PenCLAHRC, University of Exeter Medical School, University of Exeter, Exeter, UK.
PenCLAHRC, University of Exeter Medical School, University of Exeter, Exeter, UK.
J Am Med Dir Assoc. 2014 Mar;15(3):185-193. doi: 10.1016/j.jamda.2013.10.016. Epub 2014 Jan 6.
Elderly residents with dementia commonly exhibit increased agitation at mealtimes. This interferes with eating and can be distressing for both the individual and fellow residents. This review examines the effectiveness of mealtime interventions aimed at improving behavioral symptoms in elderly people living with dementia in residential care.
Systematic review.
Medline, PsycINFO, Embase, HMIC, AMED (OvidSP); CDSR, CENTRAL, DARE (Cochrane Library, Wiley); CINAHL (EBSCOhost); British Nursing Index (NHS Evidence); ASSIA (ProQuest); Social Science Citation Index (Web of Knowledge); EThOS (British Library); Social Care Online and OpenGrey from inception to November 2012. Forward and backward citation chases, hand searches of other review articles identified in the search, and key journals.
All comparative studies were included. Articles were screened for inclusion independently by 2 reviewers. Data extraction and quality appraisal were performed by one reviewer and checked by a second with discrepancies resolved by discussion with a third if necessary. Data were not suitable for meta-analysis so narrative synthesis was carried out.
A total of 6118 articles were identified in the original search. Eleven articles were finally included. Mealtime interventions were categorized into 4 types: music, changes to food service, dining environment alteration, and group conversation. Study quality was poor, making it difficult to reach firm conclusions. Although all studies showed a trend in favor of the intervention, only 6 reported a statistically significant improvement in behavioral symptoms. Four studies suggest cumulative or lingering effects of music on agitated and aggressive behaviors.
There is some evidence to suggest that mealtime interventions improve behavioral symptoms in elderly people with dementia living in residential care, although weak study designs limit the generalizability of the findings. Well designed, controlled trials are needed to further understand the utility of mealtime interventions in this setting.
患有痴呆症的老年居民在进餐时通常会表现出更多的躁动。这会干扰进食，对个人和其他居民都会造成困扰。本综述考察了旨在改善居住在养老院的老年痴呆症患者行为症状的进餐干预措施的有效性。
系统综述。
Medline、PsycINFO、Embase、HMIC、AMED（OvidSP）；CDSR、CENTRAL、DARE（Cochrane 图书馆，Wiley）；CINAHL（EBSCOhost）；英国护理索引（NHS 证据）；ASSIA（ProQuest）；社会科学引文索引（Web of Knowledge）；EThOS（大英图书馆）；Social Care Online 和 OpenGrey 从创建到 2012 年 11 月。向前和向后引用追踪、在搜索中发现的其他综述文章的手工搜索以及重点期刊。
所有比较研究均包括在内。文章由 2 位评审员独立筛选纳入。数据提取和质量评估由一位评审员进行，第二位评审员进行检查，如有分歧，必要时与第三位评审员进行讨论解决。由于数据不适合进行荟萃分析，因此进行了叙述性综合。
原始搜索共确定了 6118 篇文章。最终纳入了 11 篇文章。进餐干预措施分为 4 类：音乐、改变餐饮服务、就餐环境改变和小组对话。研究质量较差，难以得出明确结论。尽管所有研究都表明干预措施有改善行为症状的趋势，但只有 6 项研究显示行为症状有统计学意义的改善。四项研究表明音乐对激越和攻击行为有累积或持续的影响。
有一些证据表明，进餐干预措施可改善居住在养老院的老年痴呆症患者的行为症状，尽管薄弱的研究设计限制了研究结果的普遍性。需要进行精心设计的对照试验，以进一步了解进餐干预措施在这种环境下的实用性。
