Christine E Lynn, College of Nursing, Florida Atlantic University, Boca Raton, FL, USA.
Department of Nutritional Sciences, University of Georgia, Athens, GA, USA.
Dementia (London). 2023 Aug;22(6):1241-1258. doi: 10.1177/14713012231177491. Epub 2023 May 21.
The prevalence of dementia is growing as the population and longevity increase. Caregivers of adults with dementia report stress and fatigue and often neglect their health. They also indicate the need for information to address health-related issues, including nutritional problems, of their family members with dementia (FMWD). This study examined the impact of coaching to improve family caregiver (FCG) stress and well-being and to increase the protein intake of both FCGs and their FMWD. All participants received nutrition education including a protein prescription (1.2 g/kg body weight/day) and FCGs received stress-reduction materials. Coached-group randomized participants also received weekly diet coaching and stress-reduction coaching. At baseline and 8 weeks, anthropometrics, a mini-nutritional assessment questionnaire, and diet (protein intake) were assessed in FCGs and FMWD; well-being, fatigue and strain were assessed in FCGs. Repeated two words measures analysis of variance and Fisher's exact tests examined within group and intervention effects. Twenty-five FCGs (13 coached group, 12 not-coached group) and 23 FMWD (12 coached group, 11 not-coached group) completed the study. No significant differences were found between coached and not-coached FCGs and FMWD at baseline. After 8- weeks, FCGs' protein intake significantly increased from 1.00 ± 0.17 to 1.35 ± 0.23 g/kg/body weight in the coached group and from 0.91 ± 0.19 to 1.01 ± 0.33 g/kg/body weight in the not-coached group; there was also an intervention effect (p=.01, η2 = .24). The percentage of FCGs with baseline protein intake less than prescription guidelines and with an end-of-study protein intake meeting/exceeding the prescription significantly differed, with 60% of coached FCGs versus 10% of not coached FCGs meeting the prescription. No intervention effects were shown for protein intake in FMWD or for well-being, fatigue or strain among FCGs. Diet coaching with nutrition education successfully assisted FCGs with improving their protein intake versus nutrition education alone.
随着人口老龄化和寿命延长，痴呆症的患病率不断增加。痴呆症成年患者的护理人员报告称压力大、疲劳，且常常忽视自身健康。他们还表示需要了解相关信息，以解决与健康相关的问题，包括痴呆症家庭成员（FMWD）的营养问题。本研究旨在评估辅导对改善家庭护理人员（FCG）压力和幸福感以及增加 FCG 和 FMWD 蛋白质摄入量的影响。所有参与者均接受营养教育，包括蛋白质处方（1.2g/kg 体重/天），FCG 还接受减压材料。接受辅导的随机分组参与者还接受每周饮食辅导和减压辅导。在基线和 8 周时，对 FCG 和 FMWD 进行人体测量、迷你营养评估问卷和饮食（蛋白质摄入量）评估；对 FCG 进行幸福感、疲劳和紧张感评估。重复双词测量方差分析和 Fisher 精确检验用于检验组内和干预效果。25 名 FCG（13 名接受辅导组，12 名未接受辅导组）和 23 名 FMWD（12 名接受辅导组，11 名未接受辅导组）完成了研究。基线时，接受辅导的 FCG 和未接受辅导的 FCG 以及 FMWD 之间无显著差异。8 周后，接受辅导组 FCG 的蛋白质摄入量从 1.00±0.17g/kg/体重增加到 1.35±0.23g/kg/体重，未接受辅导组从 0.91±0.19g/kg/体重增加到 1.01±0.33g/kg/体重；且存在干预效果（p=.01，η2=0.24）。基线时蛋白质摄入量低于处方指南且研究结束时蛋白质摄入量符合/超过处方指南的 FCG 百分比差异显著，接受辅导的 FCG 中有 60%符合，而未接受辅导的 FCG 中只有 10%符合。在 FMWD 的蛋白质摄入量或 FCG 的幸福感、疲劳或紧张感方面，均未观察到干预效果。与单独进行营养教育相比，饮食辅导加营养教育成功帮助 FCG 提高了蛋白质摄入量。
