Other Titles
Factors Associated with Choking Among Patients with Schizophrenia in Psychiatric Inpatient Settings: A Case-Control Study [Title Slide]
Abstract
Background: Choking risks include advanced age, swallowing disorders, poor dental health, rapid eating, and large bites, especially in older adults and those with intellectual disabilities. Protective factors are adequate chewing and slower eating. More research is needed on psychiatric inpatients, especially those with schizophrenia.
Purpose: This study aimed to identify factors related to choking in psychiatric inpatients with schizophrenia.
Methods: A total of 250 participants were recruited from a psychiatric institution in Northern Taiwan. The case group comprised 50 high choking-risk participants, identified by a history of choking and a Choking Risk Assessment (CRA) score above 20 or a “Yes” on the Choking Screening Assessment (CSA). Control participants were matched by sex and age.
Data was collected through interviews, observations, and medical record reviews, using tools such as the Eating Assessment Tool (EAT-10), Mini Nutritional Assessment (MNA®), Oral Health Assessment Tool (OHAT), Chinese Montreal Cognitive Assessment (MoCA), Repetitive Saliva Swallowing Test (RSST), and Simpson–Angus Scale (SAS). The CRA is a 10-item tool assessing swallowing and choking risks, while the CSA provides a screening checklist and guidance for managing choking risk. Statistical analyses included chi-square tests, t-tests, and stepwise logistic regression to identify choking risk factors.
Results: The study found factors related to choking risk, such as EAT-10, MNA, OHAT, MoCA, diet type, chewing count, RSST, and SAS. Risk factors included high EAT-10 scores and poor oral health, while protective factors included high MNA scores and increased chewing counts.
Linear regression analysis revealed no multicollinearity, with variance inflation factors < 3. The Hosmer–Lemeshow test confirmed adequate model fit. Stepwise logistic regression identified four significant predictors: EAT-10 (odds ratio [OR] = 10.831, p < .001), MNA® (OR = 0.578, p = .021), chewing count (OR = 0.803, p = .011), and SAS (OR = 3.221, p < .001).
Conclusions and Implications: This study identified EAT-10, MNA®, chewing count, and SAS as predictors of choking in psychiatric inpatients with schizophrenia. Poor swallowing function and extrapyramidal symptoms increase choking risk, while good nutritional status and chewing ability offer protection. Routine screening with EAT-10 and SAS could enhance patient safety by preventing choking incidents.
Notes
Reference list attached as separate document.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Case-Control Study
Research Approach
Quantitative Research
Keywords:
Acute Care, Choking Predictors, Schizophrenia, People with Schizophrenia, Asphyxia, Risk Assessment, Risk Factors
Recommended Citation
Tsung, Ying-Jyun and Yang, Chiu-Yueh, "Predictors of Choking in People with Schizophrenia in a Psychiatric Hospital: A Case-Control Study" (2026). International Nursing Research Congress (INRC). 138.
https://www.sigmarepository.org/inrc/2026/presentations_2026/138
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-06
Predictors of Choking in People with Schizophrenia in a Psychiatric Hospital: A Case-Control Study
Toronto, Ontario, Canada
Background: Choking risks include advanced age, swallowing disorders, poor dental health, rapid eating, and large bites, especially in older adults and those with intellectual disabilities. Protective factors are adequate chewing and slower eating. More research is needed on psychiatric inpatients, especially those with schizophrenia.
Purpose: This study aimed to identify factors related to choking in psychiatric inpatients with schizophrenia.
Methods: A total of 250 participants were recruited from a psychiatric institution in Northern Taiwan. The case group comprised 50 high choking-risk participants, identified by a history of choking and a Choking Risk Assessment (CRA) score above 20 or a “Yes” on the Choking Screening Assessment (CSA). Control participants were matched by sex and age.
Data was collected through interviews, observations, and medical record reviews, using tools such as the Eating Assessment Tool (EAT-10), Mini Nutritional Assessment (MNA®), Oral Health Assessment Tool (OHAT), Chinese Montreal Cognitive Assessment (MoCA), Repetitive Saliva Swallowing Test (RSST), and Simpson–Angus Scale (SAS). The CRA is a 10-item tool assessing swallowing and choking risks, while the CSA provides a screening checklist and guidance for managing choking risk. Statistical analyses included chi-square tests, t-tests, and stepwise logistic regression to identify choking risk factors.
Results: The study found factors related to choking risk, such as EAT-10, MNA, OHAT, MoCA, diet type, chewing count, RSST, and SAS. Risk factors included high EAT-10 scores and poor oral health, while protective factors included high MNA scores and increased chewing counts.
Linear regression analysis revealed no multicollinearity, with variance inflation factors < 3. The Hosmer–Lemeshow test confirmed adequate model fit. Stepwise logistic regression identified four significant predictors: EAT-10 (odds ratio [OR] = 10.831, p < .001), MNA® (OR = 0.578, p = .021), chewing count (OR = 0.803, p = .011), and SAS (OR = 3.221, p < .001).
Conclusions and Implications: This study identified EAT-10, MNA®, chewing count, and SAS as predictors of choking in psychiatric inpatients with schizophrenia. Poor swallowing function and extrapyramidal symptoms increase choking risk, while good nutritional status and chewing ability offer protection. Routine screening with EAT-10 and SAS could enhance patient safety by preventing choking incidents.
Description
This study investigated the predictors of choking among psychiatric inpatients with schizophrenia. Among 250 participants, logistic regression identified four key predictors: higher EAT-10 and SAS scores increased choking risk, whereas higher MNA® scores and greater chewing count were protective. These findings emphasize the need for routine swallowing, nutritional, and medication assessments to enhance patient safety in psychiatric nursing care.