Adaptación de una pauta y protocolo de evaluación clínica fonoaudiológica para la deglución para niños de 0 a 1 año
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2018
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es
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Universidad Andrés Bello
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Resumen
La primera necesidad de un niño al nacer después de la respiración es la alimentación, si un neonato no logra una alimentación segura, eficaz y confortable, puede llegar a tener alteraciones sistémicas debido, por ejemplo, a una hipoglicemia. El proceso de alimentación en un infante está dividido en 3 estadios según el Comité de Nutrición de la Academia Americana de Pediatría (2010), el primero conocido como “Periodo de lactancia”, el cual se da desde el primer día hasta los 6 meses de vida, en este periodo se realiza la evaluación de la succión no nutritiva (succión sin presencia de líquido), la evaluación de la succión nutritiva (succión con ingesta de alimento) con consistencia líquido claro. El segundo estadio es denominado, “Periodo transicional” el cual abarca el segundo semestre de vida. Se realiza la evaluación de la alimentación nutritiva con consistencia semisólido. Por último, el tercer estadio, se denomina “Periodo adulto modificado”, el cual se encuentra presente desde la edad pre-escolar, este no será evaluado. En Chile las pautas formales disponibles para los profesionales capacitados frente al tema son escasas y dentro de la poca variedad que existe, comparten entre sí un costo económico elevado para poder aplicarlas.
Objetivo: El objetivo del presente estudio consiste en medir la confiabilidad de la pauta de evaluación de la deglución en menores de 0 a 1 año, creada por Herrán y Cols en el año 2017.
Metodología: Se evaluó a 60 individuos, de los cuales cada uno fue evaluado 2 veces. Cada evaluación fue realizada por un evaluador distinto. De los 60 individuos, 50 pertenecen a un grupo control y 10 a un grupo caso. Por otra parte, de los 60 evaluados, 45 fueron evaluados en el Hospital El Pino y 15 individuos fueron evaluados en sus domicilios.
Resultados: Los resultados arrojaron que la pauta creada es confiable, con un índice de correlación de Pearson cercano al 1 en todas las variables comparadas. Así también, demostraron que la pauta de evaluación es sensible, dicho análisis se realizó con la prueba de Mann-Whitney y el análisis de t de student. Ambos análisis presentan valores 0 para la significancia cuando el intervalo de confianza es 95% (𝛼=0.05). Por lo tanto, la pauta es capaz de detectar trastorno o alteración en individuos con factores de riesgo o patologías asociadas a problemas en la deglución.
The first need of a child to be born after breathing is food, if a newborn does not achieve a safe, effective and comfortable diet, it can have systemic alterations due, for example, to a low level of sugar. The feeding process in an infant is divided into 3 stages according to the Nutrition Committee of the American Academy of Pediatrics (2010), the first name known as the "Breastfeeding Period", which is from the first day until the 6th months of life, in this period the evaluation of the non-nutritive suction is carried out, the evaluation of the nutritive suction, with clear liquid consistency. The second stage is called, "Transitional Period," which covers the second semester of life. The evaluation of the nutritious food with semi-solid consistency is carried out. Finally, the third stage, is called "Modified adult period", which is present in the preschool age, it will not be evaluated. In Chile, the formal guidelines available to professionals trained in this field are scarce and, within the limited variety that exists, share a high economic cost to apply them. Objective: The objective of the present study is to measure the reliability of the swallowing evaluation guideline in children from 0 to 1 year old, created by Herrán y Cols in 2017. Methodology: Sixty individuals were evaluated, of which each was evaluated twice. Each evaluation was done by a different evaluator. Of the 60 individuals, 50 belong to a control group and 10 to a case group. On the other hand, of the 60 evaluated, 45 were evaluated in El Pino Hospital and 15 individuals were evaluated in their homes. Results: The results showed that the pattern created is reliable, with a Pearson correlation index close to 1 in all the variables compared. Likewise, they showed that the evaluation guideline is sensitive, this analysis was done with the Mann-Whitney test and the student's t-test. Both analyzes present 0 values for significance when the confidence interval is 95% (α = 0.05). Therefore, the pattern is able to detect disorder or alteration in individuals with risk factors or pathologies associated with problems in swallowing.
The first need of a child to be born after breathing is food, if a newborn does not achieve a safe, effective and comfortable diet, it can have systemic alterations due, for example, to a low level of sugar. The feeding process in an infant is divided into 3 stages according to the Nutrition Committee of the American Academy of Pediatrics (2010), the first name known as the "Breastfeeding Period", which is from the first day until the 6th months of life, in this period the evaluation of the non-nutritive suction is carried out, the evaluation of the nutritive suction, with clear liquid consistency. The second stage is called, "Transitional Period," which covers the second semester of life. The evaluation of the nutritious food with semi-solid consistency is carried out. Finally, the third stage, is called "Modified adult period", which is present in the preschool age, it will not be evaluated. In Chile, the formal guidelines available to professionals trained in this field are scarce and, within the limited variety that exists, share a high economic cost to apply them. Objective: The objective of the present study is to measure the reliability of the swallowing evaluation guideline in children from 0 to 1 year old, created by Herrán y Cols in 2017. Methodology: Sixty individuals were evaluated, of which each was evaluated twice. Each evaluation was done by a different evaluator. Of the 60 individuals, 50 belong to a control group and 10 to a case group. On the other hand, of the 60 evaluated, 45 were evaluated in El Pino Hospital and 15 individuals were evaluated in their homes. Results: The results showed that the pattern created is reliable, with a Pearson correlation index close to 1 in all the variables compared. Likewise, they showed that the evaluation guideline is sensitive, this analysis was done with the Mann-Whitney test and the student's t-test. Both analyzes present 0 values for significance when the confidence interval is 95% (α = 0.05). Therefore, the pattern is able to detect disorder or alteration in individuals with risk factors or pathologies associated with problems in swallowing.
Notas
Tesis (Fonoaudiología)
Palabras clave
Protocolos Clínicos, Deglución