Watson R
University of Edinburgh, Scotland.
J Adv Nurs. 1993 Jan;18(1):25-31. doi: 10.1046/j.1365-2648.1993.18010025.x.
The feeding problems of demented elderly people are well documented and the need for research into the assessment of feeding difficulty and intervention by nurses has been raised. The present paper reviews the literature in this area of care and outlines the problems which exist in attempting to investigate the feeding difficulty of demented patients. Demented elderly people display a range of behaviours related to feeding including excessive eating in the early stages of dementia and then difficulty with feeding, refusal to eat and, finally, inability to self-feed at all. The problems with research in this area revolve around the issue of measurement of feeding difficulty. There are problems in deciding what to measure and in how measurements should be made which are clinically meaningful. A possible strategy for investigating the feeding difficulty of demented elderly patients is suggested which includes the design of a tool for measurement and the application of single-case studies. Any tool which is used for measurement should enable researchers, in the first instance, and then clinicians to categorize the feeding difficulty of individual patients. Moreover, such a tool should also be sufficiently sensitive to respond to change in feeding ability. The single-case methodology is considered to be the most ethically and statistically appropriate for research with this particular group of patients.
痴呆老年人的进食问题已有充分记载，并且有人提出需要对护士评估进食困难及进行干预的研究。本文回顾了该护理领域的文献，并概述了在试图调查痴呆患者进食困难时存在的问题。痴呆老年人表现出一系列与进食相关的行为，包括在痴呆早期过度进食，随后出现进食困难、拒绝进食，最终完全无法自行进食。该领域的研究问题围绕进食困难的测量问题展开。在决定测量什么以及如何进行具有临床意义的测量方面存在问题。本文提出了一种调查痴呆老年患者进食困难的可能策略，包括设计一种测量工具和应用单病例研究。任何用于测量的工具首先应使研究人员，然后使临床医生能够对个体患者的进食困难进行分类。此外，这样的工具还应足够灵敏，以应对进食能力的变化。单病例方法被认为是对这一特定患者群体进行研究在伦理和统计上最合适的方法。
