Alice Temu, PhD, RD - IDDSIiddsi.org/wp-content/uploads/2017/06/Swahili... · chepesi sana K inatiririka kwenye mrija, ncha ya bomba la sindano, chuchu Sawa na uzito wa maziwa ya

FOOTER 1

CreativeCommons Attribution-‐Sharealike 4.0 International License

https://creativecommons.org/licenses/by-‐sa/4.0/

10 Octobre, 2016

VYAKULA

VINYWAJI

Alice Temu, PhD, RD

VYA KAWAIDA

VYEPESI SANA

LAINI NA UKUBWA WA TONGE LA KUNG’ATA

VILIVYOSAGWA NA VITEPE

VYEPESI

VIZITO KIDOGO

VIZITO KIASI

VIZITO SANA

VYA MAJIMAJI

VILIVYOPONDWA

The IDDSI Framework and Descriptors are licensed under the 2 CreativeCommons Attribution-‐Sharealike 4.0 International License


October 10, 2016

Complete IDDSI Framework

and Descriptors

FOOTER 1



10 Octobre, 2016

UTANGULIZI

Mpango wa kimataifa wa viwango vya chakula kwa wenye matatizo ya kumeza “The International Dysphagia Diet Standardisation Initiative (IDDSI)” ulizinduliwa mwaka 2013 kwa madhumuni ya kuanzisha istilahi na ufafanuzi mpya wa kimataifa kuelezea urekebishaji wa uepesi wa vyakula na uzito wa vinywaji vinavyotumiwa na watu walio na matatizo ya kumeza wa umri wowote, katika mpangilio wa huduma yeyote, na utamaduni wowote.

Miaka mitatu mfululizo ya kazi iliyofanywa na kamati ya kimataifa ya viwango vya vyakula kwa watu wenye matatizo ya kumeza, imetoa nakala ya mwisho ya mfumo wa viwango vya vyakula kwa watu wenye matatizo ya kumeza ambao una hatua za viwango 8, kuanzia hatua ya chini mpaka juu (0-7). Viwango hivyo vinatambulika kwa kutumia namba, maandishi na rangi.

Nakala hii inatoa maelekezo ya viwango vyote vya IDDSI kwa undani zaidi. Vielelezi vinadhihirishwa na njia rahisi za vipimo ambazo zinaweza kutumiwa na watu wenye matatizo ya kumeza, wahudumu, madaktari, wataalamu wa huduma za chakula, ama viwanda kuthibitisha viwango vya vyakula vinavyofaa.

Nakala hii inabidi isomwe pamoja na nakala za njia za upimaji wa IDDSI, uthibitishaji wa IDDSI, na nakala za maswali yanayoulizwa mara kwa mara (http://iddsi.org/framework/).

Kamati ya IDDSI inapenda kutambua hamu na ushirikiano wa jumuiya ya kimataifa, ikiwa ni pamoja na wagonjwa, wahudumu, wataalam wa afya, viwanda, vyama vya wataalam na watafiti. Pia tunapenda kuwashukuru wadhamini wetu kwa msaada wao wa hali na mali.

Tafadhali tembelea tovuti hii www.iddsi.org kwa maelezo zaidi

Kamati ya IDDSI:

Wenyeviti: Peter Lam (Kanada) na Julie Cichero (Australia);

Wanakamati: Jianshe Chen (China), Roberto Dantas (Brazili), Janice Duivestein (Kanada), Ben Hanson (Uingereza), Jun

Kayashita (Japani), Caroline Lecko (Uingereza), Mershen Pillay (ZAF), Luis Riquelme (Marekani), Soenke Stanschus

(Ujerumani), Catriona Steele (Kanada).

Wanakamati wa zamani: Joe Murray (Marekani)

Mpango wa kimataifa wa viwango vya chakula kwa wenye matatizo ya kumeza (IDDSI) ni chombo kinachojitegemea

na si kwa ajili ya kupata faida. IDDSI inashukuru idadi kubwa ya mashirika na viwanda kwa msaada wa kifedha na

kadhalika. Wadhamini hawajashirikishwa katika kubuni wala kutengeneza mfumo huu wa IDDSI.

Utengenezaji wa IDDSI (2012-‐2015)

IDDSI inapenda kutambua na kushukuru wadhamini wafuatao kwa msaada wao wa hali na mali kuwezesha

utengenezaji wa mfumo wa IDDSI:

Nestlé Nutrition Institute (2012-‐2015)

Nutricia Advanced Medical Nutrition (2013-‐2014)

Hormel Thick & Easy (2014-‐2015)

Campbell’s Food Service (2013-‐2015)

apetito (2013-‐2015)

Trisco (2013-‐2015)

Food Care Co. Ltd. Japan (2015)

Flavour Creations (2013-‐2015)

http://iddsi.org/framework/)

http://www.iddsi.org/



October 10, 2016

Simply Thick (2015)

Lyons (2015)

Utekelezaji wa mfumo wa IDDSI unaendelea. IDDSI inashukuru sana wadhamini wote wanaosaidia utekelezaji. http://iddsi.org/about-‐us/sponsors/

http://iddsi.org/about-

FOOTER 3



10 Octobre, 2016

INTRODUCTION

The International Dysphagia Diet Standardisation Initiative (IDDSI) was founded in 2013 with the goal of developing new global standardised terminology and definitions to describe texture modified foods and thickened liquids used for individuals with dysphagia of all ages, in all care settings, and all cultures.

Three years of ongoing work by the International Dysphagia Diet Standardisation Committee has culminated in a final dysphagia diet framework consisting of a continuum of 8 levels (0-‐7). Levels are identified by numbers, text labels and colour codes.

This document provides detailed descriptors for all levels of the IDDSI Framework. Descriptors are supported by simple measurement methods that can be used by people with dysphagia or by caregivers, clinicians, food service professionals or industry to confirm the level a food fits into.

This document is to be read in conjunction with IDDSI Testing Methods, IDDSI Evidence and IDDSI Frequently Asked Questions (FAQs) documents (http://iddsi.org/framework/).

The IDDSI Committee would like to acknowledge the interest and participation of the global community including patients, caregivers, health professionals, industry, professional associations and researchers. We would also like to thank our sponsors for their generous support.

Please visit the www.iddsi.org for further information

The IDDSI Committee:

Co-‐Chairs: Peter Lam (CAN) & Julie Cichero (AUS);

Committee Members: Jianshe Chen (CHN), Roberto Dantas (BRA), Janice Duivestein (CAN), Ben Hanson (UK), Jun

Kayashita (JPN), Caroline Lecko (UK), Mershen Pillay (ZAF), Luis Riquelme (USA), Soenke Stanschus (GER), Catriona

Steele (CAN).

Past Committee Members: Joe Murray (USA)

The International Dysphagia Diet Standardisation Initiative Inc. (IDDSI) is an independent, not-‐for-‐profit entity.

IDDSI is grateful to a large number of agencies, organizations and industry partners for financial and other support.

Sponsors have not been involved with the design or development of the IDDSI framework.

Development of the IDDSI framework (2012-‐2015)

IDDSI would like to thank and acknowledge the following sponsors for their generous support in the development

of the IDDSI framework:

Nestlé Nutrition Institute (2012-‐2015)

Nutricia Advanced Medical Nutrition (2013-‐2014)

Hormel Thick & Easy (2014-‐2015)

Campbell’s Food Service (2013-‐2015)

apetito (2013-‐2015)

Trisco (2013-‐2015)

Food Care Co. Ltd. Japan (2015)

Flavour Creations (2013-‐2015)

Simply Thick (2015)

Lyons (2015)

Implementation of the IDDSI framework is in progress. IDDSI is extremely grateful to all sponsors

http://iddsi.org/framework/)

http://www.iddsi.org/



October 10, 2016

supporting implementation http://iddsi.org/about-‐us/sponsors/

http://iddsi.org/about-

FOOTER 5



10 Octobre, 2016

Maelezo / Tabia

Kinatiririka kama maji

Mtiririko wa haraka

Unaweza kunywa kwa njia ya aina yeyote ya chuchu, kikombe, au mrija ipasavyo kulingana na umri na uwezo

Mantiki ya mumbile inayofaa kwa kiwango hiki cha wororo

Uwezo wa kumudu vimiminika vya aina zote kwa usalama

Njia ya upimaji

http://iddsi.org/framework/drink-testing-methods/

IDDSI Flow Test* Upimaji wa mtiririko wa IDDSI

Kimiminika kinatiririka kupitia ncha ya bomba la sindano la mililita 10 ndani ya sekunde 10 bila kuacha mabaki (angalia maelekezo ya upimaji wa mtiririko wa IDDSI*).

0 VYEPESI SANA



October 10, 2016

Description / Characteristics

Flows like water

Fast flow

Can drink through any type of teat/nipple, cup or straw as appropriate for age and skills

Physiological rationale for this level of thickness

Functional ability to safely manage liquids of all types

Testing method


IDDSI Flow Test*

Test liquid flows through a 10 mL slip tip syringe completely within 10 seconds, leaving no residue (see IDDSI Flow Test instructions*).

0 THIN

FOOTER 7



10 Octobre, 2016

Maelezo / Tabia

Kizito kuliko maji

Kinahitaji juhudi kidogo kunywa kuliko kimiminika chepesi sana

Kinatiririka kwenye mrija, ncha ya bomba la sindano, chuchu

Sawa na uzito wa maziwa ya chupa ya watoto wachanga

Mantiki ya maumbile inayofaa kwa kiwango hiki cha uzito

Zaidi sana kinatumika kwa watoto wodogo kama kinywaji kinachomiminika taratibu lakini kinapita kwenye chuchu. Kutiririka kwenye chuchu kuzingatiwe kulingana na kesi na kesi

Njia ya upimaji



Kimiminika kinatiririka kupitia ncha ya bomba la sindano la mililita 10 na kuacha kiasi cha mililita 1 – 4 ndani ya sekunde 10 (rejea maelekezo ya upimaji wa mtiririko wa IDDSI*).

1 VYEPESI



October 10, 2016


Thicker than water

Requires a little more effort to drink than thin liquids

Flows through a straw, syringe, teat/nipple

Similar to the thickness of commercially available ‘Anti-‐‐regurgitation’ (AR) infant formula


Predominantly used in the paediatric population as a thickened drink that reduces speed of flow yet is still able to flow through an infant teat/nipple. Consideration to flow through a teat/nipple should be determined on a case-by-case basis.

Testing method


IDDSI Flow Test*

Test liquid flows through a 10 mL slip tip syringe leaving 1-4mL in the syringe 10 seconds, leaving no residue (see IDDSI Flow Test instructions*).

1 SLIGHTLY THICK

FOOTER 9



10 Octobre, 2016

Maelezo / Tabia

Kinatiririka kutoka kwenye kijiko

Kinanyweka, kinamiminika haraka kutoka kwenye kijiko, lakini taratibu kuliko kinywaji chembamba

Juhudi inahitajika kunywa kinywaji cha uzito huu kwa kutumia mrija wa kawaida (mrija wa kawaida wenye mzingo wa inchi 0.209 au milimeta 5.3)


Kama vinywaji vyepesi vitatiririka kwa haraka vidhibitiwe kwa usalama, vinywaji vizito kidogo sana vinatiririka kwa mwendo mdogo kidogo

Inafaa ikiwa uwezo wa kuzungusha ulimi umepungua kidogo

Njia ya upimaji



Kimiminika kinatiririka kupitia ncha ya bomba la sindano la mililita 10 na kuacha kiasi cha mililita 4 – 8 ndani ya sekunde 10 (rejea maelekezo ya upimaji wa mtiririko wa IDDSI*).

2 VIZITO KIDOGO



October 10, 2016


Flows off a spoon

Sippable, pours quickly from a spoon, but slower than thin drinks

Effort is required to drink this thickness through standard bore straw (standard bore straw = 0.209 inch or 5.3 mm diameter)


If thin drinks flow too fast to be controlled safely, these Mildly Thick liquids will flow at a slightly slower rate

May be suitable if tongue control is slightly reduced.

Testing method


IDDSI Flow Test*

Test liquid flows through a 10 mL slip tip syringe leaving 4 to 8 ml in the syringe after 10 seconds (see IDDSI Flow Test instructions*)

2 MILDLY THICK

FOOTER 11



10 Octobre, 2016

Maelezo / Tabia

Vinaweza kunywewa kutoka kwenye kikombe

Juhudi inahitajika kunyonya kutoka kwenye bomba la mrija wa kawaida au mrija mpana (mrija mpana = inchi 0.275 au milimeta 6.9)

Haviwezi kunyonywa, kupangwa wala kufinyangwa kwenye sahani

Haviwezi kuliwa kwa kutumia uma kwa sababu kitadondoka kupitia mianya kati ya meno ya uma

Vinaweza kuliwa kwa kutumia kijiko

Havihitaji mchakato wa mdomo wala kutafunwa - vinaweza kumezwa moja kwa moja

Vyepesi bila ‘vipande’ (mabonge, nyuzinyuzi, vipande vya maganda au ngozi, chembe chembe za mifupa mwororo au mfupa migumu)


Kama ulimi hauwezi kumudu vinywaji vizito kidogo (Kiwango cha 2), Kiwango hiki cha Vya Majimaji/Vizito Kiasi kinaweza kufaa

Kinachukuwa muda zaidi mdomoni Kinahitaji juhudi kuzungusha ulimi

Wenye maumivu wakati wa kumeza

Njia ya upimaji

http://iddsi.org/framework/drink-testing-methods/ and

http://iddsi.org/framework/food-testing-methods/


Kimiminika kinatiririka kupitia ncha ya bomba la sindano la mililita 10 na kuacha kiasi cha zaidi ya mililita 8 ndani ya sekunde 10 (rejea maelekezo ya upimaji wa mtiririko wa IDDSI*).

Jaribio la kudondosha matone ya mtiririko wa vyakula kwa uma

Kinadondoka taratibu kupitia mianya kati ya meno ya uma Meno ya uma hayaachi alama safi Kinasambaa kama kikimwagwa kwenye eneo lililo sawasawa

Jaribio la kugeuza kijiko juu chini

Kinamwagika kwa urahisi kutoka kwenye kijiko wakati kimegeuzwa juu chini, hakinganganii kwenye kijiko

Jaribio la vijiti vya kulia

Vijiti vya kulia havifai kwa wororo huu

Jaribio la kidole Haiwezekani kushika sampuli ya chakula hiki kwa kutumia vidole.

Hata hivyo, ukikishika chakula hiki kinapenya kiurahisi kati ya kidole gumba na vidole vingine na kuacha alama za mabaki au

3 VYA MAJIMAJI VIZITO KIASI

KIZITO KIASI

3

http://iddsi.org/framework/food-



October 10, 2016

mnato kwenye vidole ulivyotumia kukishika.

FOOTER 13



10 Octobre, 2016


Can be drunk from a cup

Some effort is required to suck through a standard bore or wide bore straw (wide bore straw = 0.275 inch or 6.9 mm)

Cannot be piped, layered or moulded on a plate

Cannot be eaten with a fork because it drips slowly in dollops through the prongs

Can be eaten with a spoon

No oral processing or chewing required – can be swallowed directly

Smooth texture with no ‘bits’ (lumps, fibers, bits of shell or skin, husk, particles of gristle or bone)


If tongue control is insufficient to manage Mildly Thick drinks (Level 2), this Liquidised/Moderately thick level may be suitable

Allows more time for oral control Needs some tongue propulsion effort Pain on swallowing

Testing method



IDDSI Flow Test*

Test liquid flows through a 10 ml slip tip syringe leaving > 8 ml in the syringe after 10 seconds (see Syringe Test Guide*).

Fork Drip Test

Drips slowly in dollops through the prongs of a fork Tines/prongs of a fork do not leave a clear pattern on the surface Spreads out if spilled onto a flat surface

Spoon Tilt Test Easily pours from spoon when tilted; does not stick to spoon

Chopstick Test Chopsticks are not suitable for this texture

Finger Test It is not possible to hold a sample of this food texture using fingers.

However, this texture slides smoothly and easily between the thumb and fingers, leaving a coating.

3 LIQUIDISED

MODERATELY THICK

3

http://iddsi.org/framework/food-



October 10, 2016

Aina ya vyakula maalum au mifano mingine

(Orodha hii haina kikomo)

Orodha ya vyakula vifuatavyo inaweza kufaa katika kiwango cha 3 cha Upimaji wa IDDSI:

Chakula cha kwanza cha mtoto mchanga (uji wa mchele ama matunda yaliyosagwa)

Mchuzi Maji matamu ya matunda

Jaribio la uma kupima mtiririko wa IDDSI:

Kinadondoka taratibu kwa matone kupitia mianya kati ya meno ya uma

MAJIMAJI VIZITO KIASI

FOOTER 15



10 Octobre, 2016

Food specific or Other examples

(NB. this list is not exhaustive)

The following items may fit into IDDSI Level 3: Infant “first foods” (runny rice cereal or runny pureed fruit) Sauces and gravies Fruit syrup

IDDSI Fork Drip Test:

Drips slowly in dollops through the prongs of a fork



October 10, 2016

Maelezo / Tabia

Kwa kawaida huliwa kwa kijiko (kwa uma inawezekana pia)

Haviwezi kunywewa kwa kikombe

Haviwezi kunyonywa kwa mrija

Havihitaji kutafuna

Vinaweza kuvutwa, kupangwa au kusongwa

Vinatiririka taratibu kwenda chini lakini hakiwezi kumwagika

Vinaanguka kutoka kwenye kijiko kikiinamishwa chini na kinaendelea kushikilia sura yake kwenye sahani

Hakuna mabonge

Havinati

Sehemu ya maji haitengani na sehemu ngumu ya chakula


Kama udhibiti wa ulimi umepungua kwa kiasi kikubwa, kiwango hiki kinaweza kuwa rahisi kumudu

Kinahitaji nguvu kidogo ya kuinua ulimi kuliko kwa vyakula Vilichosagwa na Vitepe (kiwango cha 5), Laini na Ukubwa wa Tonge la Kung’ata (kiwango cha 6) na Vya Kawaida (kiwango cha 7), lakini zaidi kuliko Vya Majimaji/Vizito Kiasi (kiwango cha 3)

Hakihitaji kung’ata wala kutafuna Kuongezeka kwa mabaki ni hatari kama kinanata Chakula chochote kinachohitaji kutafunwa, kukusanywa na

kutengeneza tonge hakifai Wenye maumivu wakati wa kutafuna au kumeza Wenye mapengo, meno bandia yasiyotosha vizuri

Njia ya upimaji




Hakuna mtiririko au matone kupitia ncha ya bomba la sindano la mililita 10 baada ya sekunde 10 (rejea maelekezo ya upimaji wa mtiririko wa IDDSI*).

4 VILIVYOPONDWAPONDWA

VIZITO SANA

4

FOOTER 17



10 Octobre, 2016


Usually eaten with a spoon (a fork is possible)

Cannot be drunk from a cup

Cannot be sucked through a straw

Does not require chewing

Can be piped, layered or molded

Shows some very slow movement under gravity but cannot be poured

Falls off spoon in a single spoonful when tilted and continues to hold shape on a plate

No lumps

Not sticky

Liquid must not separate from solid


If tongue control is significantly reduced, this category may be easiest to manage

Requires less propulsion effort than Minced & Minced (level 5), Soft & Bite-‐‐Sized (Level 6) and Regular (Level 7) but more than Liquidised/Moderately thick (Level 3)

No biting or chewing is required Increased residue is a risk if too sticky Any food that requires chewing, controlled manipulation or bolus

formation are not suitable

Pain on chewing or swallowing Missing teeth, poorly fitting dentures

Testing method



IDDSI Flow Test*

No flow or drip through a slip tip syringe after 10 sec (refer to IDDSI Flow test instructions)*

4 PUREED

EXTREMELY THICK 4



October 10, 2016

Jaribio la mgandamizo wa uma

Meno ya uma yanaweza kuacha alama ya michirizi ya umbo la uma juu ya uso wa chakula na/au kubaki na alama ya mgandamizo kutoka kwenye uma

Hakuna mabonge

Jaribio la kudondosha matone kwa uma

Sampuli inakaa kama mlima/rundo juu ya uma, kiasi kidogo kinaweza kupita kati ya mianya ya meno ya uma na kuunda kitu kama mkia, lakini hakiwezi kupita kati ya mianya ya meno ya uma au kuendelea kudondoka


Kinadondoka kwa urahisi kutoka kwenye kijiko kikigeuzwa juu chini, hakigandi kwenye kijiko


Vijiti vya kulia havifai kwa wororo huu

Jaribio la vidole Haiwezekani kushika sampuli ya vyakula hivi kwa vidole. Hata

hivyo, wororo huu unateleza kwa urahisi kati ya kidole gumba na vidole vingine na kuacha alama ya mabaki ya chakula

Viashiria kuwa sampuli ni nzito sana

Hakidondoki kutoka kwenye kijiko kikigeuzwa juu chini

Vyakula maalumu au mifano mingine

Aina zifuatazo zinaweza kuwa zinafaa kwa kiwango cha 4 cha IDDSI: Vilichopondwapondwa vinafaa kwa watoto wachanga (kwa mfano,

nyama ya kusaga, uji mzito)

IDDSI Jaribio la kuangusha matone kwa uma:

Jaribio la kugeuza kijiko juu chini: Chakula kinabaki na umbo lake kwenye kijiko; sio imara na hakinati; chakula kidogo kinabaki kwenye kijiko

Kiasi kidogo kinaweza kupita na kuunda kitu kama mkia chini ya uma Hakiundi donge, hakipiti, hakitiririki wala kuendelea kudondoka

kupitia mianya ya meno ya uma

Kinakaa kama mlima au lundo juu ya uma

FOOTER 19



10 Octobre, 2016

Fork Pressure Test The tines/prongs of a fork can make a clear pattern on the surface,

and/or the food retains the indentation from the fork

No lumps

Fork Drip Test Sample sits in a mound/pile above the fork; a small amount may

flow through and form a tail below the fork tines/prongs, but it does not flow or drop continuously through the prongs of a fork

Spoon Tilt Test Easily pours from spoon when tilted; does not stick to spoon

Chopstick Test Chopsticks are not suitable for this texture

Finger Test It is not possible to hold a sample of this food texture using fingers.

However, this texture slides smoothly and easily between the thumb and fingers, leaving a coating.

Indicators that a sample is too thick

Does not fall off the spoon when tilted Sticks to spoon

Specific Food or other examples

The following items may be suitable for IDDSI Level 4: Purees suitable for infants (e.g., pureed meat, thick cereal)

IDDSI Fork Drip Test:

Sits in a mound or

pile above the fork

A small amount may flow through and form a tail below the fork Does not dollop, flow or drip continuously through the fork prongs

Spoon Tilt Test: Holds shape on spoon; not firm and sticky; little food left on spoon



October 10, 2016

Maelezo / Tabia

Vinaweza kuliwa kwa kijiko

Mara nyingine vinaweza kuliwa na vijiti vya kulia, ikiwa mtu anaweza kumudu kutumia mikono

Vinaweza kuchotwa na kuumbwa (mfano wa umbo la mpira) kwenye sahani

Laini na vitepe bila majimaji pembeni

Mabonge madogo dogo yanayoonekana kwenye chakula (ukubwa wa milimeta 2-4 kwa watoto; milimeta 4 kwa watu wazima)

Ni rahisi kusaga mabonge kwa ulimi


Havihitaji kung’ata Vinahitaji kutafunwa kidogo Nguvu ya ulimi peke yake inaweza kutumika kuvunja vipande

vidogo laini vya wororo huu Nguvu ya ulimi inahitajika kusukuma tonge Wenye maumivu au uchovu wakati wa kutafuna

Wenye mapengo au meno bandia yasiyotosha vizuri

Njia ya upimaji


Jaribio la mgandamizo wa uma

Vikigandamizwa na uma vipande vinapita kwa urahisi katikati ya mianya ya meno ya uma

Vinaweza kusagwa kwa urahisi na mgandamizo mdogo wa uma (shinikizo halitakiwi kufanya ukucha wa dole gumba kupauka kuwa mweupe)

Jaribio la kudondosha matone kwa uma

Sampuli iliyochotwa inakaa kama bonge au mlima kwenye uma na haiwezi kupita kwa urahisi au kuendelea kutiririka kati ya mianya ya meno ya uma


Kina mshikamano wa kutosha kushikilia sura yake kwenye kijiko

Kijiko kilichojaa lazima kidondoke kama kikigeuzwa juu chini, kikigeuzwa kwa upande, ama kikitingishwa kidogo; sampuli lazima iteremke kwa urahisi na kuacha chakula kidogo sana kwenye kijiko, yaani sampuli haipaswi kunata

Kiasi kilichochotwa kinaweza kusambaa ama kushuka kidogo sana kwenye sahani


Vijiti vya kulia vinaweza kutumika kuchotea au kushikilia wororo huu ikiwa sampuli ina unyevu na imeshikamana na mtu anaweza kumudu kutumia vijiti vya kulia

5 VILIVYOSAGWA NA VITEPE

FOOTER 21



10 Octobre, 2016

Jaribio la vidole

Ni rahisi kushika sampuli ya wororo huu kwa kutumia vidole; ndogo laini, chembe za mviringo zinaweza kusagwa kwa urahisi kwa vidole. Chakula hiki kitapelekea hisia ya unyevu na alama ya majimaji kwenye vidole.



October 10, 2016


Can be eaten with a fork or spoon

Could be eaten with chopsticks in some cases, if the individual has very good hand control

Can be scooped and shaped (e.g. into a ball shape) on a plate

Soft and moist with no separate thin liquid

Small lumps visible within the food (Paediatric 2-4 mm; adult 4mm)

Lumps are easy to squash with tongue


Biting is not required Minimal chewing is required Tongue force alone can be used to break soft small particles

inthis texture

Tongue force is required to move the bolus Pain or fatigue on chewing Missing teeth, poorly fitting dentures

Testing method


Fork Pressure Test

When pressed with a fork the particles should easily be separated between and come through the tines/prongs of a fork

Can be easily mashed with little pressure from a fork [pressure should not make the thumb nail blanch to white]

Fork Drip Test A scooped sample sits in a pile or can mound on the fork and does

not easily or completely flow or fall through the tines/prongs of a fork

Spoon Tilt Test

Cohesive enough to hold its shape on the spoon A full spoonful must slide/pour off the spoon if the spoon is tilted

or turned sideways or shaken lightly; the sample should slide off easily with very little food left on the spoon; i.e. the sample should not be sticky

A scooped mound may spread or slump very slightly on a plate

Chopstick Test Chopsticks can be used to scoop or hold this texture if the sample

is moist and cohesive and the person has very good hand control to use chopsticks

Finger Test It is possible to easily hold a sample of this texture using fingers;

small soft, smooth, rounded particles can be easily squashed between fingers. The material will feel moist and leave fingers wet.

5 MINCED AND MOIST

FOOTER 23



10 Octobre, 2016

Vyakula maalumu au mifano mingine:

NYAMA

Iliyosagwa laini sana au kukatwa vipande vidogovidogo sana, msago laini

(vipande ukubwa wa milimeta 2-4)

Hutumika na mchuzi mzito sana, laini na ambao haumiminiki

Kama wororo huu hauwezi kusagwa na kuwa laini inatakiwa upondwepondwe

SAMAKI

Iliyopondwa kwenye sosi au mchuzi laini na mzito sana usiomiminika

TUNDA

Hudumia tunda lililopondwapondwa

Chuja majimaji ya matunda ya ziada

NAFAKA

Nzito sana na laini yenye mabonge laini (milimeta 2-4)

Wororo uliolainishwa kikamilifu

Maziwa ama maji yeyote yanatakiwa yasitengane na nafaka. Chuja maji ya

ziada kabla ya kuhudumia

MKATE

Mkate wenye jeli au ulioloana ambao una unyevu sana na umechovywa

kwenye jeli

Usitumie mkate wa kawaida wala mkate mkavu isipokuwa kwa ushauri wa

mtaalamu wa mambo ya matatizo ya kumeza

MCHELE

Sio wakunata au wa kuganda (hasa mchele mfupi) na usiwe na chembechembe

mojamoja ambazo zimetengana wakati ukipikwa na kupakuliwa (haswa mchele

mrefu)

Tumia nafasi kati ya mianya ya meno ya uma kuamua kama vipande vilivyosagwa ni sawa au si sawa na (kwa

watoto kiasi cha milimeta 2 hadi 4, milimeta 4 kwa watu wazima)



October 10, 2016

Specific Foods or Other examples:

MEAT

Finely minced or chopped, tender mince (pieces 2-4 mm)

Serve in extremely thick, smooth, non-pouring sauce or gravy

If texture cannot be finely minced it should be pureed

FISH

Finely mashed in extremely thick smooth, non-pouring sauce or gravy

FRUIT

Serve mashed

Drain excess juice

CEREAL

Very thick and smooth with small (2-4 mm) soft lumps

Texture fully softened

Any milk/fluid must not separate away from cereal. Drain any excess fluid

before serving

BREAD

Pre-gelled or slurried breads that are very moist and gelled through the entire

thickness

No regular, dry bread unless recommended by a dysphagia specialist

RICE

Not sticky or glutinous (particularly short grain rice) and should not be

particulate or separate into individual grains when cooked and served

(particularly long grain rice)

Use slot between fork prongs to determine whether minced pieces are the correct or incorrect size (pediatric 2 to

4 mm; adult 4 mm).

FOOTER 25



10 Octobre, 2016

Maelezo / Tabia

Vinaweza kuliwa kwa uma

Vinaweza kusagwa/kuvunjwavunjwa kwa mgandamizo wa uma, kijiko au vijiti vya kulia

Visu havihitajiki kukata vyakula hivi, lakini vinaweza kutumika kujazia uma au kijiko

Kutafuna kunahitajika kabla ya kumeza

Laini na vitepe bila kutofautisha sehemu ya majimaji na sehemu ngumu ya chakula

Vipande vya ukubwa wa kiwango cha tonge kufuatana na uwezo wa kutafuna

Watoto,

Watu wazima vipande ukubwa wa milimeta 15 = sentimeta 1.5


Havihitaji kung'ata Vinahitaji kutafunwa Nguvu ya ulimi inahitajika kuzungusha chakula kwa ajili ya

kutafuna na kuweka chakula mdomoni wakati wa kutafuna Ulimi unahitajika kuzungusha tonge kwa ajili ya kumeza

Wenye maumivu au uchovu wa kutafuna Wenye mapengo au meno bandia yasiyoyotosha vizuri

Njia ya upimaji


Jaribio la mgandamizo wa uma Mgandamizo kutoka kwenye uma ulioshikwa kwa upande unaweza kutumika kukata wororo huu vipande vidogo vidogo

Wakati sampuli ya chakula yenye ukubwa wa kidole gumba (kama sentimeta 1.5 kwa sentimeta 1.5) inagandamizwa kwa kutumia mgongo wa uma kiasi kwamba kidole gumba kinapauka na kuwa cheupe, sampuli inasagika na kubalika umbo, na hairudii katika umbo lake la awali wakati uma umeondolewa

Jaribio la mgandamizo wa kijiko

Mgandamizo kutoka kwenye kijiko kilichoshikwa kwa upande kinaweza kutumika kukata wororo huu vipande vidogo vidogo

Wakati sampuli yenye ukubwa wa kidole gumba (kama sentimeta 1.5 kwa sentimeta 1.5 cm) inagandamizwa na mgongo wa kijiko, sampuli inapondeka na kubadilika umbo, na hairudii katika umbo lake la awali wakati kijiko kimeondolewa


Vijiti vya kulia vinaweza kutuma kuvunja wororo huu katika vipande vidogo vidogo

LAINI NA UKUBWA WA TONGE LA KUNG’ATA

6



October 10, 2016

Jaribio la vidole

Tumia sampuli yenye ukubwa wa kidole gumba (kama sentimeta 1.5 kwa sentimeta 1.5). Inawezekana kusaga sampuli ya wororo huu kwa kutumia mgandamizo wa vidole kiasi kwamba kidole gumba na vidole vingine vinapauka kuwa vyeupe. Sampuli haitarudia umbo lake la awali wakati umeacha kugandamiza.


NYAMA

Nyama iliyopikwa, laini isiyozidi ukubwa wa sentimeta 1.5 kwa sentimeta 1.5

Kama haiwezi kuhudumiwa kwa wororo huu hauwezi katika ukubwa wa sentimeta 1.5 kwa

sentimeta 1.5, hudumia iliyosagwa na yenye unyevunyevu

SAMAKI

Samaki iliyopikwa laini ya kutosha kuvunjwa vipande vidogo vidogo kwa uma, kijiko na vijiti vya kulia

Hakikisha hakuna mifupa

MSETO/MCHUZI/SOSI

Mchuzi lazima uwe mzito

Unaweza kuwa na nyama, samaki ama mbogamboga kama baada ya kupikwa ni laini vipande havizidi

ukubwa wa sentimeta 1.5 kwa sentimeta 1.5

Hakikisha hakuna mabonge makubwa

MATUNDA

Tumia yaliyosagwa

Sehemu ya kambakamba ya tunda haifai

Chuja juisi ya ziada

Tathmini uwezo wa mtu kula matunda yenye maji mengi (mfano tikiti maji) ambapo juisi inatengana

na sehemu ngumu ya tunda mdomoni wakati wa kutafuna

MBOGAMBOGA

Mbogamboga zilizopikwa kwa mvuke au kuchemshwa zenye ukubwa wa Sentimeta 1.5 kwa

sentimeta 1.5 baada ya kupikwa

Mbogamboga za kukaanga mara nyingi huwa ngumu na sio laini

NAFAKA

Nyororo na yenye mabonge laini yasiyozidi ukubwa wa sentimeta 1.5 kwa sentimeta 1.5 inakubalika

wororo umelainishwa kikamilifu

Maji ya ziada lazima yakaushwe

MKATE

Hakuna kutumia mkate mpaka mtu amefanyiwa tathmini na mtaalamu wa matatizo ya kumeza kuona kwamba inafaa, kwa misingi ya mtu binafsi

MCHELE

Usiwe na chembechembe /chenga, wa kunata au wa kuganda

Ukucha wa kidole gumba unapauka kuwa mweupe

Sampuli inasagwa na hairudii sura yake ya awali wakati mgandamizo umeondolewa au wakati

umeacha kugandamiza

FOOTER 27



10 Octobre, 2016



October 10, 2016


Can be eaten with a fork

Can be mashed/broken down with pressure from fork, spoon or

chopsticks

A knife is not required to cut this food, but may be used to help

loading a fork or spoon

Chewing is required before swallowing

Soft, tender and moist throughout but with no separate thin liquid

‘Bite sized’ pieces as appropriate for size and oral processing skills

Paediatric,

Adults, 15 mm = 1.5 cm pieces


Biting is not required

Chewing is required Tongue force and control is required to move the food for

chewing and to keep it within the mouth during chewing

Tongue force is required to move the bolus for swallowing

Pain or fatigue on chewing Missing teeth, poorly fitting dentures

Testing method


Fork Pressure Test

Pressure from a fork held on its side can be used to ‘cut’ or break this texture into smaller pieces

When a sample the size of a thumb nail (~1.5x1.5 cm) is pressed with the base of a fork to a pressure where the thumb nail blanches to white, the sample squashes and changes shape, and does not return to its original shape when the fork is removed

Spoon Pressure Test

Pressure from a spoon held on its side can be used to ‘cut’ or break this texture into smaller pieces.

When a sample the size of a thumb nail (~1.5 cm x1.5 cm) is pressed with the bowl of a spoon, the sample squashes and changes shape, and does not return to its original shape when the spoon is removed

Chopstick Test

Chopsticks can be used to break this texture into smaller pieces

SOFT AND BITE-SIZED

6

FOOTER 29



10 Octobre, 2016

Finger Test

Use a sample the size of the thumb nail (~1.5 cm x 1.5 cm). It is possible to squash a sample of this texture using finger pressure such that the thumb and index finger nails blanch to white. The sample will not return to its initial shape once pressure is released.

Specific Food or Other examples:

MEAT

Cooked, tender meat no bigger than 1.5 cm x 1.5 cm

If texture cannot be served soft and tender at 1.5 cm x 1.5 cm, serve minced and moist

FISH

Soft enough cooked fish to break into small pieces with fork, spoon or chopsticks

No bones

CASSEROLE/STEW/CURRY

Liquid portion must be thick

Can contain meat, fish or vegetables if final cooked pieces are nolarger than 1.5 cm x 1.5 cm and are

soft and tender

No hard lumps

FRUIT

Serve mashed

Fibrous parts of fruit are not suitable

Drain excess juice

Assess individual ability to manage fruit with high water content (e.g. watermelon) where juice

separates from solid in the mouth during chewing

VEGETABLES

Steamed or boiled vegetables with final cooked size of 1.5cmx1.5cm

Stir fried vegetables are often too firm and not soft or tender

CEREAL

Smooth with soft tender lumps no bigger than 1.5 cm acceptable

Texture fully softened

Any excess milk or fluid must drained

BREAD

No bread unless assessed as suitable by dysphagia specialist, on an individual basis RICE

Not particulate/grainy, sticky or glutinous

Thumb nail blanched to white

Sample squashes and does not return to its

original shape when pressure is released



October 10, 2016

Maelezo / Tabia

Vyakula vya kawaida, vyakula vya kila siku vya mifumo mbalimbali ambayo vinafaa kimaendeleo na kwa umri sawia

Mbinu yeyote inaweza kutumika kwa kula vyakula hivi

Vyakula vinaweza kuwa vigumu, vya kutafunika ama laini kiasilia

Ukubwa wa sampuli ya ngazi ya 7 hauna vipingamizi, kwa hiyo vyakula vinaweza kuwa na ukubwa mbalimbali

Vipande vidogo au vikubwa kuliko milimeta 8 (Watoto)

Vipande vidogo au vikubwa kuliko milimeta 15 sawa na sentimeta 1.5 (Watu wazima)

Hakuna vikwazo vya wororo katika ngazi hii

Ni pamoja na vipande vigumu, vya kutafunika, vyenye nyuzinyuzi, vikavu, au vinavyomeguka

Ni pamoja na vyakula ambavyo vina mbegu, nyuzinyuzi ndani ya ngozi, magamba au mifupa

Ni pamoja na vyakula na vinywaji vya namna mbili ama namna ya mchanganyiko

Mantiki inayofaa kwa kiwango hiki cha uzito

Uwezo wa kung'ata vyakula vigumu au laini na kutafuna kwa muda wa kutosha kiasi kwamba kuunda mshikamano laini kama tonge ambalo liko tayari kumezwa

Uwezo wa kutafuna vyakula vya mifumo yote bila kuchoka kiurahisi

Uwezo wa kuondoa mfupa au mifupa laini mdomoni ambayo haiwezi kumezwa kwa usalama

Njia ya upimaji

Haihusiani

VYA KAWAIDA

7

FOOTER 31



10 Octobre, 2016


Normal, everyday foods of various textures that are developmentally and age appropriate

Any method may be used to eat these foods

Foods may be hard and crunchy or naturally soft

Sample size is not restricted at Level 7, therefore, foods may be of a range of sizes

Smaller or greater than 8mm pieces (Paediatric)

Smaller or greater than 15 mm = 1.5 cm pieces (Adults)

There are NO texture restrictions at this level

Includes hard, tough, chewy, fibrous, stringy, dry, crispy, crunchy, or crumbly bits

Includes food that contains pips, seeds, pith inside skin, husks or bones

Includes ‘dual consistency’ or ‘mixed consistency’ foods and liquids


Ability to bite hard or soft foods and chew them for long enough that they form a soft cohesive ball/bolus that is ‘swallow ready’

An ability to chew all food textures without tiring easily An ability to remove bone or gristle that cannot be swallowing

safely from the mouth

Testing method

Not applicable

REGULAR

7



October 10, 2016

Maelezo / Tabia

Vyakula ambavyo vinaanza kama wororo fulani (mfano kigumu) halafu vinabadilika kuwa wororo mwingine hasa wakati vina unyevu (mfano maji au mate yametumika), au wakati mabadiliko ya hali ya joto yametokea (mfano kupasha joto)


Havihitaji kung'ata Vinahitaji kutafunwa kidogo

Ulimi unaweza kutumika kuvunja vyakula hivi mara joto linapobadilika au kwa kuongeza unyevu/mate

Inaweza kutumika kwa ajili ya kufuatilia maendeleo au ujuzi wa kutafuna upya (mfano maendeleo ya kutafuna kwa watoto na walemavu , kujifunza tena kutafuna baada ya kiharusi

Njia ya upimaji


Jaribio la mgandamizo wa uma Baada ya unyevu au joto kutumika, sampuli inaweza kuharibiwa sura kwa urahisi na bila kurudia sura yake ya awali wakati unapoacha kugandamiza na uma.

Tumia sampuli yenye ukubwa wa ukucha wa kidole gumba (makadirio ya sentimeta 1.5 kwa sentimeta 1.5), Weka maji mililita 1 kwenye sampuli na kusubiri dakika moja. Gandamiza kwa kutumia mgongo wa uma mpaka kidole gumba kipauke na kuwa cheupe. Sampuli ni ya chakula cha mpito ikiwa baada ya kuondoa mgandamizo wa uma au ukiacha kugandamiza na uma:

Sampuli imepondwa na kusambaratika na haionekani katika sura yake ya awali.

Au imeyeyuka kwa kiasi kikubwa na haionekani tena katika sura yake ya awali (mfano vipande cha barafu).

Jaribio la kugangamiza na kijiko

Kama hapo juu, tumia mgongo wa kijiko badala ya uma.


Tumia sampuli yenye ukubwa wa ukucha wa kidole gumba (makadirio ya sentimeta 1.5 kwa sentimeta 1.5), weka maji mililita 1 kwenye sampuli na usubiri dakika moja. Sampuli inatakiwa ivunjike kwa urahisi kwa kutumia vijiti vya kulia kwa kugandamiza kidogo.

Jaribio la vidole

Tumia sampuli yenye ukubwa wa ukucha wa kidole gumba (makadirio ya sentimeta 1.5 kwa sentimeta 1.5), weka maji kwenye sampuli na usubiri dakika moja. Sampuli itasambaratika kabisa kwa kusugua sampuli kati ya kidole gumba na kidole cha kunyooshea. Sampuli haitarudia sura yake ya mwanzo.

VYAKULA VYA MPITO

FOOTER 33



10 Octobre, 2016


Food that starts as one texture (e.g. firm solid) and changes into another texture specifically when moisture (e.g. water or saliva) is applied, or when a change in temperature occurs (e.g. heating)


Biting not required Minimal chewing required Tongue can be used to break these foods once altered by

temperature or with addition of moisture/saliva May be used for developmental teaching or rehabilitation of chewing skills (e.g. development of chewing in the paediatric population and developmental disability population; rehabilitation of chewing function post stroke)

Testing method


Fork Pressure Test

After moisture or temperature has been applied, the sample can be easily deformed and does not recover its shape when the force is lifted

Use a sample the size of the thumb nail (~1.5 cm x 1.5 cm), place 1 ml of water on the sample and wait one minute. Apply fork pressure using the base of the fork until the thumbnail blanches to white. The sample is a transitional food texture if after removing the fork pressure:

The sample has been squashed and disintegrated and no longer looks like its original state

Or it has melted significantly and no longer looks like its original state (e.g. ice chips).

Spoon Pressure Test As above, using the bowl of the spoon in place of the fork

Chopstick Test

Use a sample the size of the thumb nail (~1.5 cm x 1.5 cm), place 1 ml of water on the sample and wait one minute. The sample should be easily broken apart using chopsticks with minimal pressure

Finger Test

Use a sample the size of the thumb nail (~1.5 cm x 1.5 cm), place1 ml of water on the sample and wait one minute. The sample will break apart completely by rubbing the sample between the thumb and index finger. The sample will not return to its initial shape.

TRANSITIONAL FOODS



October 10, 2016


Wororo huu ni pamoja na, na sio tu:

Vipande vya barafu

Barafu kama imefanyiwa tathmini na mtaalamu wa mambo ya kumeza na inafaa

Kipande cha jeli ya kijapani ya mafunzo ya kumeza ukubwa wa milimeta 1 kwa milimeta 15

Mkate (pia ni pamoja na mkate wa kushiriki wa kidini)

Mkate wa unaotumika kushikilia barafu

Baadhi ya biskuti

Chipsi za viazi – aina ya kusagika tu (mfano Pringles ambazo ni chipsi zilizotegenezwa kwa mchanganyiko wa

unga wa viazi na ngano)

Biskuti

Chipsi zenye ladha ya samaki kamba

Mifano maalumu inayotumika kwa watoto au watu wazima kudhibiti matatizo ya kumeza

Vyakula vinavyopatikana kibiashara ambavyo ni vya wororo wa mpito vimeonyeshwa katika picha hapa chini ni

pamoja na, na sio tu:

:

Veggie StixTM

Cheeto PuffsTM

Rice PuffsTM

Baby Mum MumsTM

Gerber Graduate PuffsTM

Mifano ya vyakula vya mpito

Cheese puffs

Wafers

Mifano ya vyakula vya mpito

Cheese puffs

Wafers

Kipande cha jeli ya kijapani ya mafunzo ya kumeza – tambua ukubwa umekatwa wa milimeta 1 kwa milimeta 15

http://image.rakuten.co.jp/iryosyoku/cabinet/03511530/03511532/img59981825.jpg

Ukucha wa kidole gumba umepauka kuwa mweupe

Sampuli imesagwa na kuvunjika, na hairudii sura yake ya awali mgandamizo ukiondolewa au unapoacha

kugandamiza

FOOTER 35



10 Octobre, 2016

Specific Food or Other examples

This texture may include and is not limited to:

Ice chips

Ice cream/Sherbet if assessed as suitable by a Dysphagia specialist

Japanese Dysphagia Training Jelly sliced 1 mm x 15 mm

Wafers (also includes Religious Communion wafer)

Waffle cones used to hold ice cream

Some biscuits/ cookies/ crackers

Potato crisps – only the mashed type (e.g. Pringles)

Shortbread

Prawn crisps

Specific examples used in paediatric or adult disability dysphagia management

Commercially available foods that are transitional foods textures are shown in pictures below and include but are

not limited to:

Veggie StixTM

Cheeto PuffsTM

Rice PuffsTM

Baby Mum MumsTM

Gerber Graduate PuffsTM

Transitional food examples

Cheese puffs

Wafers

Transitional food examples

Cheese puffs

Wafers

Example of Japanese dysphagia training jelly - note size has been cut to 1mm x 15 mm

http://image.rakuten.co.jp/iryosyoku/cabinet/03511530/03511532/img59981825.jpg



October 10, 2016

Thumb nail blanched to white

Sample squashes and fractures, and does not return to its original shape when pressure is released

Documents

Alice Temu, PhD, RD - IDDSIiddsi.org/wp-content/uploads/2017/06/Swahili... · chepesi sana K inatiririka kwenye mrija, ncha ya bomba la sindano, chuchu Sawa na uzito wa maziwa ya