臺灣語言治療師執行成人吞嚥障礙評估的現況調查：臨床/床邊評估項目與儀器檢查使用狀況

本研究探討臺灣語言治療師執行成人吞嚥障礙評估的狀況，包括臨床/床邊評估（clinical swallowing examination, CSE）項目的執行頻率、一致性、選擇原因與其實證狀況，以及吞嚥儀器檢查的取得率、執行狀況與影響因素。本研究採用問卷調查法，招募具有臺灣語言治療師證照、於臺灣累積一年以上的臨床經驗，過去一年內曾於臺灣執行成人吞嚥障礙業務的語言治療師填寫具專家效度的自編問卷，共收回155份有效問卷。研究結果顯示，臺灣語言治療師使用的CSE核心項目共13項，其中69.2%經實證顯示具良好診斷性效能（diagnostic performance）。選擇CSE項目的原因依序為臨床經驗（82.4%）、教育訓練（78.1%）、讀過相關文獻（58.1%）。臺灣的吞嚥儀器檢查取得率為49.7%。影響因素的部分，達顯著差異且具有中度以上效果量或關聯性的背景變項與吞嚥障礙評估變項共6組，例如：「工作場域」與「儀器取得狀況」。本研究建立臺灣語言治療師執行成人吞嚥障礙評估的臨床數據，可供醫療端以及教育訓練單位作為參考。

The purpose of this survey study was to obtain a comprehensive view of the adult dysphagia evaluation practice patterns of speech–language pathologists(SLPs) in Taiwan, specifically in terms of (a) frequency, consistency, reasons of using certain components of clinical swallowing examination (CSE), and the condition of data-based support, and (b) availability, execution and factors of utilization of swallowing instrumental examination. SLPs who were Taiwanese-certified clinicians, had over one year of clinical experience, and had been providing services to individuals with swallowing disorders in the past year in Taiwan were recruited to fill out a self-administered survey with expert validity. A total of 155 questionnaires were returned.Results indicate there were 13 core components of CSE, and 69.2% of them had valid diagnostic performance. Reasons of using components of CSE were clinical experiences (82.4%), education and training (78.1%), and data support (58.1%). Furthermore, 49.7% SLPs had access to swallowing instrumental examination. There were 6 pairs of background and practice patterns variables with significant correlation and valid effect size, for example, workplace versus access to swallowing instrumental examination. The study obtained a comprehensive view of adult dysphagia evaluation practice patterns of SLPs in Taiwan.