치매 환자의 연하장애 평가에 대한 ICF 적용 현황 및 평가도구 분석: 주제범위 고찰
ICF Application and Assessment Tool Analysis for Dysphagia Evaluation in Patients with Dementia: A Scoping Review
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Objective: To analyze dysphagia assessment tools for dementia patients using the International Classification of Functioning, Disability and Health (ICF) framework and suggest future clinical directions. Methods: A scoping review of literature published between 2015 and 2025 identified 44 studies. Thirty assessment tools were mapped to the four ICF components: Body functions, activities, participation, and environmental factors. Results: Instrumental assessments (Videofluoroscopic Swallowing Study [VFSS], Fiberoptic Endoscopic Evaluation of Swallowing [FEES]) and the Water Swallow Test were most frequently used. ICF mapping revealed that 96.7% of tools focused on body functions, while only approximately 20% addressed participation and environmental factors. Self/caregiver-report questionnaires covered multidimensional domains but were limited by subjectivity, whereas instrumental assessments were objective but restricted to body functions. Conclusion: Current assessments prioritize physiological safety, often overlooking actual eating activities and environmental contexts. Future research should focus on developing ICF-based standardized observational tools to objectively assess eating behaviors, environmental factors, and body functions. This approach will support occupational therapist-led integrated rehabilitation to improve the quality of life of patients.
Abstract
Objective: To analyze dysphagia assessment tools for dementia patients using the International Classification of Functioning, Disability and Health (ICF) framework and suggest future clinical directions. Methods: A scoping review of literature published between 2015 and 2025 identified 44 studies. Thirty assessment tools were mapped to the four ICF components: Body functions, activities, participation, and environmental factors. Results: Instrumental assessments (Videofluoroscopic Swallowing Study [VFSS], Fiberoptic Endoscopic Evaluation of Swallowing [FEES]) and the Water Swallow Test were most frequently used. ICF mapping revealed that 96.7% of tools focused on body functions, while only approximately 20% addressed participation and environmental factors. Self/caregiver-report questionnaires covered multidimensional domains but were limited by subjectivity, whereas instrumental assessments were objective but restricted to body functions. Conclusion: Current assessments prioritize physiological safety, often overlooking actual eating activities and environmental contexts. Future research should focus on developing ICF-based standardized observational tools to objectively assess eating behaviors, environmental factors, and body functions. This approach will support occupational therapist-led integrated rehabilitation to improve the quality of life of patients.