基于行动研究法的蒙台梭利进食训练对阿尔茨海默病患者进食行为的影响

朱如璜; 郑慧慧; 王婉慧; 王贞

doi:10.16766/j.cnki.issn.1674-4152.003461

基于行动研究法的蒙台梭利进食训练对阿尔茨海默病患者进食行为的影响

doi: 10.16766/j.cnki.issn.1674-4152.003461

温州医科大学附属第一医院神经内科17病区，浙江温州 325000

基金项目:

浙江省自然科学基金项目 LY19H090013

详细信息

通讯作者:
王贞，E-mail：amhiht@163.com

中图分类号: R749.16 R473.74
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- 文章访问数: 209
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- 被引次数: 0
出版历程
- 收稿日期: 2023-10-28
- 网络出版日期: 2024-05-29

Effect of action research-based Montessori feeding training on feeding behavior of Alzheimer's disease patients

Ward 17, Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的基于行动研究法建立蒙台梭利进食训练，观察其对阿尔茨海默病患者进食行为的影响，为提高患者自主进食能力，减轻照护者负担提供理论依据。方法采用随机数字表法将2022年3月—2023年3月于温州医科大学附属第一医院诊疗的104例阿尔茨海默病患者分为2组，对照组(52例)给予常规进食照护干预，观察组(52例)给予基于行动研究法的蒙台梭利进食训练干预，比较2组干预前后进食行为、进食能力及营养状况。结果观察组干预后异常进食行为发生率低于对照组(P＜0.05)、自主进食时间[(17.89±3.11)min]长于对照组[(11.34±2.10)min，t=13.568，P＜0.05]，进食行为量表(EBS)[(14.23±3.14)分]高于对照组[(10.12±2.67)分，t=9.076，P＜0.05]，爱丁堡痴呆进食评估量表(EdFED)[(10.13±2.11)分]低于对照组[(16.34±3.56)分，t=11.906，P＜0.05]，微型营养评估量表(MNA)[(10.67±2.18)分]高于对照组[(8.33±1.14)分，t=10.987，P＜0.05]，BMI(20.47±4.12)与对照组(20.24±4.67)比较差异无统计学意义(t=0.675，P＞0.05)。结论基于行动研究法的蒙台梭利进食训练对减少阿尔茨海默病患者的异常进食行为，提高进食能力，防止营养不良具有积极的作用。
- 阿尔茨海默病 /
- 蒙台梭利进食训练 /
- 行动研究法 /
- 进食行为 /
- 营养状况
Abstract: Objective To establish Montessori feeding training based on action research method, observe its influence on eating behavior of patients with Alzheimer's disease, so as to provide theoretical basis for improving patients' ability to eat independently and reducing the burden of caregivers. Methods A total of 104 patients with Alzheimer's disease treated in the First Affiliated Hospital of Wenzhou Medical University from March 2022 to March 2023 were divided into two groups by random number table method. The control group (52 cases) received routine feeding care intervention, and the observation group (52 cases) received Montessori feeding training intervention based on action research method. The eating behavior, eating capacity and nutritional status of the two groups were compared before and after the intervention. Results The incidence of abnormal eating behavior in the observation group was lower than that in the control group (P < 0.05), and the time of eating independently was longer than that in the control group [(17.89±3.11) min vs. (11.34±2.10) min, t=13.568, P < 0.05]. The score of eating behavior scale (EBS) was higher than that of control group (14.23±3.14 vs. 10.12±2.67, t=9.076, P < 0.05), and the Edinburgh feeding evaluation in dementia scale (EdFED) was lower than that of control group (10.13±2.11 vs. 16.34±3.56, t=11.906, P < 0.05), the score of mini nutritional assessment (MNA) was higher than that of control group (10.67±2.18 vs. 8.33±1.14, t=10.987, P < 0.05). There was no significant difference in BMI between the two groups (20.47±4.12 vs. 20.24±4.67, t=0.675, P>0.05). Conclusion Montessori feeding training based on action research has a positive effect on reducing abnormal eating behavior, improving eating ability and preventing malnutrition in patients with Alzheimer's disease.
- Alzheimer's disease /
- Montessori feeding training /
- Action research method /
- Eating behavior /
- Nutritional status

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表 1 2组阿尔茨海默病患者一般资料比较

Table 1. Comparison of general data between the two groups of Alzheimer's disease patients

一般资料	对照组(n=52)	观察组(n=52)	统计量	P值
性别(例)			0.616^a	0.432
男性	23	27
女性	29	25
婚姻状况(例)			1.195^a	0.274
已婚	40	35
离婚或丧偶	12	17
年龄(x±s，岁)	65.34±5.10	66.13±7.19	0.646^b	0.520
入院体重(x±s，kg)	60.23±5.13	61.45±8.90	0.856^b	0.394
受教育年限(x±s，年)	11.09±2.44	12.11±3.20	1.828^b	0.071
病程(x±s，年)	2.57±0.47	2.60±0.45	0.332^b	0.740
简易精神状态量表(x±s，分)	12.03±2.10	11.89±2.07	0.342^b	0.733
照护者与患者关系(例)			1.948^a	0.378
配偶	37	33
子女	10	9
外请陪护	5	10
照护者受教育年限(x±s, 年)	10.45±2.10	11.01±1.45	1.582^b	0.117
照顾患者时间(x±s，月)	6.34±1.10	5.96±1.23	1.661^b	0.100
注：^a为χ²值，^b为t值。

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表 2 2组阿尔茨海默病患者干预前后异常进食行为比较(例)

Table 2. Comparison of abnormal eating behavior before and after intervention between the two groups of Alzheimer's disease patients (cases)

组别	例数	①		②		③		④		⑤
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
对照组	52	35	31	30	28	29	21	26	19	21	17
观察组	52	36	12^a	34	18^a	30	10^a	27	7^a	24	8^a
χ²值		0.044	14.313	0.650	3.898	0.039	5.561	0.039	7.385	0.353	4.265
P值		0.833	< 0.001	0.420	0.048	0.843	0.018	0.844	0.007	0.553	0.039

组别	例数	⑥		⑦		⑧		⑨		⑩
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
对照组	52	20	20	18	16	17	17	15	13	13	11
观察组	52	22	10^a	17	7^a	16	3^a	15	2^a	15	2^a
χ²值		0.160	4.685	0.043	0.523	0.044	12.133	0.000	9.426	0.196	7.121
P值		0.689	0.030	0.836	0.033	0.833	< 0.001	1.000	0.002	0.658	0.008
注：与同组干预前比较，^aP＜0.05；①口头拒绝进餐，②进餐时需要照护和帮助，③吐出食物，④未结束进餐说不吃了，⑤餐前和用餐时明显不耐烦，⑥咀嚼但不吞咽食物，⑦进餐所花时间长，⑧拒绝张嘴，⑨抗拒喂食，⑩含食。

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表 3 2组阿尔茨海默病患者干预前后自主进食时间、进食能力和困难程度比较(x±s)

Table 3. Comparison of voluntary eating time, feeding ability and difficulty in 2 betwwen the two groups of Alzheimer' s patients(x±s)

组别	例数	自主进食时间(min)		EBS评分(分)		EdFED评分(分)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
对照组	52	11.09±2.50	11.34±2.10	9.57±2.09	10.12±2.67	16.78±3.12	16.34±3.56
观察组	52	11.45±2.17	17.89±3.11^b	9.89±2.33	14.23±3.14^b	16.75±2.19	10.13±2.11^b
统计量		0.784^a	13.568^c	0.737^a	9.076^c	0.057^a	11.906^c
P值		0.435	＜0.001	0.463	＜0.001	0.955	＜0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05；EBS为进食能力评分；EdFED为进食困难程度评分。

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表 4 2组阿尔茨海默病患者干预前后营养状况评估(x±s)

Table 4. Assessment of nutritional status in 2 between the two groups of Alzheimer' s disease patients before and after intervention(x±s)

组别	例数	MNA评分(分)		BMI
组别	例数	干预前	干预后	干预前	干预后
对照组	52	7.89±1.34	8.33±1.14	19.14±3.10	20.24±4.67
观察组	52	8.09±2.11	10.67±2.18^b	19.33±4.15	20.47±4.12
统计量		0.577^a	10.987^c	0.264^a	0.675^c
P值		0.565	＜0.001	0.792	0.748
注：^a为t值，^c为F值；与同组干预前比较，^bP＜0.05。

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