Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

Feeding Difficulty and its influencing factors of Elders with Dementia in Long-term Care Facilities

요양시설 치매노인의 식사행동장애와 관련요인

  • Hong, Hyun-Hwa (Department of Nursing, Kyungnam University) ;
  • Gu, Mee-Ock (College of Nursing, Gyeongsang Nation University)
  • Received : 2014.12.31
  • Accepted : 2015.02.12
  • Published : 2015.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to investigate feeding difficulty and its influencing factors of elders with dementia in long-term care facilities. Participants were 158 elders with dementia residing in three nursing facilities. Data were collected from Aug. 18 to Sep. 12 in 2014. The feeding difficulty in dementia scale, Korean version-Activities of Daily Living and Mini-Mental State Exam-Korean version were used as instruments. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation and stepwise multiple regression by SPSS 17.0. Mean feeding difficulty score was $0.62{\pm}0.43$(range of 0-2). The highest feeding difficulty item was "patient require close supervision while feeding". The variables influencing the feeding difficulty was ADL(${\beta}=.312$), cognitive function(${\beta}=-.172$) which explained about 20.0% of total variance. The results suggest the need of developing feeding difficulty coping strategy according to dietary behavior phase, In addition, the development and testing the educational program for caregivers to help feeding difficulty of the elders with dementia in long-term facility are recommended.

본 연구는 요양시설 치매노인을 대상으로 식사행동장애 실태와 영향요인을 규명하기 위한 서술적 조사연구이다. 연구대상은 일 지역 3개 요양시설에 거주하는 치매노인 158명이었으며, 연구기간은 2014년 8월18일부터 9월12일까지였으며, 식사행동장애, 신체기능(K-ADL) 및 인지기능(MMSE-K)을 측정하였다. 수집된 자료는 t-test, ANOVA, 상관관계, 회귀분석으로 검정하였다. 식사행동장애 정도는 전체 평균이 $0.62{\pm}0.43$점(0-2점 범위)이었고, 식사 중 주의 깊은 감독이 필요하다가 가장 빈도가 높은 식사행동장애였다. 회귀분석결과 신체기능(${\beta}=.312$), 인지기능(${\beta}=-.172$) 순으로 식사행동장애에 영향을 미쳤고, 이들 변수의 설명력은 20.0%였다. 이러한 연구결과는 요양시설 치매노인의 식사행동장애를 돕기 위한 식사행동단계별 대처전략 개발, 시설 돌봄 제공자의 교육프로그램 개발 연구의 필요성을 제시한다.

Keywords

References

  1. Korean National Statistical Office. Population Projections for Korea, 2012. http://kosis.kr
  2. Korean Ministry of Health and Welfare. Nationwide study on the prevalence of dementia in Korean elders, 2012. http://www.mw.go.kr
  3. Health insurance review & assessment service. Medical Expenses of statistics accounts, 2013. http://www.hira.or.kr
  4. Korean Ministry of Health and Welfare. The Present Status of Welfare Facilities for the Senior, 2014. http://www.mw.go.kr
  5. I. D. Choi, Y. M. Lee, "Study on the Efficient Integration of Long-term Care Facilities and Geriatric Hospitals by Using NHIC Survey Data", Journal of the Korean Gerontological Society, Vol. 30, No. 3, pp. 855-869, 2010.
  6. M. M. Burke, & J. A. Laramie, "Primary care of the older adult", Philadelphia : Mosby, Inc, 2004.
  7. Canadian Study of Health and Aging Working Group. Patterns of caring for people with dementia in Canada, Canada Journal Aging, Vol. 13, pp. 470-87, 1994. https://doi.org/10.1017/S0714980800006334
  8. B. H. Oh, "Diagnosis and Treatment for Behavioral and Psychological Symptoms of Dementia", Journal of the Korean Medical Association, Vol. 52, No. 11, pp. 1048-1054, 2009. DOI: http://dx.doi.org/10.1111/j.1752-7325.1995.tb02370.x
  9. E. J. Amella, "Resistance at mealtimes for persons with dementia". Journal of Nutrition and Health in Aging, Vol. 6, pp. 117-122, 2002.
  10. C. Ferri, M. Prince, C. Brayne, H. Brodaty, L. Fratiglioni, M. Ganguli, K. Hall, K. Hasegawa, H. Hendrie, Y. Huang, A. Jorm, C. Mathers, P. Menezes, E. Rimmer & M. Scazufca, "Global prevalence of dementia: a delphi consensus study". Lancet Vol. 366, pp. 2112-2217, 2005. DOI: http://dx.doi.org/10.1016/S0140-6736(05)67889-0
  11. R. Watson, "Eating difficulty in older people with dementia", Nursing Older People, Vol. 14, No. 3, pp. 21-25, 2002. DOI: http://dx.doi.org/10.7748/nop2002.05.14.3.21.c2208
  12. C. C. Chang, & B. L. Roberts, "Feeding difficulty in older adults with dementia", Journal of Clinical Nursing, Vol. 17, pp. 2266-2274, 2008. DOI: http://dx.doi.org/10.1111/j.1365-2702.2007.02275.x
  13. R. Watson, & S. M. Green, "Feeding and dementia: a systematic literature review". Journal of Advanced Nursing, Vol. 54, pp. 86-93, 2006. DOI: http://dx.doi.org/10.1111/j.1365-2648.2006.03793.x
  14. The Alzheimer' society 2000. Food for Thought. Alzheimer's society, London
  15. L. Volicer, B. Seltzer, Y. Rheaume, J. Karner, M. Glennon, M. E. Riley, & P. Crino, "Progrssion of Alzhimer type dementia in institutionalized patients:a cross-sectional study", Journal of Applied Gerontology, Vol. 6, pp. 83-94, 1987. DOI: http://dx.doi.org/10.1177/073346488700600107
  16. S. Y. Wang, "Weight loss and metabolic changes in dementia", Journal of Nutrition and Health in Aging, Vol. 6, pp. 210-205, 2002.
  17. H. K. White, "Nutrition in advanced Alzheimer's disease", North Carolina Medical Journal, Vol. 66, pp. 307-312, 2005.
  18. S. Riviere, S. Gillette-Guyonnet, S. Andrieu, F. Nourhashemi, S. Lauque, C. Cantet, A. Salva, G. Frisoni, & B. Vellas, "Cognitive function and caregiver burden: predictive factors for eating behavior disorders in Alzhiemer's disease", International Journal of Geriatric Psychiatry, Vol. 17, pp. 950-955, 2002. DOI: http://dx.doi.org/10.1002/gps.724
  19. E. J. Amella, "Mealtime difficulties. In Evidence -Based Geriatric Nursing Protocols for Best Practice", 3rd edn. (Capezuti E, Zwicker D, Mezey M, Fulmer T, Gray-Miceli D & Kluger M. eds). Springer Publishing Company, LLC, New York, pp. 337-351, 2008.
  20. G. R. Hall, "Chronic dementia: Challenges in feeding a patient", Journal of Gerontological Nursing, Vol. 20, pp. 21-30, 1994. DOI: http://dx.doi.org/10.3928/0098-9134-19940401-06
  21. N. Colodny, "Comparison of dysphagics and nondysphagics on pulse oximetry during oral feeding", Dysphagia, Vol. 15, pp. 68-73, 2000. DOI: http://dx.doi.org/10.1007/s004550010003
  22. N. L. Crogan, J. A. Shultz, C. E. Adams, & L. K. Massey, "Barriers to nutrition care for nursing home residents", Journal of Gerontological Nursing, Vol. 27, No. 12, pp. 25-31, 2001. DOI: http://dx.doi.org/10.3928/0098-9134-20011201-09
  23. L. C. Lin, R. Watson, Y. C. Lee, Y. C. Chou, & S. C. Wu, "Edinburgh Feeding Evaluation in Dementia (EdFED) scale: Cross-cultural validation of the Chinese version". Journal of Advanced Nursing, Vol. 62, pp. 116-123, 2008. DOI: http://dx.doi.org/10.1111/j.1365-2648.2008.04596.x
  24. M. W. Tully, K. L. Matrakas, J. Muir, & K. Musallam, "The Eating Behavior Scale. A simple method of assessing functional ability in patients with Alzheimer's disease", Journal of Gerontological Nursing, Vol. 23, No. 7, pp. 9-15, 1997. DOI: http://dx.doi.org/10.3928/0098-9134-19970701-08
  25. K. M. Lee, J. A. Song, "Characteristics of Eating Behavior in Elders with Dementia residing in Long-Term Care Facilities", Journal of Korean Academy Nursing, Vol. 42, No. 4, pp. 466-476, 2012. DOI: http://dx.doi.org/10.4040/jkan.2012.42.4.466
  26. G. Blandford, L. B. Watkins, M. N. Mulvihill, & B. Taylor, "Assessing abnormal feeding behavior in dementia: A taxonomy and initial findings", 1998.
  27. C. C. Chang, "Prevalence and factors associated with feeding difficulty in institutionalized elderly with dementia in taiwan", The Journal of Nutrition Health & Aging, Vol. 16, No. 3, pp. 258-261, 2012. DOI: http://dx.doi.org/10.1007/s12603-011-0158-6
  28. Y. C. Park, A Study on the Architectural Planning of Behavior of Users in Long-Term Care Health Facilities in Japan, Unpublished PhD thesis, Hanyang University, Seoul, 2011.
  29. F. Faul, E. Erdfelder, A. G. Lang, & A. Buchner, "Statistical power analysis using G*power 3.1: Tests for correlation and regression analyses", Behavior Research Methods, Vol. 41, pp. 1149-1160, 2009. DOI: http://dx.doi.org/10.3758/BRM.41.4.1149
  30. R. Watson, "Measuring feeding difficulty in patients with dementia: developing a scale", Journal of Advanced Nursing, Vol. 19, pp. 257-263, 1994. DOI: http://dx.doi.org/10.1111/j.1365-2648.1994.tb01160.x
  31. R. Watson, "Undernutrition, weight loss and feeding difficulty in elderly patients with dementia: a nursing perspective", Reviews in Clinical Gerontology, Vol. 7, pp. 317-326, 1997. DOI: http://dx.doi.org/10.1017/S0959259897007454
  32. R. Watson, S. M. Green, & L. Legg, "The edinburgh feeding evaluation in dementia scale #2: convergent and discriminant validity", Clinical Effectiveness in Nursing, Vol. 5, pp. 44-46, 2001 DOI: http://dx.doi.org/10.1054/cein.2000.0169
  33. L. C. Lin, & C. C. Chang, "A Chinese translation of the EdFED-Q and assessment of equivalence", Alzheimer Disease and Associated Disorders, Vol. 17, pp. 230-235, 2003. DOI: http://dx.doi.org/10.1097/00002093-200310000-00006
  34. T. Durnbaugh, B. Haley & S. Roberts, "Assessing problem feeding behaviors in mid-stage Alzhiemer's disease", Geriatric Nursing, Vol. 17, pp. 63-67, 1996. https://doi.org/10.1016/S0197-4572(96)80170-4
  35. H. Keller, A. Gibbs-Ward, J. Randall-Simpson, M. Bocock & E. Dimon, "Meal rounds: an essential aspect of quality nutrition services in long-term care". JAMA, Vol. 7, pp. 40-45, 2006.
  36. R. Stockdell & E. J. Amella, "The Edinburgh feeding evaluation in dementia scale: determining how much help people with dementia need at mealtime", American Journal of Nursing Vol. 108, pp. 46-54, 2008. DOI: http://dx.doi.org/10.1097/01.NAJ.0000327831.51782.8e
  37. C. Y. Kim, Y. M. Lee and E. H. Ha, "Development and Evaluation of a Dysphagia Assessment Tool and an Intervention Program for the Elderly in the Long-Term Care Facilities", Journal of the Korea Academia-Industrial cooperation Society, Vol. 13, No. 2, pp. 685-693, 2012. https://doi.org/10.5762/KAIS.2012.13.2.685
  38. J. W. Won, Y. G. Rho, S. Y. Kim, B. R. Cho, Y. S. Lee, "Validity and reliability of Korean Activities of Daily Living (K-ADL) scale", Journal of Korean Geriatric Society, Vol. 6, pp. 98-106, 2002.
  39. Y. H. Cho, "Family caregivers' needs for a professional help by the symptom level of senile dementia", Unpublished master's thesis, Yonsei University, Seoul, 2007.
  40. M. F. Folstein, S. E. Folstein, & P. R. McHugh, "Mini-mental state": A practical method for grading the cognitive state of patients for the clinician, Journal of Psychiatric Research, Vol. 12, pp. 189-198, 1975. DOI: http://dx.doi.org/10.1016/0022-3956(75)90026-6
  41. J. H. Park, & Y. C. Kwon, "Korean version of Mini-Mental State Exa-mination (MMSE-K) part : development of the test for the elderly", Journal Korean Neuropsychiatry Association, Vol. 28, pp. 125-135, 1989.
  42. B. H. Oh, Y. S. Shin, D. W. Kim, T. H. Kim, D. O. Kim, S. H. Park, H. S. Park, J. A. Lim and W. S. J. M. Kim, wisdom, and Song, Understanding Dementia: dementia treatments waxed Assistant. Seoul: Rainbow Corp, 2002.
  43. National health insurance, 2014.
  44. International Obesity Task Force Report on the Asia-Pacific perspective: redefining obesity and its treatment, 2000.
  45. H. C. Park, "A Study on the Effects of the Art Therapy of Memory Recollection on the Improvement of Cognitive Functions and Life Quality of the Elderly with Dementia", The Korean Journal of Arts Therapy, Vol. 9, No. 1, pp. 1-21, 2009.
  46. H. L. Ro, K. C. Hwang, J. A. Kam, "Effects of Intentional Snoezelen Program on activities of daily living and Cognitive Functions of the Demented Elderly", Journal of Special Education & Rehabilitation Science, Vol. 50, No. 3, pp. 393-412, 2011.
  47. H. K. Yang, "The Effects of the Recreational Music Therapy on the Cognitive Functional of the Aged People with Dementia", Journal of the Korean Gerontological Society, Vol. 26, No. 4, pp. 749-765, 2006.
  48. S. T. Kim, J. H. Hwang, J. H. Lim, Effect of Physical Activity Program for Cognition in the Alzheimer's Dementia, The Journal of Occupational Therapy for the Aged and Dementia, Vol. 8, No. 1, pp. 1-11, 2014.
  49. National Health Insurance Corporation, 2013.
  50. V. H. Castellanos, H. J. Silver, C. Gallagher-Allred, & T. R. Smith, "Nutrition issues in the home, community, and long-term care setting", Nutrition in Clinical Practice, Vol. 18, pp. 21-36, 2003. DOI: http://dx.doi.org/10.1177/011542650301800121
  51. J. Kayser-Jones, & E. Schell, "The mealtime experience of a cognitively impaired elders: Ineffective and effective strategies", Journal of Gerontological Nursing, Vol. 23, pp. 33-39, 1997b. DOI: http://dx.doi.org/10.3928/0098-9134-19970701-11
  52. C. A. Pierson, "Ethnomethodologic analysis of accounts of feeding demented residents in long-term care", Image: Journal of Nursing Scholarship, Vol. 31, pp. 127-131, 1999. DOI: http://dx.doi.org/10.1111/j.1547-5069.1999.tb00447.x
  53. W. B. Bonnel, "Managing mealtime in the independent group dining room: an educational program for nurse's aids", Geriatric Nursing, Vol. 16, pp. 28-32, 1995. DOI: http://dx.doi.org/10.1016/S0197-4572(05)80076-X
  54. S. F. Simmons, D. Osterweil, & J. F. Schnelle, " Improving food intake in nursing home residents with feeding assistance: a staffing analysis", Journal of Gerontology: Medical Sciences, Vol. 56A, pp. 790-794, 2001.