用于痴呆症的改良 Cue Utilization and Engagement in Dementia（CUED）进餐视频编码方案的易用性、可行性和评分者间信度。
Ease of use, feasibility and inter-rater reliability of the refined Cue Utilization and Engagement in Dementia (CUED) mealtime video-coding scheme.
机构信息
The University of Iowa College of Nursing, Iowa City, IA, USA.
School of Nursing, George Washington University, Washington, D.C., USA.
出版信息
J Adv Nurs. 2020 Dec;76(12):3609-3622. doi: 10.1111/jan.14548. Epub 2020 Sep 30.
AIMS
To refine the Cue Utilization and Engagement in Dementia mealtime video-coding scheme and examine its ease of use, feasibility, and inter-rater reliability in assessing the food intake process and dyadic verbal and nonverbal interactions.
DESIGN
This study was a secondary analysis of 110 videotaped observations of mealtime interactions collected under usual care conditions from a dementia communication trial during 2011-2014.
METHODS
The videos involved 29 staff and 25 residents with dementia (42 unique staff-resident dyads) in nine nursing homes. Data coding and analysis were performed in 2018-2019. Logs of coding challenges with matched solutions and coding time were collected. Inter-rater reliability was examined through rating of randomly selected 22 videos across four trained coders.
RESULTS
It took a mean of 10.81 hr to code a one-hour video using the refined coding scheme. Coding challenges, including identification of key intake process characteristics and differentiation of similar verbal or nonverbal behaviours, were identified with appropriate solutions. The refined coding scheme had good inter-rater reliability (Cohen's Kappa range = 0.93 - 0.99, 95% CI = 0.92 - 0.99).
CONCLUSION
Findings supported preliminary evidence on feasibility, usability and inter-rater reliability of the refined coding scheme. Future psychometric testing is needed in diverse populations with dementia across different care settings.
IMPACT
Existing tools assessing the food intake process and dyadic interactions are few and have limited feasibility and/or reliability and fail to capture the complexity and dynamics of mealtime care. The refined coding scheme showed preliminary feasibility, usability, and inter-rater reliability. In consideration of the balance between time intensity and the richness of data obtained, the tool may be appropriate and useful in addressing certain research inquires (e.g., characterizing and clustering dyadic behaviours, temporal relationship between behaviours and intake) pertaining older adults with or without dementia and their formal or informal caregivers.
目的
完善“痴呆症就餐时 cue 利用和参与”视频编码方案，并检验其在评估进食过程和人际言语及非言语互动中的易用性、可行性和组内信度。
设计
本研究是对 2011-2014 年在一个痴呆症交流试验中，根据常规护理条件下收集的 110 个就餐时互动视频进行的二次分析。
方法
视频涉及 9 家养老院的 29 名员工和 25 名痴呆症患者（42 对独特的员工-患者二人组）。数据编码和分析于 2018-2019 年进行。记录编码挑战及其匹配解决方案和编码时间的日志。通过对 4 名经过培训的编码员随机选择的 22 个视频进行评分，检验组内信度。
结果
使用改良编码方案对一个小时的视频进行编码平均需要 10.81 小时。包括确定关键进食过程特征和区分相似言语或非言语行为在内的编码挑战已确定，并找到了相应的解决方案。改良编码方案具有良好的组内信度（Cohen's Kappa 范围为 0.93-0.99，95%置信区间为 0.92-0.99）。
结论
研究结果支持改良编码方案在可行性、易用性和组内信度方面的初步证据。未来需要在不同护理环境下的不同痴呆症人群中进行心理测量学测试。
影响
评估进食过程和人际互动的现有工具数量有限，可行性和/或可靠性有限，无法捕捉就餐护理的复杂性和动态性。改良编码方案显示出初步的可行性、易用性和组内信度。考虑到时间强度和所获得数据的丰富性之间的平衡，该工具可能适用于解决某些与老年人（包括痴呆和非痴呆）及其正式或非正式照护者有关的研究问题（例如，对人际行为和进食之间的时间关系进行特征描述和聚类）。
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