老年痴呆患者异常进食行为特征及潜在需求分析

Analysis of characteristics of abnormal eating behaviors and potential needs in patients with Alzheimer's disease

目的调查老年痴呆患者的异常进食行为特征,探究其所表达的潜在需求。方法以痴呆需求代偿行为模式为理论依据,采用老年痴呆进食行为清单,观察并记录120例老年痴呆患者的进食行为,筛选异常进食行为;选取12名照护者进行一对一半结构式访谈,选取5名照护者参加焦点团体访谈,采用内容分析法分析资料。结果 57例(47.5%)老年痴呆患者出现异常进食行为;异常进食行为出现频率第1位的条目是口头拒绝进食陈述说"不吃""不饿""已经饱了"(64.9%),第2位的条目是吐出食物(63.2%),并列第3位的条目是进餐前或进餐时出现不耐烦的行为(38.6%)、进餐时注意力不集中(38.6%)、拒绝协助进餐(38.6%)、拒绝张嘴(38.6%)。提取异常进食行为的4个潜在需求主题为:渴望亲情、渴望陪伴、渴望尊严、渴望安全感。结论老年痴呆患者异常进食行为发生较为普遍,其反映了老年痴呆患者的潜在需求,应对照护者进行培训,识别老年痴呆患者异常进食行为及其反映的潜在需求,并尽量满足潜在需求,提高老年痴呆患者的照护质量,减轻照护者负担。

Objective To investigate characteristics of abnormal eating behaviors in patients with Alzheimer＇s disease and explore the potential needs of the patients. Methods Based on the model of Need-driven Dementia- compromised Behavior （NDB）,we used the list of eating behaviors in patients with Alzheimer＇s disease to observe and record the behaviors of 120 patients and extracted the characteristics of abnormal eating behaviors. Twelve caregivers were selected to participate in the individual in-depth interview using semi-structured interview method, and then 5 of them were involved in the focus group interview for richness and accuracy. Content analysis was used to analyze data. Results Abnormal eating behaviors were identified in 47.5%（57/120） of the patients with Alzheimer＇s disease. The most common abnormal eating behavior was verbal refusal to eat or stating ＂No more＂, ＂Not hungry＂,＂I＇m fu11＂（64.9%）,the second was spiting food out（63.2%）,the simultaneous items were impatient behaviors prior to or during meal time（38.6%）,being distracted from eating（38.6%）,resisting help with meal（38.6%）, refusal to open mouth （38.6%）. Four potential needs were extracted,including desire for family,desire for compan- ion,desire for eating dignity,and eagerness for a sense of inner security. Conclusion It is common for patients with Alzheimer＇s disease to show abnormal eating behaviors,which demonstrate their potential needs. Careglvers need to be trained to identify the abnormal behaviors of patients and reflected potential needs. Those needs should be met to improve patients＇ quality of care,and reduce burdens of caregivers.