Institute of Clinical & Community Health Nursing, National Yang-Ming University, Taipei, Taiwan.
J Clin Nurs. 2011 Nov;20(21-22):3092-101. doi: 10.1111/j.1365-2702.2011.03858.x.
To investigate the efficacy of applying a Montessori intervention to improve the eating ability and nutritional status of residents with dementia in long-term care facilities.
An early intervention for eating difficulties in patients with dementia can give them a better chance of maintaining independence and reduce the risk of malnutrition.
An experimental crossover design was employed. Twenty-nine residents were chosen from two dementia special care units in metropolitan Taipei. To avoid contamination between participants in units using both Montessori and control interventions, two dementia special care units were randomly assigned into Montessori intervention (I1) and routine activities (I2) sequence groups. A two-period crossover design was used, with 15 residents assigned to Montessori intervention sequence I (I1, I2) and 14 residents assigned to Montessori intervention sequence II (I2, I1). On each intervention day, residents were given their assigned intervention. Montessori intervention was provided in 30-min sessions once every day, three days per week, for eight weeks. There was a two-week washout period between each intervention.
There was a significant reduction in the Edinburgh Feeding Evaluation in Dementia score for the Montessori intervention period but not for the routine activities period, while the mean differences for the Eating Behavior Scale score, self-feeding frequency and self-feeding time were significantly higher than those of the routine activities period. Except for the Mini-Nutritional Assessment score post-test being significantly less than the pre-test for the routine activities period, no significant differences for any other variables were found for the routine activities period.
This study confirms the efficacy of a Montessori intervention protocol on eating ability of residents with dementia. Adopting Montessori intervention protocols to maintain residents' self-feeding ability in clinical practice is recommended.
Montessori-based activities could provide caregivers with an evidence-based nursing strategy to deal with eating difficulties of people with dementia.
探讨蒙台梭利干预对改善长期护理机构痴呆患者进食能力和营养状况的疗效。
对痴呆患者进食困难进行早期干预，可以让他们更好地保持独立性，降低营养不良的风险。
采用实验性交叉设计。从台北市两个老年痴呆症特别护理病房中选择 29 名居民。为避免蒙台梭利干预和常规活动干预组的参与者之间发生交叉污染，将两个老年痴呆症特别护理病房随机分配到蒙台梭利干预（I1）和常规活动（I2）顺序组。采用两周期交叉设计，将 15 名居民分配到蒙台梭利干预顺序 I（I1，I2），14 名居民分配到蒙台梭利干预顺序 II（I2，I1）。在每个干预日，居民接受指定的干预。蒙台梭利干预每天进行 30 分钟，每周 3 天，持续 8 周。每次干预之间有两周的洗脱期。
蒙台梭利干预期间，痴呆症进食评估量表（Edinburgh Feeding Evaluation in Dementia，EFEID）评分显著降低，但常规活动期间评分无显著降低；而饮食行为量表（Eating Behavior Scale，EBS）评分、自我进食频率和自我进食时间的平均差异显著高于常规活动期间。除常规活动期间的迷你营养评估量表（Mini-Nutritional Assessment，MNA）后测得分显著低于前测外，常规活动期间的其他变量均无显著差异。
本研究证实了蒙台梭利干预方案对痴呆症患者进食能力的疗效。建议在临床实践中采用蒙台梭利干预方案来维持居民的自我进食能力。
基于蒙台梭利的活动可为护理人员提供一种基于证据的护理策略，以应对痴呆患者的进食困难。
