Chang Chia-Chi, Roberts Beverly L
Taipei Medical University, Taipei, Taiwan.
J Clin Nurs. 2008 Sep;17(17):2266-74. doi: 10.1111/j.1365-2702.2007.02275.x.
To use concept analysis to identify characteristics of feeding difficulty and its antecedents and consequences that provide direction for assessment and management.
Feeding difficulty is often recognised as a common problem for older adults and is associated with weight loss, poor nutrition and risk for aspiration pneumonia. The cognitive impairment found in persons with dementia impairs the ability of these adults to complete motor and perceptual tasks required for eating and often prevent the older adult from accepting help with feeding from caregivers.
Systematic review.
In 2006, literature searches using keywords (feeding, eating, nutrition, malnutrition, feeding assessment, dementia, ageing and concept analysis, dementia and feeding and excluding enteral feeding, tube feedings, PEG and enteral nutrition) were done in Medline, CINHAL, AGELINE and Social Science Full Text. Seventy relevant articles in English were found. After a review of the relevant articles, concept analysis was used to develop a definition of feeding difficulty, its defining characteristics and to delineate feeding difficulty from its antecedents and consequences.
Feeding difficulties arise at the interface between the caregiver strategies to assist the older adult with getting food into the mouth and chewing and swallowing food. A model of feeding difficulty delineates the antecedents and consequences of feeding difficulties.
The conceptual model of feeding difficulties provides a strong and clear organising structure for research that can be used to developed evidence based guidelines for practice.
The conceptual model provides directions for assessment of feeding difficulties and their antecedents. The model can be used to identify interventions that address antecedents of feeding difficulty (risk factors) and different types of feeding difficulties.
运用概念分析来确定喂养困难的特征及其相关因素和后果，为评估和管理提供指导。
喂养困难通常被认为是老年人的常见问题，与体重减轻、营养不良及吸入性肺炎风险相关。痴呆患者出现的认知障碍会损害这些成年人完成进食所需的运动和感知任务的能力，并且常常使老年人拒绝护理人员提供的喂食帮助。
系统评价。
2006年，在医学期刊数据库（Medline）、护理学与健康领域数据库（CINHAL）、老年学数据库（AGELINE）和社会科学全文数据库中，使用关键词（喂养、进食、营养、营养不良、喂养评估、痴呆、衰老与概念分析、痴呆与喂养，排除肠内喂养、管饲、经皮内镜下胃造口术和肠内营养）进行文献检索。共找到70篇英文相关文章。在对相关文章进行综述后，运用概念分析来界定喂养困难的定义、其界定特征，并将喂养困难与其相关因素和后果区分开来。
喂养困难出现在护理人员协助老年人将食物送入口中以及咀嚼和吞咽食物的策略之间。喂养困难模型描绘了喂养困难的相关因素和后果。
喂养困难的概念模型为研究提供了强大而清晰的组织结构，可用于制定基于证据的实践指南。
该概念模型为喂养困难及其相关因素的评估提供了指导。该模型可用于识别针对喂养困难相关因素（风险因素）和不同类型喂养困难的干预措施。
