeding Difficulty in Infants with Congenital Heart Disease
| Autor: | Yun-Hua Chao, 趙韻華 |
|---|---|
| Rok vydání: | 2018 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 106 Background: Due to the advancement of the pediatric cardiology operation, the survival rate of the infants with congenital heart disease (CHD) has been increased. However, the oral feeding difficulty issue has affected the patients’ growth and development. The aim of the research is to investigate the situation including influential factors relevant to the oral feeding ability of CHD infants that need the open heart surgery throughout the period of hospitalization. Purpose: The purpose of this study was: (1) To understand the type of oral feeding difficulty and when would it happen.; (2) To analyze the relationships between the demographic information about the CHD infants, the severity of the CHD and the medical histories of the CHD infants. Methods: This research applied the prospective, longitudinal study with consecutive sampling., by means of purposive sampling approach at the children’s hospital in Taipei, from July, 2017 to May 2018. Further, this research targeted at the CHD infant patients under 6 months that received an open heart surgery. The content of the structured questionnaire includes the Early Feeding Skills Assessment (EFS), observation schedule, and demographic information form. Finally, the SPSS 21.0 was used to conduct the descriptive and inferred statistic analysis. Results: In total, 30 participants were included in this study, the average length of nasogastric tube were 35.67 days. For oral feeding difficulty before the operation, the data shows that the prevalence rate of instability of vital signs was 83.33%, and the prevalence of poor endurance after oral feeding was 76.67%. The total score of EFS improved after extubation, especially it increased significantly (p < .05) on the third day after extubation. The ability of engagement during oral feeding (from 7.37 to 10.03), the stability of vital signs (from 19.3 to 25.45), and also the endurance after oral feeding (from 3.90 to 5.37). The average oral intake was 85.82% of daily intake on the day our participants removed the nasogastric tube. 24 patients (80%) had been discharged without a nasogastric tube, but 20 of them still need some clinical concerns for their oral feeding ability. According to the general estimate equations model, the oral feeding ability measured by the EFS was related to the length of intubation(β = -8.83, p < .001), type of the open heart surgery (β = -3.90, p = .03), whether received other thoracic range operation(β = -4.53, p = .04), and time (β = 0.45, p < .001). Conclusion: Receiving an open heart surgery can improve the cardiac haemodynamics of CHD infants and promote their tolerance of engaging in the daily activities. Also, long-term intubation, receiving multiple operations and infection affected their oral feeding ability, especially the oral-motor skill and the swallowing process of our participants still did not fully recover when discharge from the hospital. The finding of this research emphasized the importance of early extubation, infection prevention, and comorbidity prevention toward the recovery of oral feeding ability in CHD infants. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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