The Influence of Oral Aperture in Fowler’s Position for Oral Care in The Elderly

  • Yonezawa Tomoe
    Department of Nursing,Faculty of Health Science,Aino University
  • Honda Yoko
    Department of Nursing,Faculty of Health Science,Aino University
  • Tamaru Tomoko
    Faculty of Nursing, Mukogawa Women’s University
  • Iwasa Yumi
    Department of Nursing,Faculty of Health Science,Aino University
  • Kawahara Fumitoshi
    Department of Nursing,Faculty of Health Science,Aino University

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Other Title
  • ファウラー位での口腔ケアのための開口が高齢者に及ぼす影響
  • ファウラーイ デ ノ コウコウ ケア ノ タメ ノ カイコウ ガ コウレイシャ ニ オヨボス エイキョウ

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Abstract

<p>When performing oral care in elderly persons requiring nursing care, Fowler’s position, in which the head is raised to an upright position (45-60 degrees), is said to be a safe position in which aspiration is a relatively rare occurrence and patients experience considerably less pain. However, it is not understood how much physical load is caused during oral aperture when in Fowler’s position while undergoing oral care. Therefore, the principal aim of the present study was to examine the somatic effects of Fowler’s position when the mouth was open and closed. We performed an experiment in which 11 elderly women were placed in Fowler’s position when the mouth was open and closed, and performed a comparative examination of blood pressure, pulse, and heart rate variability. When the mouth was open, systolic blood pressure was significantly higher when the patient was in Fowler’s position compared with a pre-experiment supine position (p=0.021). When the mouth was open and closed, diastolic blood pressure was significantly higher when the patient was in Fowler’s position compared with a pre-experiment supine position (p=0.014 ; p=0.006). No significant differences with regard to pulse were noted. There was no significant difference in parasympathetic nervous system activity (high frequency [HF]) or sympathetic nervous system activity (low frequency [LF]/HF) with regard to heart rate variability. These findings suggest that when the mouth is open while in Fowler’s position, the spine and abdominal muscles contract to maintain posture so that the body does not slide down, and systolic blood pressure increases due to the work of the muscles involved in oral aperture.</p>

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