PhD, RN, Chair Professor, Department of Nursing, Asia University, Taiwan, ROC.
MSN, RN, Xingyi Clinic, Taiwan, ROC.
J Nurs Res. 2024 Dec 1;32(6):e365. doi: 10.1097/jnr.0000000000000650.
Approximately 50% of residents living in institutions have insufficient fluid intake, and 20%-30% experience dehydration. Implementing strategies that effectively increase fluid intake is crucial to preventing dehydration-related complications and reducing complications and comorbidities in this population.
This study was designed to explore the effects on fluid intake and hydration status of a hydration game-based learning program in institutional residents.
A single-blind, cluster, randomized controlled trial was conducted. Sixty-four subjects from five long-term care facilities in northern Taiwan were randomly assigned to either an experimental or control group. The experimental group received a 40-minute game-based hydration care program intervention twice weekly for 8 weeks. The control group received routine care. The data obtained were analyzed using generalized estimating equation analysis to verify changes in observed variables in the two groups at 4 and 8 weeks (during and immediately after the intervention).
The results showed a significant improvement in fluid intake in the experimental group at 4 and 8 weeks (p = .002 and p < .001, respectively). In terms of dehydration-related indicators, although total body water was significantly improved at 8 weeks in the experimental group (p = .009), no significant improvement was found in urine-specific gravity. In terms of signs of possible urinary tract infection, the experimental group showed significant improvement in urine leukocytes (p = .029) and nitrites (p = .004) at 8 weeks.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The findings of this study support the positive effects of applying the concept of uncertain rewards and game-based learning in institutional group activities. Specifically, the interventions increased social interaction and enhanced enjoyment of drinking. The findings call for nursing professionals at institutions to offer similar hydration game-based learning programs as part of residents' daily activities to improve fluid intake.
约有 50%居住在机构中的居民摄入的液体不足，20%-30%存在脱水情况。实施能有效增加液体摄入的策略对于预防与脱水相关的并发症以及减少该人群的并发症和合并症至关重要。
本研究旨在探讨基于游戏的补水学习方案对机构居民液体摄入和水合状态的影响。
采用单盲、整群、随机对照试验设计。从台湾北部的 5 家长期护理机构中招募了 64 名受试者，将他们随机分为实验组和对照组。实验组接受 40 分钟的基于游戏的补水护理方案干预，每周 2 次，共 8 周。对照组接受常规护理。使用广义估计方程分析来分析获得的数据，以验证两组在 4 周和 8 周（干预期间和干预后立即）时观察变量的变化。
结果显示，实验组在 4 周和 8 周时液体摄入均有显著改善（p =.002 和 p <.001）。在与脱水相关的指标方面，虽然实验组的总体水在 8 周时显著改善（p =.009），但尿比重没有显著改善。在可能的尿路感染迹象方面，实验组在 8 周时尿液白细胞（p =.029）和亚硝酸盐（p =.004）显著改善。
结论/对实践的启示：本研究结果支持将不确定奖励和基于游戏的学习概念应用于机构群体活动中的积极作用。具体而言，干预措施增加了社会互动并提高了饮水的乐趣。研究结果呼吁机构中的护理专业人员将类似的基于游戏的补水学习方案作为居民日常活动的一部分，以提高液体摄入。
