蒙臺梭利方法干預對老年癡呆患者進食能力的影響
發(fā)布時間：2019-03-15 13:11
【摘要】：目的1.漢化英文版進食行為量表(Eating behavior scale,EBS),評價簡體中文版EBS的測量性能,為本研究提供特異性測量工具,并豐富我國大陸地區(qū)老年癡呆患者進食能力評估工具。2.設計蒙臺梭利方法干預方案并實施,評價其對改善老年癡呆患者進食能力的效果。方法1.進食行為量表漢化及性能評價獲取量表漢化授權(quán)后,采用Lee等的直譯-回譯模式翻譯英文版EBS,通過咨詢5名專家和預調(diào)查30例患者調(diào)適量表條目,最后將簡體中文版EBS應用于100例符合標準的老年癡呆患者中,以Cronbach’sɑ系數(shù)、Guttman Spilt折半系數(shù)以及重測信度評價其信度,以內(nèi)容效度以及效標關(guān)聯(lián)效度(簡體中文版愛丁堡癡呆進食評估量表為效標)評價其效度,以項目分析評價其區(qū)分度。2.干預為單因素重復測量設計的類試驗性研究。依據(jù)“國際功能、殘疾和健康分類”理論和蒙臺梭利方法,采用現(xiàn)狀調(diào)查、文獻回顧、專家咨詢、預試驗以及課題小組討論方法,設計蒙臺梭利方法干預方案。選取符合標準的河南省某養(yǎng)老院和鄭州市某老年公寓10個樓層內(nèi)64例患者,按照患者數(shù)量由多到少對樓層排序,對兩相鄰序號樓層抽簽,隨機分為實驗組和對照組,各32例。對實驗組患者實施每周2次、共8周的蒙臺梭利方法干預,對照組患者僅為常規(guī)照護。收集干預前、干預結(jié)束時、干預結(jié)束后1個月及3個月患者的EBS得分、EdFED得分和自主進食時間。采用SPSS17.0分析資料。分類資料描述采用頻數(shù)、構(gòu)成比,計量資料描述采用均數(shù)、標準差、中位數(shù)、四分位數(shù);兩組基線資料統(tǒng)計推斷,計量資料采用t檢驗或秩和檢驗,分類資料采用2χ檢驗;兩組干預前后四個時間點比較,資料滿足正態(tài)分布和方差齊性,采用重復測量方差分析,不滿足者采用廣義估計方程。結(jié)果1.進食行為量表漢化及性能評價簡體中文版EBS各條目與總分的相關(guān)系數(shù)為0.420~0.729(P0.001),均大于0.4,各條目的決斷值為6.360~16.464,均大于3.0,區(qū)分度良好(P0.001);量表Cronbach’sα系數(shù)為0.842,Guttman Spilt折半系數(shù)為0.865,重測信度為0.840,信度良好;條目水平內(nèi)容效度(I-CVI)均為1.00,量表水平內(nèi)容效度(S-CVI)為1.00,效標關(guān)聯(lián)效度為0.727,效度良好。2.干預64例患者中,4例因死亡或合并其他疾病失訪(流失率6.25%),最終對照組31例,實驗組29例。(1)干預8周后,實驗組患者EBS得分由(12.94±3.62)分提高為(14.31±2.63)分,EdFED得分由(9.79±4.16)分降低為(7.86±4.16)分,自主進食時間由(16.73±6.84)min增加至(21.44±7.17)min。(2)干預后兩組比較,實驗組EBS得分及自主進食時間在各時間點均高于對照組(P0.05),EdFED得分在各時間點均低于對照組(P0.05),兩組間差異均隨時間變化而變化(P0.05)。(3)干預后,實驗組患者EBS得分、自主進食時間在干預8周后最高,之后開始下降,EdFED得分在干預8周后最低,之后開始增加。結(jié)論1.簡體中文版EBS具有良好的測量性能,適用于我國大陸地區(qū)老年癡呆患者進食能力的評估。2.蒙臺梭利方法干預可改善老年癡呆患者進食能力,減輕其進食困難,增加其自主進食時間,但干預效應隨時間推移衰減。
[Abstract]:Objective 1. In this paper, the measurement performance of EBS in Chinese version was evaluated, the specific measuring tool was provided for this study, and the assessment tool of feeding capacity of senile dementia in mainland China was enriched. To design the method of Montessori's intervention and to evaluate its effect on improving the feeding capacity of senile dementia patients. Method 1. After the Han and the performance evaluation of the feeding behavior scale, the English-English EBS was translated by the direct-translation model of Lee and the like, and an appropriate amount of the table entry was adjusted by consulting the 5 experts and the pre-survey 30 patients. and finally, the simplified Chinese version of EBS is applied to 100 patients with senile dementia according to the standard, and the reliability is evaluated by the Cronbach's noise coefficient, the Gutsman Spilt folding coefficient and the retest reliability, The validity of the evaluation was evaluated with the content validity and the validity of the validity criterion (Simplified Chinese version of Edinburgh Dementia-eating Evaluation Scale), and the regional index was evaluated by the project analysis. The experimental study on the design of repeated measurement of single factor. According to the "International function, disability and health classification" theory and the Montessori method, the method of current investigation, literature review, expert consultation, pre-test and panel discussion is adopted to design the method of Montessori's intervention. According to the standard,64 patients in a nursing home in Henan province and 10 floors of a certain age apartment in Zhengzhou were selected according to the number of patients, and the two adjacent serial numbers were randomly divided into experimental group and control group according to the number of patients, and 32 cases were randomly divided into experimental group and control group. The patients in the experimental group were treated twice a week for 8 weeks, and the patients in the control group were only routine care. At the end of the intervention, the EBS score, the EdFED score, and the self-feeding time of the patient at the end of the intervention,1 month and 3 months after the end of the intervention. The SPSS17.0 was used to analyze the data. The description of the classification data adopts frequency, component ratio, and the description of the measurement data adopts the average, standard deviation, median and quartile; the two groups of baseline data statistical inference, the measurement data is t-test or rank sum test, and the classification data is 2-time test; and the four time points before and after the two groups of intervention are compared, The data can meet the normal distribution and the homogeneity, and a repeated measurement of variance is used, and the non-satisfying person adopts the generalized estimation equation. Results 1. The correlation coefficient between the Chinese version of EBS and the total score was 0.420-0.729 (P0.001), which was greater than 0.4, and the determination value of each item was 6.360-16.464, which was greater than 3.0, and the division index was good (P0.001); the coefficient of the scale Cronbach's was 0.842, the half-factor of the Gutsman Spilt was 0.865, and the retest reliability was 0.840. The reliability is good, the content validity of the entry level (I-CVI) is 1.00, the content validity of the scale level (S-CVI) is 1.00, the validity of the validity is 0.727, and the validity is good. Of the 64 patients,4 cases were lost to follow-up with death or other diseases (the flow rate was 6.25%), the final control group was 31 cases, and the experimental group was 29 cases. (1) After 8 weeks of intervention, the scores of EBS in the experimental group were increased from (12.94 to 3.62) to (14.31 to 2.63), and the score of the EdFED was decreased from (9.79 to 4.16) to (7.86 to 4.16) minutes, and the self-feeding time was increased from (16.73 to 6.84) min to (21.44 to 7.17) min. (2) After the intervention, the scores of EBS and the time of self-feeding in the experimental group were higher than that of the control group at all time points (P0.05). The scores of the two groups were lower than that of the control group (P0.05). (3) After the intervention, the EBS score and the self-feeding time of the experimental group were the highest after 8 weeks of intervention, and then decreased, and the EdFED score was the lowest after 8 weeks of intervention and then started to increase. Conclusion 1. The Simplified Chinese EBS has good measurement performance and is suitable for the assessment of the feeding capacity of senile dementia patients in the mainland of China. Montessori's method of intervention can improve the eating ability of senile dementia patients, reduce their eating difficulty, increase their self-feeding time, but the effect of intervention will be attenuated over time.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.74
本文編號：2440653
[Abstract]:Objective 1. In this paper, the measurement performance of EBS in Chinese version was evaluated, the specific measuring tool was provided for this study, and the assessment tool of feeding capacity of senile dementia in mainland China was enriched. To design the method of Montessori's intervention and to evaluate its effect on improving the feeding capacity of senile dementia patients. Method 1. After the Han and the performance evaluation of the feeding behavior scale, the English-English EBS was translated by the direct-translation model of Lee and the like, and an appropriate amount of the table entry was adjusted by consulting the 5 experts and the pre-survey 30 patients. and finally, the simplified Chinese version of EBS is applied to 100 patients with senile dementia according to the standard, and the reliability is evaluated by the Cronbach's noise coefficient, the Gutsman Spilt folding coefficient and the retest reliability, The validity of the evaluation was evaluated with the content validity and the validity of the validity criterion (Simplified Chinese version of Edinburgh Dementia-eating Evaluation Scale), and the regional index was evaluated by the project analysis. The experimental study on the design of repeated measurement of single factor. According to the "International function, disability and health classification" theory and the Montessori method, the method of current investigation, literature review, expert consultation, pre-test and panel discussion is adopted to design the method of Montessori's intervention. According to the standard,64 patients in a nursing home in Henan province and 10 floors of a certain age apartment in Zhengzhou were selected according to the number of patients, and the two adjacent serial numbers were randomly divided into experimental group and control group according to the number of patients, and 32 cases were randomly divided into experimental group and control group. The patients in the experimental group were treated twice a week for 8 weeks, and the patients in the control group were only routine care. At the end of the intervention, the EBS score, the EdFED score, and the self-feeding time of the patient at the end of the intervention,1 month and 3 months after the end of the intervention. The SPSS17.0 was used to analyze the data. The description of the classification data adopts frequency, component ratio, and the description of the measurement data adopts the average, standard deviation, median and quartile; the two groups of baseline data statistical inference, the measurement data is t-test or rank sum test, and the classification data is 2-time test; and the four time points before and after the two groups of intervention are compared, The data can meet the normal distribution and the homogeneity, and a repeated measurement of variance is used, and the non-satisfying person adopts the generalized estimation equation. Results 1. The correlation coefficient between the Chinese version of EBS and the total score was 0.420-0.729 (P0.001), which was greater than 0.4, and the determination value of each item was 6.360-16.464, which was greater than 3.0, and the division index was good (P0.001); the coefficient of the scale Cronbach's was 0.842, the half-factor of the Gutsman Spilt was 0.865, and the retest reliability was 0.840. The reliability is good, the content validity of the entry level (I-CVI) is 1.00, the content validity of the scale level (S-CVI) is 1.00, the validity of the validity is 0.727, and the validity is good. Of the 64 patients,4 cases were lost to follow-up with death or other diseases (the flow rate was 6.25%), the final control group was 31 cases, and the experimental group was 29 cases. (1) After 8 weeks of intervention, the scores of EBS in the experimental group were increased from (12.94 to 3.62) to (14.31 to 2.63), and the score of the EdFED was decreased from (9.79 to 4.16) to (7.86 to 4.16) minutes, and the self-feeding time was increased from (16.73 to 6.84) min to (21.44 to 7.17) min. (2) After the intervention, the scores of EBS and the time of self-feeding in the experimental group were higher than that of the control group at all time points (P0.05). The scores of the two groups were lower than that of the control group (P0.05). (3) After the intervention, the EBS score and the self-feeding time of the experimental group were the highest after 8 weeks of intervention, and then decreased, and the EdFED score was the lowest after 8 weeks of intervention and then started to increase. Conclusion 1. The Simplified Chinese EBS has good measurement performance and is suitable for the assessment of the feeding capacity of senile dementia patients in the mainland of China. Montessori's method of intervention can improve the eating ability of senile dementia patients, reduce their eating difficulty, increase their self-feeding time, but the effect of intervention will be attenuated over time.
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.74
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