Turkiye Klinikleri Journal of Health Sciences

.: REVIEW
Pediatrik Popülasyonda Beslenme ve Yutma Bozukluklarında Klinik Değerlendirme Basamakları
Clinical Evaluation Steps of Feeding and Swallowing in Pediatrics
Ayşe Kübra ŞAHANa, Mahmut SEVİMa, Selen SEREL ARSLANa
aHacettepe Üniversitesi Fizik Tedavi ve Rehabilitasyon Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Ankara, TÜRKİYE
Turkiye Klinikleri J Health Sci. 2020;5(1):157-65
doi: 10.5336/healthsci.2019-65836
Article Language: TR
ÖZET
Beslenme ve yutma bozukluğu birçok hastalık ve genetik sendrom sonucu ortaya çıktığı gibi sağlıklı çocuklarda da görülmektedir. Günümüzde erken doğum ve kompleks medikal durumlar sonrası sağkalım oranlarının artmasıyla birlikte beslenme ve yutma bozukluklarının görülme oranı da artmaktadır. Artan beslenme ve yutma bozukluğu prevalansı ve yol açtığı ciddi medikal sorunlar göz önünde bulundurulduğunda, bu bozuklukların erken dönemde teşhis ve tedavisinin hayati öneme sahip olduğu görülmektedir. Klinik beslenme ve yutma değerlendirmesi erken teşhiste birincil öneme sahiptir. Kapsamlı değerlendirme; öykü alınması, davranış ve duyu değerlendirmesi, postüral kontrol ve tonus değerlendirmesi, solunum fonksiyonlarının değerlendirilmesi, oral motor yapı ve fonksiyonların değerlendirilmesi ile beslenme ve yutma fonksiyonlarının değerlendirilmesini içermektedir. Aynı zamanda literatürde belirli tanılarda kullanılmak üzere geliştirilmiş, geçerli, güvenilir ve standardize klinik yutma değerlendirme araçları da mevcuttur. Bu araçlar oral motor beceriler, duyu ve davranışsal faktörler, yaşam kalitesi, aile ve çevre ile ilgili faktörler gibi parametrelerden bir veya birkaçını değerlendirmektedir. Pediatrik alanda çalışan klinisyenlerin klinik yutma değerlendirme basamaklarını bilmeleri ve doğru değerlendirme aracını seçebilmeleri gerekmektedir. Çünkü klinik değerlendirme, hastanın mevcut problemi hakkında bilgi elde edilmesini, ileri aletsel bir değerlendirmeye ihtiyaç olup olmadığına karar verilmesini, uygun tedavi planının hazırlanması ve gereken bölümlere yönlendirme yapılmasını sağlamaktadır. Bu çalışmada, pediatrik popülasyonda beslenme ve yutma fonksiyonunun klinik değerlendirme basamakları ile beslenme ve yutma fonksiyonuna özel olarak geliştirilmiş klinik değerlendirme araçları ve özellikleri rapor edilmiş olup, yutma bozukluğu alanında çalışan klinisyenlere rehberlik etmek amaçlanmıştır.

Anahtar Kelimeler: Pediatri; beslenme ve yeme bozuklukları; yutma bozuklukları; değerlendirme
ABSTRACT
Feeding and swallowing disorders occur as a result of many diseases and genetic syndromes and also could be seen in healthy children. The incidence of feeding and swallowing disorders is increasing with the increase of survival rates after premature birth and complex medical conditions. Considering the frequency of increased feeding and swallowing disorders and related serious medical problems, early diagnosis and treatment of these problems have vital importance. Clinical feeding and swallowing assessments have primary importance in early diagnosis. Comprehensive evaluation includes history taken, evaluations of behavioral and sensory state, postural control and tonus, respiratory function, oral motor structure and function, feeding and swallowing functions. There are also valid, reliable and standardized clinical swallowing assessment tools developed for use in specific diagnoses in the literature. These tools evaluate one or more parameters including oral motor skills, sensory and behavioral factors, quality of life, family and environment related factors. Clinicians working in the pediatric area should be able to know the steps of clinical evaluation of feeding and swallowing and choose the correct assessment tool. Because clinical evaluation allows to obtain information about the current problem of the patient, decide if there is a need for a further instrumental evaluation, make an appropriate treatment plan and consult patients to the related health professionals. In this study, the clinical evaluation steps of feding and swallowing function, specialized clinical assessment tools and their features in the pediatric population have been reported and it was aimed to guide clinicians working in the field of swallowing disorders.

Keywords: Pediatrics; feeding and eating disorders; deglutition disorders; evaluation
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