Thickened beverages or swallowing aid jelly (SAJ), commonly used as tablet-swallowing aids for dysphagic patients, may influence the disintegration of orally administered tablets. With this in mind, we evaluated the disintegration times of therapeutic tablets immersed in thickened beverages or SAJ compared to immersion in ones without them. Thickened beverages and SAJs were prepared with various beverages (water, orange juice, and milk) using food thickeners and SAJ powders marketed in Korea. The tablet disintegration times were the same in thickened beverages and SAJs, and there was no statistically significant difference associated with the thickness levels of the thickened beverages. The disintegration times of Tylenol immersed in orange juice or milk were slightly higher compared to those immersed in water. Moreover, there was no difference in disintegration time when using the thickened beverages and SAJs. The disintegration times of Aspirin were similar in all of the thickened beverages or SAJs, and there were no differences between non-immersed and immersed tablets. These results demonstrate that the disintegration of Tylenol and Aspirin is not greatly affected by immersion in any of the thickened beverages and SAJs.
Food thickeners are commonly used to prepare thickened liquids for the management of dysphagia. The National Dysphagia Diet (NDD) thickness levels of thickened liquids prepared with commercial food thickeners are known to vary depending on the thickener type, recommended amount of thickener, thickener brand, and preparation instructions. Particularly, detailed preparation instructions must be provided by the manufacturers to achieve the correct thickness levels. However, the rheological information on product labels provided by manufacturers is typically not accurate. Here, various pudding-thick liquids were prepared by mixing commercial xanthan gum (XG)-based thickeners based on the manufacturers’ guidelines, and their rheological properties were characterized. Several thickened liquids prepared with four different XG-based thickeners (A-D) marketed in Korea did not meet the pudding-like criterion (> 1,750 mPa·s) based on the NDD guidelines. Significant differences in rheological parameter values (ηa,50, n, and G′) were also identified among the various thickened liquids. Only one thickener (thickener A) manufactured in Korea showed optimal results, which satisfied the pudding-thick viscosity range for various food liquids and also showed lower stickiness and enhanced bolus formation ability for easy and safe swallowing when compared to other thickeners (B, C, and D).
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This study aimed to examine nutrition care management for in-patients with dysphagia and to evaluate knowledge on nutrition care related to dysphagia among dietitians in clinical settings. A total of 554 questionnaires were distributed to dietitians at hospitals located in Seoul and Gyeonggi Province in Korea, and 147 responses were used for data analysis after excluding responses with significant missing data. Study participants worked at general hospitals (37.2%), long-term care hospitals (24.3%), hospitals (19.2%), and tertiary hospitals (11.5%). Prior education and training related to dysphagia was received by 69.9% of the respondents. The percentage of hospitals that had diet guidelines for dysphagia was 68.0%. Dysphagia diets of 2 levels and 3 levels were provided in 55.1% and 34.7% of the hospitals, respectively. Overall 74.7% of the dietitians responded that they provided information on dysphagia diets to in-patients and caregivers, but only 45.7% of dietitians did so in the long-term care hospitals. Among the respondents who used commercial thickening agents, 77.2% used only one type of commercial thickening agent. Patients or caregivers (75.7%) or nurses (34.5%) were reported to modify viscosity of liquid. Dietitians showed low levels of knowledge on nutrition care related to dysphagia (a mean of 5.14 based on possible scores from 0 to 10 points). To promote nutritional consumption and prevent malnutrition and aspiration, hospitals need the standardized diet guidelines, and dietitians should improve their expertise in nutritional care for patients with dysphagia.
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