蒙台梭利方法干预对老年痴呆患者进食能力的影响
发布时间：2019-03-15 13:11
【摘要】：目的1.汉化英文版进食行为量表(Eating behavior scale,EBS),评价简体中文版EBS的测量性能,为本研究提供特异性测量工具,并丰富我国大陆地区老年痴呆患者进食能力评估工具。2.设计蒙台梭利方法干预方案并实施,评价其对改善老年痴呆患者进食能力的效果。方法1.进食行为量表汉化及性能评价获取量表汉化授权后,采用Lee等的直译-回译模式翻译英文版EBS,通过咨询5名专家和预调查30例患者调适量表条目,最后将简体中文版EBS应用于100例符合标准的老年痴呆患者中,以Cronbach’sɑ系数、Guttman Spilt折半系数以及重测信度评价其信度,以内容效度以及效标关联效度(简体中文版爱丁堡痴呆进食评估量表为效标)评价其效度,以项目分析评价其区分度。2.干预为单因素重复测量设计的类试验性研究。依据“国际功能、残疾和健康分类”理论和蒙台梭利方法,采用现状调查、文献回顾、专家咨询、预试验以及课题小组讨论方法,设计蒙台梭利方法干预方案。选取符合标准的河南省某养老院和郑州市某老年公寓10个楼层内64例患者,按照患者数量由多到少对楼层排序,对两相邻序号楼层抽签,随机分为实验组和对照组,各32例。对实验组患者实施每周2次、共8周的蒙台梭利方法干预,对照组患者仅为常规照护。收集干预前、干预结束时、干预结束后1个月及3个月患者的EBS得分、EdFED得分和自主进食时间。采用SPSS17.0分析资料。分类资料描述采用频数、构成比,计量资料描述采用均数、标准差、中位数、四分位数;两组基线资料统计推断,计量资料采用t检验或秩和检验,分类资料采用2χ检验;两组干预前后四个时间点比较,资料满足正态分布和方差齐性,采用重复测量方差分析,不满足者采用广义估计方程。结果1.进食行为量表汉化及性能评价简体中文版EBS各条目与总分的相关系数为0.420~0.729(P0.001),均大于0.4,各条目的决断值为6.360~16.464,均大于3.0,区分度良好(P0.001);量表Cronbach’sα系数为0.842,Guttman Spilt折半系数为0.865,重测信度为0.840,信度良好;条目水平内容效度(I-CVI)均为1.00,量表水平内容效度(S-CVI)为1.00,效标关联效度为0.727,效度良好。2.干预64例患者中,4例因死亡或合并其他疾病失访(流失率6.25%),最终对照组31例,实验组29例。(1)干预8周后,实验组患者EBS得分由(12.94±3.62)分提高为(14.31±2.63)分,EdFED得分由(9.79±4.16)分降低为(7.86±4.16)分,自主进食时间由(16.73±6.84)min增加至(21.44±7.17)min。(2)干预后两组比较,实验组EBS得分及自主进食时间在各时间点均高于对照组(P0.05),EdFED得分在各时间点均低于对照组(P0.05),两组间差异均随时间变化而变化(P0.05)。(3)干预后,实验组患者EBS得分、自主进食时间在干预8周后最高,之后开始下降,EdFED得分在干预8周后最低,之后开始增加。结论1.简体中文版EBS具有良好的测量性能,适用于我国大陆地区老年痴呆患者进食能力的评估。2.蒙台梭利方法干预可改善老年痴呆患者进食能力,减轻其进食困难,增加其自主进食时间,但干预效应随时间推移衰减。
[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.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.74
本文编号：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.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.74
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