Liu Wen, Perkhounkova Yelena, Hein Maria
The University of Iowa College of Nursing, Iowa City, Iowa, USA.
Innov Aging. 2022 May 5;6(6):igac025. doi: 10.1093/geroni/igac025. eCollection 2022.
Nursing home (NH) staff mealtime care approaches are associated with behaviors of residents with dementia, but their impact on food intake remains unexplored. This study examined the role of staff person-centered and task-centered approaches and resident positive, neutral, and challenging behaviors on food intake.
Videotaped mealtime observations ( = 160) involving 36 staff and 27 residents (53 unique staff-resident dyads) in 9 NHs were coded using the refined Cue Utilization and Engagement in Dementia mealtime video-coding scheme. The dependent variable was resident food intake. The independent variables were staff person-centered approaches that support resident abilities, staff-resident (dyadic) interactions, and dining environments, staff task-centered approaches, and resident positive, neutral, and challenging behaviors. Resident challenging behaviors included mealtime functional impairments and resistive behaviors. Linear mixed modeling was used. Moderating effects of staff approaches, food type, and length of dyadic mealtime interactions (ie, video duration) were examined.
The relationship between food intake and resident mealtime functional impairments was moderated by food type ( < .001). The relationship between food intake and resident resistive behaviors was moderated by food type ( = .002) and staff person-centered verbal approaches ( = .001). The relationships between food intake and staff person-centered nonverbal approaches ( = .003) and resident positive/neutral nonverbal behaviors ( = .004) were moderated by the length of dyadic mealtime interactions.
Food intake was associated with staff person-centered approaches and resident positive/neutral and challenging behaviors. Findings emphasize the importance of facilitating positive dyadic interactions using individualized, context-based, multifaceted, person-centered care. Future research on temporal and causal relationships is warranted in larger diverse samples.
养老院工作人员的用餐护理方式与痴呆症患者的行为有关，但其对食物摄入量的影响尚待探索。本研究探讨了工作人员以居民为中心和以任务为中心的方式以及居民积极、中性和具有挑战性的行为对食物摄入量的作用。
采用改良的痴呆症用餐提示利用与参与视频编码方案，对9家养老院中36名工作人员和27名居民（53对独特的工作人员 - 居民二元组）的用餐观察视频（ = 160）进行编码。因变量是居民的食物摄入量。自变量包括支持居民能力的工作人员以居民为中心的方式、工作人员 - 居民（二元）互动和用餐环境、工作人员以任务为中心的方式，以及居民积极、中性和具有挑战性的行为。居民具有挑战性的行为包括用餐时的功能障碍和抗拒行为。使用线性混合模型。研究了工作人员方式、食物类型和二元用餐互动时长（即视频时长）的调节作用。
食物类型调节了食物摄入量与居民用餐功能障碍之间的关系（ <.001）。食物类型（ =.002）和工作人员以居民为中心的言语方式（ =.001）调节了食物摄入量与居民抗拒行为之间的关系。二元用餐互动的时长调节了食物摄入量与工作人员以居民为中心的非言语方式（ =.003）以及居民积极/中性非言语行为之间的关系（ =.004）。
食物摄入量与工作人员以居民为中心的方式以及居民积极/中性和具有挑战性的行为有关。研究结果强调了使用个性化、基于情境、多方面、以居民为中心的护理促进积极二元互动的重要性。未来有必要在更多样化的大样本中研究时间和因果关系。
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