食事場面における嚥下機能評価法(SK式食事場面嚥下機能アセスメント)の信頼性と妥当性の検討

An examination of the reliability and validity of the "SK-type Meal Scene Swallowing Function Assessment"

　目的：われわれは，実際に安全な経口摂取ができているかどうかの観察と評価から効果的な摂食嚥下訓練の選択および対応が可能になることを目的に，食事場面の嚥下機能評価法「SK式食事場面嚥下機能アセスメント」を開発した．この研究の目的は，SK式食事場面嚥下機能アセスメントの食事場面における嚥下機能評価法としての信頼性と妥当性の検討である．対象と方法：嚥下機能評価の依頼があった40例を対象に，同一患者に対して2名の言語聴覚士でSK式食事場面嚥下機能アセスメントを実施し，各項目の一致率を検証した．また，171例に対しSK式食事場面嚥下機能アセスメントとThe Mann Assessment of Swallowing Ability(MASA)を施行し，相関を検証した．結果：言語聴覚士間の一致率は2項目のみが中等度で，その他はかなり，またはほぼ完全な一致であった．SK式アセスメントスコアとMASAスコアには強い相関があった．結論：SK式食事場面嚥下機能アセスメントは，食事場面における嚥下機能評価法として信頼性，妥当性のある尺度であることが示された．

　We developed the “SK-type Meal Scene Swallowing Function Assessment (SK-type Assessment)” to assess a patient's swallowing function while eating, with the aim of evaluating whether or not the patient's oral intake is safe and selecting the most effective method of rehabilitation. The purpose of this study was to examine the reliability and validity of the SK-type Assessment as a method of evaluating the swallowing function. In 40 patients referred for a swallowing function assessment, two speech-language-hearing therapists performed the SK-type Assessment on the same patient independently, and the concordance rate of each item was verified. The SK-type Assessment and the Mann Assessment of Swallowing Ability (MASA) were performed on 171 patients, and the correlation between the scores of the two assessment methods was verified. The results showed that the concordance rate among speech-language-hearing therapists was moderate for two items and fairly or nearly perfect for all the others. There was a strong correlation between the SK-type Assessment score and the MASA score. Thus, the SK-type Assessment is a reliable and valid examination for evaluating the swallowing function in the dietary scene.