Effects of Spaced-retrieval Combined Montessori-based Activities in Improving Eating Difficulty of Institutionalized Elders with Dementia: A Longitudinal Research Report

• Main Authors: Hua-Shan Wu, 吳樺姍
• Other Authors: Li-Chan Lin
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/00582121028882527581

博士 === 國立陽明大學 === 護理學系暨研究所 === 98 === Background & Objectives: In Taiwan, above 50% residents in dementia care units had eating difficulties. Now one study had proved that spaced retrieval or Montessori-based activities could improve eating difficulty and self-eating ability of institutionalized residents with dementia, but did not significantly increase eating amount and body weights/body mass index (BMI). Here we proposed a quasi-experimental and longitudinal study design used to explore the immediately and long-term effects of spaced retrieval combined Montessori-based activities for improving eating difficulties of institutionalized residents with dementia. Methods: Subjects who were diagnosed with dementia were chosen from dementia special care units in four veteran homes in north and middle regions. Twenty five subjects in the experimental Ⅰ group were given an eight-week spaced retrieval combined Montessori-based activities with fixed sessions. Thirty eight subjects in the experimental Ⅱ group were given individualized spaced retrieval combined Montessori-based activities having different numbers of training session for each subject. Twenty seven subjects in the control group didn’t be given any intervention and received routine care by staff in the long term care facilities. Every training session in the experimental Ⅰand Ⅱ group lasted about forty minutes. Spaced-retrieval was to teach subjects to learn eight messages about eating procedures and feeding behaviors. Between time interval trials used by spaced-retrieval, Montessori-based activities related eating were practiced. After interventions, the three groups collected post-test and following data for the fist, third and sixth month, including the scores of the Edinburgh Feeding Evaluation in Dementia (EdFED), Mini-Nutritional Assessment (MNA), the Cornell scale for depression in Dementia (CSDD) and Mini-Mental State Examination (MMSE), self-eating time, body weight/BMI and eating amount. Results: After intervention, the scores of obstinacy behaviors in EdFED, MNA and CSDD, eating amount and body weights/BMI in the experimental Ⅰgroup improved by time significantly better than those in the control group. The scores of obstinacy behaviors in EdFED in the experimental Ⅱ group exhibited decreasing distribution by time. In addition, the scores of assisted feeding, MNA and CSDD, eating amount and body weights/BMI in the experimental Ⅱ group improved by time significantly better than those in the control group. But, the improved extent of eating difficulty, eating amount and body weights/BMI in the experimental Ⅱ group was less than that in the experimental Ⅰgroup. Conclusion: According to these study findings, the spaced retrieval combined Montessori-based activities with fixed sessions and the individualized spaced retrieval combined Montessori-based activities could produce the efficacy in improving eating difficulty, eating amount, eating ability, nutritional and depressive status of institutionalized elders with dementia. The individualized spaced retrieval combined Montessori-based activities was suitable for spreading in the dementia special care units for less training sessions. Increasing following time or giving booster sessions after the sixth month to exam the reserve effects for improving eating difficulties were recommended in the future research.