Diagnostic Accuracy of the Defining Characteristics of Impaired Swallowing in Children with Encephalopathy.

The purpose of this study was to analyze the accuracy of the defining characteristics of the nursing diagnosis of impaired swallowing in children with encephalopathy. The measures of diagnostic accuracy for each indicator were verified through latent class analysis. The prevalence of swallowing impairment was 59.76% for a total of 82 children evaluated. The defining characteristics that had good measures of sensitivity (range: 79.59-99.99) and specificity (range: 72.72-99.99) were as follows: food falls from the mouth, tongue action ineffective in forming bolus, prolonged bolus formation, inability to clear the oral cavity, and food refusal. Eight characteristics can be used as warning signs for impaired swallowing because they have high sensitivity values. In addition, ten characteristics presented high specificity and can be used to confirm this diagnosis in children with encephalopathy. Considering the findings of the swallowing pattern assessments through the analysis of the accuracy measures, it is verified that the evidence presented here should guide the pediatrics nurses in the diagnosis decision making. Indicators of high sensitivity should be used as warning signs for swallowing impairment, and the high specificity indicators should be used as a confirmatory sign of this condition and requires immediate intervention.