Association of "Ippatsu-Gei," a Brief Psychosocial Interaction, with Spontaneous Activity and Adverse Events in Home-Visit Dysphagia Rehabilitation: A Retrospective Cohort Study.

Background/Objectives: Direct and indirect training are well established in dysphagia rehabilitation, but the role of brief psychosocial interactions in home-based care remains unclear. This retrospective cohort study examined whether provider-based exposure to "Ippatsu-gei" was associated with spontaneous activity and adverse events during home-visit dysphagia rehabilitation. Methods: Clinical records were reviewed for patients who received at least one session between January and June 2019. Exposure was defined as care from dentists who routinely incorporated Ippatsu-gei into patient communication. Spontaneous-activity analysis required complete 180-day follow-up (N = 148); adverse-event analysis included patients with complete follow-up or a predefined event within 180 days (N = 150). Results: Spontaneous activity was documented in 18 of 148 patients (12.2%). Ippatsu-gei exposure was associated with higher odds of spontaneous activity (adjusted odds ratio 5.42; 95% confidence interval 1.62-18.18; p = 0.006), although the estimate remained imprecise. Adverse events occurred in 31 of 150 patients (20.7%) and were not significantly associated with Ippatsu-gei exposure (adjusted odds ratio 0.53; 95% confidence interval 0.20-1.39; p = 0.195). Conclusions: Provider-based Ippatsu-gei exposure was associated with retrospectively documented spontaneous activity, but causal interpretation is limited by temporal uncertainty, provider-related effects, and residual confounding. No statistically significant association with adverse events was observed.