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Akhtar RN, Behn N, Morgan S. Understanding Dysphagia Care in Pakistan: A Survey of Current Speech Language Therapy Practice. Dysphagia 2024; 39:484-494. [PMID: 38006420 PMCID: PMC11127846 DOI: 10.1007/s00455-023-10633-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 10/19/2023] [Indexed: 11/27/2023]
Abstract
Dysphagia affects individuals across all ages and has pervasive and potentially life-threatening consequences. Individuals with dysphagia are assessed and treated by speech and language therapists (SLTs), however, little attention has been paid to their practices in Pakistan. This study aimed to explore SLTs practices for dysphagia assessment, signs and symptoms observed during evaluation, and management strategies, alongside barriers and facilitators to service delivery in Pakistan. A 45-item survey was distributed to SLTs online. Responses were received from 101 participants and analyzed descriptively, and open-text responses were analyzed using content analysis. Results revealed that 65.3% SLTs worked across the lifespan, and most (79.4%) had dysphagia-related experience of five years or less. SLTs were an active workforce engaged with varying ages, disorders, and settings, yet dysphagia contributed to a small caseload percentage for most. Analyses found informal clinical exams were more frequently used than instrumental assessments. A variety of service provision facilitators were described, such as supportive teams and accessible resources, and responses about barriers revealed gaps in awareness, education, and guidance. This exploratory study presents novel and unexplored data which provides a deeper understanding of dysphagia-related care in Pakistan.
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Affiliation(s)
- Rohma N Akhtar
- Division of Language & Communication Science, Northampton Square, London, EC1V 0HB, UK.
- City University of London, London, UK.
| | - Nicholas Behn
- Division of Language & Communication Science, Northampton Square, London, EC1V 0HB, UK
- City University of London, London, UK
| | - Sally Morgan
- Division of Language & Communication Science, Northampton Square, London, EC1V 0HB, UK
- City University of London, London, UK
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Sharma S, A. Halim NA, Maniam P. Caregiver Experiences with Dementia-Related Feeding/Eating Difficulties. Healthcare (Basel) 2024; 12:133. [PMID: 38255022 PMCID: PMC10815734 DOI: 10.3390/healthcare12020133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 01/24/2024] Open
Abstract
This cross-sectional study explores caregivers' perceptions of feeding/eating difficulties in persons living with dementia, their support provisions, and the associated burdens. Cognitive decline, behavioral symptoms, and physical issues contribute to the deterioration of feeding/eating activities in people with dementia. Inadequate support during mealtimes has adverse consequences. This study includes 31 caregivers who completed an online questionnaire with three sections: sociodemographic information, feeding/eating problems and required support for individuals with dementia, and caregiver burden and distress. The questions on feeding and eating problems were adapted from the Appetite and Eating Habits Questionnaire (APEHQ). The results show that nearly all persons living with dementia had symptoms of feeding/eating problems, requiring caregiver support, ranging from verbal assistance to full physical assistance. The caregivers reported high distress, which was positively correlated with dementia severity. The findings emphasize the importance of raising caregiver awareness about dementia's impact on eating behavior, identifying effective mealtime care strategies, meeting nutritional needs, and emphasizing personal self-care. This research provides insights for healthcare professionals to develop targeted interventions, alleviate caregiver burden, improve mealtime experiences, and ensure adequate nutrition for persons living with dementia.
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Affiliation(s)
- Shobha Sharma
- Speech Sciences Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
- Centre for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Nur Atiqah A. Halim
- Speech Sciences Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Puspa Maniam
- Department of Otorhinolaryngology, Kuala Lumpur General Hospital, Kuala Lumpur 50586, Malaysia
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Saucedo Figueredo MC, Morilla-Herrera JC, Kaknani Uttumchandani S, Durá Pérez E, San Alberto Giraldos M, Nava Del Val MA, Hierrezuelo Martín MJ, Gómez Borrego AB, García Irazusta M, Gálvez González M, Miguel Morales-Asencio J. Longitudinal assessment of the eating pattern of people with dementia and its association with problems for feeding and malnutrition: a prospective follow-up study protocol. BMJ Open 2023; 13:e068790. [PMID: 37230516 DOI: 10.1136/bmjopen-2022-068790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Dementia conditions the patient's nutrition from the beginning and vice versa. Generating difficulties for feeding (FEDIF) will influence its evolution. There are currently few nutritional longitudinal studies in people with dementia. Most focus on problems already established. The Edinburgh Feeding Evaluation in Dementia (EdFED) Scale identifies FEDIF of patients with dementia by studying their behaviours while eating or being fed. It also indicates areas of potential clinical interventions. METHODS AND ANALYSIS Prospective multicentre observational study carried out in nursing homes, Alzheimer's day care centres and primary healthcare centres. The study population will be dyads composed by the patient (diagnosed of dementia, over 65 years of age and who have feeding difficulties) and their family caregiver. Sociodemographic variables and nutritional status (body mass index, Mini Nutritional Assessment, blood test and calf and arm circumference) will be assessed. The Spanish version of the EdFED Scale will be completed and the presence of nursing diagnoses related to feeding behaviours will be collected. Follow-up will take place for 18 months. ETHICS AND DISSEMINATION All data will be carried out respecting European legislation 2016/679 in data protection, and the Spanish 'Organic Law 3/2018 of December 2005'. The clinical data will be kept segregated and encrypted. The informed consent has been obtained. The research has been authorised by the Costa del Sol Health Care District on 27 February 2020 and the Ethics Committee on 2 March 2021. It has obtained funding from the Junta de Andalucía on 15 February 2021. Findings of the study will be presented at provincial, national and international conferences and published in peer-reviewed journals.
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Affiliation(s)
- María Carmen Saucedo Figueredo
- Primary Health Care Costa del Sol District, Los Boliches Health Care Centre, Andalucia Health Service (SAS), Fuengirola, Andalucia, Spain
- IR Group C-13 "Chronicity, Dependency, Care and Health Services", Biomedical Research Institute of Malaga (IBIMA), Malaga, Andalucia, Spain
| | - Juan Carlos Morilla-Herrera
- IR Group C-13 "Chronicity, Dependency, Care and Health Services", Biomedical Research Institute of Malaga (IBIMA), Malaga, Andalucia, Spain
- Residences Unit, Malaga and Valle del Guadalhorce Primary Health Care District, Andalucia Health Service (SAS), Malaga, Andalucia, Spain
| | - Shakira Kaknani Uttumchandani
- IR Group C-13 "Chronicity, Dependency, Care and Health Services", Biomedical Research Institute of Malaga (IBIMA), Malaga, Andalucia, Spain
- Nursing Department, University of Malaga, Health Science Faculty, Malaga, Andalucia, Spain
| | - Elena Durá Pérez
- Andalusian Public Foundation for Research in Biomedicine and Health of Malaga, FIMABIS, Malaga, Andalucia, Spain
| | - Mercedes San Alberto Giraldos
- Primary Health Care Costa del Sol District, La Lobilla Health Care Center, Andalucia Health Service (SAS), Estepona (Málaga), Andalucia, Spain
| | - Maria Antonia Nava Del Val
- Primary Health Care Costa del Sol District, Las Albarizas Health Care Center, Andalucia Health Service (SAS), Marbella, Andalucia, Spain
| | - María Jesús Hierrezuelo Martín
- Primary Health Care Costa del Sol District, Las Lagunas Health Care Center, Servicio Andaluz de Salud, Mijas Costa, Andalucia, Spain
| | - Ana Belén Gómez Borrego
- Community Mental Health Unit, Virgen de la Victoria University Hospital, Servicio Andaluz de Salud, Estepona, Andalucia, Spain
| | - Manuela García Irazusta
- Primary Health Care Costa del Sol District, Fuengirola Oeste Health Care Center, Servicio Andaluz de Salud, Marbella, Andalucia, Spain
| | - María Gálvez González
- Primary Health Care Costa del Sol District, La Carihuela Health Care Center, Servicio Andaluz de Salud, Benalmadena, Andalucia, Spain
| | - Jose Miguel Morales-Asencio
- IR Group C-13 "Chronicity, Dependency, Care and Health Services", Biomedical Research Institute of Malaga (IBIMA), Malaga, Andalucia, Spain
- Nursing Department, University of Malaga, Málaga, Andalucia, Spain
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Eating Difficulties and Relationship With Nutritional Status Among Patients With Dementia. THE JOURNAL OF NURSING RESEARCH : JNR 2023; 31:e260. [PMID: 36602459 DOI: 10.1097/jnr.0000000000000538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND One of the most common behavioral problems in patients with dementia is eating problems, which are known to increase the risk of malnutrition. However, few studies have been conducted in this patient group regarding the relationship between eating difficulties and nutritional status. PURPOSE This study was designed to determine the eating difficulties faced by patients with dementia and to evaluate the relationship in this population between eating difficulties and malnutrition. METHODS This study was carried out in a dementia outpatient clinic of a university hospital in Istanbul, Turkey. This cross-sectional, case-control study included 50 patients and 50 healthy controls as participants. Participants were assessed for eating difficulties and for nutritional, cognitive, and functional statuses. RESULTS The patients with dementia had more difficulties in terms of self-feeding skills. Although problems related to manipulating food on the plate and the use of utensils were not seen in the control group, these problems were found in 30% of the participants in the dementia group ( p < .001). Moreover, 30% of the patients in the dementia group were unable to eat without assistance ( p < .001). Associations were found between eating difficulties and age, duration of illness, and cognitive and functional (basic and instrumental activities of daily living) statuses. In addition, self-feeding skills were found to be associated with nutritional status. Rate of malnutrition or risk of malnutrition was higher in patients with dementia than in those in the control group. CONCLUSIONS In this study, compared with the control group, patients with dementia had more problems in self-feeding skills such as manipulation of food on a plate, use of utensils, need for assistive tools, ability to eat without assistance, and negative eating behaviors (refusal to eat). An association was found between eating difficulties and nutritional status. Evaluating eating difficulties is recommended in patients with dementia to prevent nutritional deterioration.
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Goodwin I, Lea E, Bindoff A, Doherty K. Exploring perceptions of eating with dementia: Findings from a massive open online course. Appetite 2022; 177:106126. [PMID: 35697154 DOI: 10.1016/j.appet.2022.106126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022]
Abstract
People with dementia are at high risk of malnutrition as a result of progressive symptoms that affect eating. Maximising opportunities to enhance nutrition and strategies to encourage eating are a crucial part of providing care. Caregiver knowledge and a person-centred approach to eating is essential to reduce symptom burden and maintain quality of life. There is currently limited research investigating first person perceptions of eating with dementia, particularly beyond small sample sizes. Therefore, this paper aims to explore community perceptions of how best to encourage eating for people with dementia using findings from an online course. Within the Understanding Dementia Massive Open Online Course, responses to the following statement were collected: 'If I had dementia, the things that might help me to eat include…'. A total of 3,651 participant responses were collected from the 2018 and 2019 course enrolments and analysed using structural topic modelling and secondary thematic analysis. The majority of participants were female, tertiary educated Australians over 50 years old. A third were paid caregivers. Thirteen topics were isolated from topic modelling that can be reduced into six broad categories: food type personalisation, meal choice, meal presentation, eating environment, eating assistance and end of life nutrition. Participant responses demonstrated diverse awareness of important aspects to encourage eating in dementia. Findings support the need for improved uptake of nutritional strategies in practice and education on eating with dementia to support caregivers.
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Affiliation(s)
- Isabelle Goodwin
- School of Health Sciences, University of Tasmania, Tasmania, Australia; Wicking Dementia Research and Education Centre, Tasmania, Australia.
| | - Emma Lea
- Wicking Dementia Research and Education Centre, Tasmania, Australia
| | - Aidan Bindoff
- Wicking Dementia Research and Education Centre, Tasmania, Australia
| | - Kathleen Doherty
- Wicking Dementia Research and Education Centre, Tasmania, Australia
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Eating Difficulties among Older Adults with Dementia in Long-Term Care Facilities: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910109. [PMID: 34639409 PMCID: PMC8508293 DOI: 10.3390/ijerph181910109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 01/17/2023]
Abstract
This paper reports a scoping review of the literature on eating difficulties among older adults with dementia in long-term care facilities to identify key concepts, methods of measuring outcomes, interventions, and related factors. A scoping review was performed using the bibliographic databases PubMed, CINAHL, PsycINFO, and Cochrane Library. A combination of keywords and subject headings related to eating or feeding difficulties was used. Inclusion criteria were limited to materials published in English. A total of 1070 references were retrieved, of which 39 articles were selected after applying the inclusion and exclusion criteria. Articles that met the criteria were published between 1987 and 2020. “Eating disabilities” have been defined as problems related to choosing food and/or the ability to get food to one’s mouth, chew, and swallow. Interventions for eating difficulties described in the literature include spaced retrieval training, Montessori training, and feeding skill training. Intrapersonal, interpersonal, and environmental factors related to eating difficulties were identified. This scoping review will provide direct care workers, nursing educators, and administrators with an overview of eating performance and a broad understanding of eating difficulties for older adults with dementia in long-term care facilities.
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Palese A, Achbani B, Hayter M, Watson R. Fidelity challenges while implementing an intervention aimed at increasing eating performance among nursing home residents with cognitive decline: A multicentre, qualitative descriptive study design. J Clin Nurs 2020; 31:1835-1849. [PMID: 32957159 DOI: 10.1111/jocn.15507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/04/2020] [Accepted: 08/31/2020] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To increase the knowledge on fidelity challenges in intervention studies promoting eating independence in residents with cognitive decline living in nursing homes (NHs). BACKGROUND A few studies have documented to date factors affecting fidelity in intervention studies performed in NH settings. Moreover, fidelity issues in intervention studies aimed at promoting eating independence among NH residents with cognitive decline have not been studied to date. DESIGN A hybrid study design was performed in 2018 and reported here according to the COnsolidated criteria for REporting Qualitative research. METHODS In a clustered multicentre before/after intervention study design, a nested, multicentre qualitative descriptive design was performed. Four researchers with a nursing background, who received appropriate training, implemented the designed intervention. This consisted in intentional rounds in the dining rooms during lunchtime and was based on supportive, prescriptive and informative prompts delivered to residents with cognitive decline aimed at stimulating eating independence. A momentary assessment method was used, based on daily diary filled in by participant researchers after every session of intervention delivery on the following five dimensions of fidelity: (a) adherence, (b) dose (or exposure), (c) intervention quality, (d) participant responsiveness and (e) programme differentiation. A direct content analysis of the narratives reported on the diaries was performed. RESULTS Factors increasing or hindering intervention fidelity during its implementation emerged at the NH, staff, family caregivers, resident, researchers and at the intervention itself levels. CONCLUSIONS Several factors emerged and all reported potentially both positive and negative influences on fidelity while implementing an intervention aimed at promoting eating independence among NH residents. Fidelity challenges should be considered as dynamic in NH intervention studies, where continuous adjustments of the intervention delivered are required. RELEVANCE TO CLINICAL PRACTICE A calm environment, with staff members showing a caring behaviour, and researchers having achieved good familiarity with the NH setting, the residents, their family carers and the staff members, can all increase intervention fidelity.
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Affiliation(s)
- Alvisa Palese
- Department of Medical Science, Udine University, Udine, Italy
| | - Btissam Achbani
- Department of Medical Science, Udine University, Udine, Italy
| | - Mark Hayter
- Faculty of Health Sciences, University of Hull, Hull, UK
| | - Roger Watson
- Faculty of Health Sciences, University of Hull, Hull, UK
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Palese A, Bressan V, Hayter M, Watson R. Enhancing independent eating among older adults with dementia: a scoping review of the state of the conceptual and research literature. BMC Nurs 2020; 19:32. [PMID: 32336948 PMCID: PMC7171919 DOI: 10.1186/s12912-020-00425-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background Addressing eating difficulties among older individuals with dementia living in nursing homes requires evidence-based interventions. However, to date, there is limited evidence of effective interventions designed to maintain and/or increase independent eating. In a field in which evidence is still lacking, a critical analysis of the state of research describing its main features can help identify methodological gaps that future studies should address. Hence, the aim of this study was to map the state of the research designed to maintain and/or promote independent eating in older individuals with dementia living in nursing homes. Methods A scoping review was performed by following the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Reviews and conceptual analyses performed with different methodological approaches, published in indexed journals, and written in English were included. Keywords Were searched for in the MEDLINE, the Cumulative Index of Nursing and Allied Health, and in the Scopus databases to identify papers published up to 31 May 2018. Results 17 reviews were included, assessing interventions’ effectiveness (n = 15) and providing conceptual frameworks for eating/mealtime difficulties (n = 2). Conceptual frameworks supporting interventions’ effectiveness have rarely been described in available studies. Moreover, interventions tested have been categorized according to non-homogeneous frameworks. Their effectiveness has been measured against (1) eating performance, (2) clinical outcomes, and (3) adverse event occurrence. Conclusion An increased use of conceptual frameworks in studies, as well as greater clarity in intervention categorization and outcomes, is necessary to enhance the reviews’ value in providing useful cumulative knowledge in this field. Interventions delivered should embody different components that integrate individual, social, cultural, and environmental factors, while when evaluating an intervention’s effectiveness, eating performance, clinical outcomes and adverse events should be considered. Together with more robust studies, involving clinicians could prove to be useful, as their knowledge of practice developed from direct experience can help develop innovative research questions.
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Affiliation(s)
- Alvisa Palese
- 1Department of Medical Sciences, University of Udine, Viale Ungheria, 20, 33100 Udine, Italy
| | - Valentina Bressan
- 1Department of Medical Sciences, University of Udine, Viale Ungheria, 20, 33100 Udine, Italy
| | - Mark Hayter
- 2Faculty of Health Sciences, University of Hull, Hull, UK
| | - Roger Watson
- 2Faculty of Health Sciences, University of Hull, Hull, UK
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Palese A, Bressan V, Kasa T, Meri M, Hayter M, Watson R. Interventions maintaining eating Independence in nursing home residents: a multicentre qualitative study. BMC Geriatr 2018; 18:292. [PMID: 30482168 PMCID: PMC6258290 DOI: 10.1186/s12877-018-0985-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/19/2018] [Indexed: 01/26/2023] Open
Abstract
Background Despite 32 years of research and 13 reviews published in the field, no intervention can be considered a gold standard for maintaining eating performance among residents with dementia. The study aim was to highlight the interventions derived from tacit knowledge and offered daily in assisting eating by healthcare professionals (HCPs) in nursing homes (NHs). Method A multicentre descriptive qualitative study was performed in 2017. Thirteen NHs admitting residents with moderate/severe functional dependence in eating mainly due to dementia, were approached. A purposeful sample of 54 HCPs involved on a daily basis in assisting residents during mealtime were interviewed in 13 focus groups. Data analysis was conducted via qualitative content analysis. Results The promotion and maintenance of eating performance for as long as possible is ensured by a set of interventions targeting three levels: (a) environmental, by ‘Ritualising the mealtime experience by creating a controlled stimulated environment’; (b) social, by ‘Structuring effective mealtime social interactions’; and (c) individual, by ‘Individualising eating care’ for each resident. Conclusions In NHs, the eating decline is juxtaposed with complex interventions regulated on a daily basis and targeting the environment, the social interactions, and the residents’ needs. Several interventions that emerged as effective, according to the experience of participants, have never been documented before; while others are in contrast to the evidence documented. This suggests the need for further studies in the field; as no conclusions regarding the best interventions have been established to date.
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Affiliation(s)
- Alvisa Palese
- Department of Medical Sciences, University of Udine, Viale Ungheria, 20, 33100, Udine, Italy.
| | - Valentina Bressan
- Department of Medical Sciences, University of Udine, Viale Ungheria, 20, 33100, Udine, Italy
| | - Tea Kasa
- Department of Medical Sciences, University of Udine, Viale Ungheria, 20, 33100, Udine, Italy
| | - Marin Meri
- Department of Medical Sciences, University of Udine, Viale Ungheria, 20, 33100, Udine, Italy
| | - Mark Hayter
- Faculty of Health Sciences, University of Hull, Cottingham Road, HU6 7RX, Hull, UK
| | - Roger Watson
- Faculty of Health Sciences, University of Hull, Cottingham Road, HU6 7RX, Hull, UK
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Flynn E, Smith CH, Walsh CD, Walshe M. Modifying the consistency of food and fluids for swallowing difficulties in dementia. Cochrane Database Syst Rev 2018; 9:CD011077. [PMID: 30251253 PMCID: PMC6513397 DOI: 10.1002/14651858.cd011077.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND People with dementia can have feeding and swallowing difficulties (dysphagia). Modification of the consistency of food or fluids, or both, is a common management strategy. However, diet modification can affect quality of life and may lead to dehydration and malnutrition. Evidence on the benefits and risks of modifying food and fluids is mandatory to improve the care of people with dementia and dysphagia. OBJECTIVES To determine the effectiveness and adverse effects associated with modifying the consistency of food and fluids in improving oral intake and eliminating aspiration in adults with dysphagia and dementia. SEARCH METHODS We searched ALOIS (the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group), the Cochrane Library, MEDLINE via Ovid SP, Embase via Ovid SP, PsycINFO via Ovid SP, CINAHL via EBSCOhost, LILACS via BIREME, ClinicalTrials.gov and the World Health Organization (WHO) Portal on 9 May 2018. We also checked the reference lists of relevant articles to identify any additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), quasi-RCTs and cluster-RCTs published in any language that measured any of the outcomes of interest. We included trials with adults with a clinical diagnosis of dementia with symptoms and signs of dysphagia confirmed on instrumental assessment. We included participants with all types, stages and severities of dementia. Control groups received either no intervention or interventions not involving diet modification or modification to sensory properties of food. DATA COLLECTION AND ANALYSIS Two review authors independently assessed for inclusion all potential studies identified. Data were extracted independently along with assessment of methodological quality using standard Cochrane methods. We contacted study authors for additional unpublished information. MAIN RESULTS No trials on modification of food met the inclusion criteria. We included two studies that examined modification to fluids. Both were part of the same large multicentre trial and included people with dementia and people with or without dementia and Parkinson's disease. Participation in the second trial was determined by results from the first trial. With unpublished data supplied by study authors, we examined data from participants with dementia only. The first study, a cross-over trial, investigated the immediate effects on aspiration of two viscosities of liquids (nectar thick and honey thick) compared to regular liquids in 351 participants with dementia using videofluoroscopy. Regular liquids with a chin down head posture, as well as regular liquids without any intervention were also compared. The sequence of interventions during videofluoroscopy may have influenced response to intervention. The second study, a parallel designed RCT, compared the effect of nectar and honey thick liquids with a chin down head posture over a three-month period in a subgroup of 260 participants with dementia. Outcomes were pneumonia and adverse intervention effects. Honey thick liquids, which are more consistent with descriptors for 'spoon thick' or 'extremely thick' liquids, showed a more positive impact on immediate elimination of aspiration during videofluoroscopy, but this consistency showed more adverse effects in the second follow-up study. During the second three-month follow-up trial, there were a greater number of incidents of pneumonia in participants receiving honey thick liquids than those receiving nectar thick liquids or taking regular liquids with a chin down posture. There were no deaths classified as 'definitely related' to the type of fluids prescribed. Neither trial addressed quality of life. Risk of bias for both studies is high. The overall quality of evidence for outcomes in this review is low. AUTHORS' CONCLUSIONS We are uncertain about the immediate and long-term effects of modifying the consistency of fluid for swallowing difficulties in dementia as too few studies have been completed. There may be differences in outcomes depending on the grade of thickness of fluids and the sequence of interventions trialled in videofluoroscopy for people with dementia. Clinicians should be aware that while thickening fluids may have an immediate positive effect on swallowing, the long-term impact of thickened fluids on the health of the person with dementia should be considered. Further high-quality clinical trials are required.
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Affiliation(s)
- Eadaoin Flynn
- Trinity College DublinClinical Speech and Language Studies7‐9 South Leinster Street2 DublinIreland
| | | | - Cathal D Walsh
- Department of Mathematics and StatisticsHealth Research Institute (HRI) and MACSIUniversity of LimerickIreland
| | - Margaret Walshe
- Trinity College DublinClinical Speech and Language Studies7‐9 South Leinster Street2 DublinIreland
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Saucedo Figueredo MC, Morilla Herrera JC, San Alberto Giraldos M, López Leiva I, León Campos Á, Martí García C, García Mayor S, Kaknani Uttumchandani S, Morales Asencio JM. Validation of the Spanish version of the Edinburgh Feeding Evaluation in Dementia Scale for older people with dementia. PLoS One 2018; 13:e0192690. [PMID: 29486002 PMCID: PMC5828442 DOI: 10.1371/journal.pone.0192690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 01/29/2018] [Indexed: 01/30/2023] Open
Abstract
AIMS To adapt the Edinburgh Feeding Evaluation in Dementia Scale (EdFED) for use in a Spanish-speaking population and to assess its validity and reliability in patients with dementia. METHOD A cross-sectional study was carried out in two stages: 1. Cross-cultural adaptation (translation, back-translation, review by committee of experts, pilot test and weighting of results); 2. Clinimetric validation comprising interobserver reliability assessment, test-retest reliability and internal consistency. To determine construct validity, confirmatory factorial analysis and principal components analysis were performed by oblique rotations. Criteria validity was analysed using the Pearson correlation (p<0.05) with the BMI, MNA and analytical values of albumin, transferrin, cholesterol, absolute lymphocytes and total proteins. Data collection was carried out for six months in 2016 in nursing homes and Alzheimer's day centers in the province of Málaga (Spain), at nine centers, with 262 patients (aged over 60 years and presenting feeding difficulties), 20 nurses, 20 professional caregivers and 103 family caregivers. RESULTS A version of EdFED culturally adapted to Spanish was obtained. The sample presented the following characteristics: 76.3% women, mean age 82.3 years (SD: 7.9); MNA 18.73 (SD: 4.44); BMI 23.99 (SD: 4.72); serum albumin 3.79 mg/dl (SD: 0.36). A Cronbach's alpha of 0.88 was obtained, with an inter-item global correlation of 0.43 and a homogeneity index ranging from 0.42 to 0.73. The exploratory factor analysis reproduced the three-factor model identified by the original authors, explaining 62.32% of the total variance. The criterion validity showed a good inverse correlation with MNA and a moderate one with albumin, total proteins, transferrin and BMI. DISCUSSION The Spanish version of EdFED is reliable and valid for use in elderly people with dementia. The most appropriate for our environment is the three-factor model, which maintains the original factors, with a slight redistribution of the items.
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Affiliation(s)
| | - Juan Carlos Morilla Herrera
- Nursing Home Unit Málaga-Guadalhorce, Primary Health Care District, Málaga, Spain; Faculty of Health Sciences, University of Málaga, Málaga, Spain
| | | | | | | | - Celia Martí García
- Department of Nursing, Faculty of Health Sciences University of Málaga, Málaga, Spain
| | - Silvia García Mayor
- Department of Nursing, Faculty of Health Sciences University of Málaga, Málaga, Spain
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Hong HH, Gu MO. Development and Effects of a Coping Skill Training Program for Caregivers in Feeding Difficulty of Older Adults with Dementia in Long-Term Care Facilities. J Korean Acad Nurs 2018; 48:167-181. [DOI: 10.4040/jkan.2018.48.2.167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 03/12/2018] [Accepted: 03/14/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Hyun Hwa Hong
- Department of Nursing, College of Health Sciences, Kyungnam University, Changwon, Korea
| | - Mee Ock Gu
- College of Nursing · Gerontological Health Research Center in Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
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13
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Jésus P, Guerchet M, Pilleron S, Fayemendy P, Maxime Mouanga A, Mbelesso P, Preux PM, Desport JC. Undernutrition and obesity among elderly people living in two cities of developing countries: Prevalence and associated factors in the EDAC study. Clin Nutr ESPEN 2017; 21:40-50. [PMID: 30014868 DOI: 10.1016/j.clnesp.2017.05.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/24/2017] [Accepted: 05/30/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND Nutritional status among elderly people living in Sub-Saharan Africa is poorly studied, even though undernutrition and obesity are known to cause many complications and are risk factors for progression and death in several diseases. The aims of this study were to assess the nutritional status of the elderly in Central Africa and to study the factors associated with nutritional disorders (undernutrition and obesity). METHODS Two cross-sectional population-based studies were carried out in the capitals of Central African Republic (CAR) and Republic of Congo (ROC) between 2008 and 2009. Participants were aged ≥65 years old and underwent nutritional assessment including the following measurements: weight, height, body mass index (BMI), waist circumference (WC). Diet was also investigated. Nutritional status was defined according to the WHO BMI classification (<18.5 = undernutrition; ≥30 = obesity). Multinomial regression analysis was performed in order to identify factors associated with nutritional status. RESULTS 990 elderly people underwent nutritional assessment (482 in CAR and 508 in ROC). Mean BMI was 22.7 ± 4.8 kg/m2. The prevalence of undernutrition was 19.2% and was lower in ROC than in CAR (9.5% vs. 29.5%; p < 0.0001). The prevalence of obesity was 8.8% and was higher in ROC than in CAR (14.6% vs. 2.7%; p < 0.0001). The mean WC was 85.3 ± 28.4 cm. Adjusted on study site, increasing age (OR = 1.6 [95% CI: 1.1-2.3] for 75-84 years, OR = 2.6 [95% CI: 1.4-4.8] for 85+ years), occupation as farmer/breeder (OR = 2.2 [95% CI: 1.1-4.2]), smoking (OR = 1.71 [95% CI: 1.14-2.56]) and low sugar consumption (OR = 1.7 [95% CI: 1.1-2.7]) were positively associated with undernutrition whereas only female sex was positively associated with obesity (OR = 5.0 [95% CI: 2.2-11.0]). CONCLUSIONS The prevalence of undernutrition is high in the elderly population of these countries, in contrast to obesity. Undernutrition and obesity are associated with different socio-economic factors and food consumption. Simple nutritional advice could contribute to improving the nutritional status of elderly people in Central Africa.
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Affiliation(s)
- Pierre Jésus
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Nutrition Unit, Centre for Severe Obesity and Expert Centre for Home Parenteral Nutrition, Dupuytren University Hospital of Limoges, Limoges, France.
| | - Maëlenn Guerchet
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; King's College London, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, UK
| | - Sophie Pilleron
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
| | - Philippe Fayemendy
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Nutrition Unit, Centre for Severe Obesity and Expert Centre for Home Parenteral Nutrition, Dupuytren University Hospital of Limoges, Limoges, France
| | - Alain Maxime Mouanga
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Psychiatry Department, University Hospital of Brazzaville, Brazzaville, Congo
| | - Pascal Mbelesso
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Neurology Department, Amitié Hospital, Bangui, Central African Republic
| | - Pierre Marie Preux
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Medical Information & Evaluation, Clinical Research and Biostatistics Unit, University Hospital of Limoges, Limoges, France
| | - Jean Claude Desport
- INSERM UMR1094, Tropical Neuroepidemiology, School of Medicine of Limoges, Limoges, France; Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France; Nutrition Unit, Centre for Severe Obesity and Expert Centre for Home Parenteral Nutrition, Dupuytren University Hospital of Limoges, Limoges, France
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14
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Chang CC, Lin YF, Chiu CH, Liao YM, Ho MH, Lin YK, Chou KR, Liu MF. Prevalence and factors associated with food intake difficulties among residents with dementia. PLoS One 2017; 12:e0171770. [PMID: 28225776 PMCID: PMC5321470 DOI: 10.1371/journal.pone.0171770] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 01/07/2017] [Indexed: 12/04/2022] Open
Abstract
Background Few studies have examined the prevalence of food intake difficulties and their associated factors among residents with dementia in long-term care facilities in Taiwan. The purpose of the study was to identify the best cutoff point for the Chinese Feeding Difficulty Index (Ch-FDI), which evaluates the prevalence of food intake difficulties and recognizes factors associated with eating behaviors in residents with dementia. Methods and findings A cross-sectional design was adopted. In total, 213 residents with dementia in long-term care facilities in Taiwan were recruited and participated in this study. The prevalence rate of food intake difficulties as measured by the Chinese Feeding Difficulty Index (Ch-FDI) was 44.6%. Factors associated with food intake difficulties during lunch were the duration of institutionalization (beta = 0.176), the level of activities of daily living-feeding (ADL-Q1) (beta = -0.235), and the length of the eating time (beta = 0.416). Associated factors during dinner were the illuminance level (beta = -0.204), sound volume level (beta = 0.187), ADL-Q1 (beta = -0.177), and eating time (beta = 0.395). Conclusions Food intake difficulties may potentially be associated with multiple factors including physical function and the dining environment according to the 45% prevalence rate among dementia residents in long-term care facilities.
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Affiliation(s)
- Chia-Chi Chang
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yu-Fang Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chia-Hui Chiu
- Center of General Education, Taipei Medical University, Taipei, Taiwan
| | - Yuan-Mei Liao
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Mu-Hsing Ho
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yen-Kuang Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Biostatistics Research Center, Taipei Medical University, Taipei, Taiwan
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Megan F. Liu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
- * E-mail:
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15
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Keller HH, Carrier N, Slaughter S, Lengyel C, Steele CM, Duizer L, Brown KS, Chaudhury H, Yoon MN, Duncan AM, Boscart VM, Heckman G, Villalon L. Making the Most of Mealtimes (M3): protocol of a multi-centre cross-sectional study of food intake and its determinants in older adults living in long term care homes. BMC Geriatr 2017; 17:15. [PMID: 28086754 PMCID: PMC5234152 DOI: 10.1186/s12877-016-0401-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 12/16/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Older adults living in long term care (LTC) homes are nutritionally vulnerable, often consuming insufficient energy, macro- and micronutrients to sustain their health and function. Multiple factors are proposed to influence food intake, yet our understanding of these diverse factors and their interactions are limited. The purpose of this paper is to fully describe the protocol used to examine determinants of food and fluid intake among older adults participating in the Making the Most of Mealtimes (M3) study. METHODS A conceptual framework that considers multi-level influences on mealtime experience, meal quality and meal access was used to design this multi-site cross-sectional study. Data were collected from 639 participants residing in 32 LTC homes in four Canadian provinces by trained researchers. Food intake was assessed with three-days of weighed food intake (main plate items), as well as estimations of side dishes, beverages and snacks and compared to the Dietary Reference Intake. Resident-level measures included: nutritional status, nutritional risk; disease conditions, medication, and diet prescriptions; oral health exam, signs of swallowing difficulty and olfactory ability; observed eating behaviours, type and number of staff assisting with eating; and food and foodservice satisfaction. Function, cognition, depression and pain were assessed using interRAI LTCF with selected items completed by researchers with care staff. Care staff completed a standardized person-directed care questionnaire. Researchers assessed dining rooms for physical and psychosocial aspects that could influence food intake. Management from each site completed a questionnaire that described the home, menu development, food production, out-sourcing of food, staffing levels, and staff training. Hierarchical regression models, accounting for clustering within province, home and dining room will be used to determine factors independently associated with energy and protein intake, as proxies for intake. Proportions of residents at risk of inadequate diets will also be determined. DISCUSSION This rigorous and comprehensive data collection in a large and diverse sample will provide, for the first time, the opportunity to consider important modifiable factors associated with poor food intake of residents in LTC. Identification of factors that are independently associated with food intake will help to develop effective interventions that support food intake. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT02800291 , retrospectively registered June 7, 2016.
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Affiliation(s)
- Heather H Keller
- Schlegel-University of Waterloo Research Institute for Aging, 250 Laurelwood Drive, Waterloo, ON N2J 0E2, Canada.
| | - Natalie Carrier
- École des sciences des aliments, de nutrition et d'études familiales, Faculté des sciences de la santé et des services communautaires, Université de Moncton, Moncton, NB E1A 3E9, Canada
| | - Susan Slaughter
- Faculty of Nursing, University of Alberta, Edmonton, T6G 1C9, AB, Canada
| | - Christina Lengyel
- Faculty of Agricultural & Food, Sciences, University of Manitoba, 405 Human Ecology Building, Winnipeg, MB R3T 2N2, Canada
| | - Catriona M Steele
- Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, #12-101, Toronto, M5G 2A2, ON, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, M5G 1V7, Canada
| | - Lisa Duizer
- Department of Food Science, University of Guelph, Guelph, ON N1G 2W1, Canada
| | - K Steve Brown
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, N2L 3G1, Canada
| | - Habib Chaudhury
- Department of Gerontology, Simon Fraser University, 2800-515 W. Hastings St, Vancouver, BC, V6B 5K3, Canada
| | - Minn N Yoon
- School of Dentistry, University of Alberta, 5-575, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, AB, T6G 1C9, Canada
| | - Alison M Duncan
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Veronique M Boscart
- Schlegel-University of Waterloo Research Institute for Aging, 250 Laurelwood Drive, Waterloo, ON N2J 0E2, Canada.,Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, #12-101, Toronto, M5G 2A2, ON, Canada.,Conestoga College, School of Health Sciences and Community Services, Kitchener, ON, N2G 4M4, Canada
| | - George Heckman
- Schlegel-University of Waterloo Research Institute for Aging, 250 Laurelwood Drive, Waterloo, ON N2J 0E2, Canada
| | - Lita Villalon
- École des sciences des aliments, de nutrition et d'études familiales, Faculté des sciences de la santé et des services communautaires, Université de Moncton, Moncton, NB E1A 3E9, Canada
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16
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Saucedo Figueredo MC, Morilla Herrera JC, Ramos Gil R, Arjona Gómez MN, García Dillana F, Martínez Blanco J, Morales Asencio JM. Validation of the Spanish version of the Edinburgh feeding evaluation in dementia scale applied to institutionalized older persons with dementia: a study protocol. Nurs Open 2016; 3:236-242. [PMID: 27708835 PMCID: PMC5050548 DOI: 10.1002/nop2.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 02/08/2016] [Indexed: 11/11/2022] Open
Abstract
Aim The aim of this study was to obtain a Spanish version of the Edinburgh Feeding Evaluation in Dementia Scale version, to assess its reliability for use by medical staff and caregivers at residential care homes, to evaluate by confirmatory methods its construct validity. A further aim was to determine the criterion validity with respect to biochemical markers of malnutrition such as serum albumin, transferrin, cholesterol and lymphocytes, the body mass index and the mini nutritional assessment. Design Clinimetric cross‐validation study. Methods Institutionalized subjects with dementia will be observed while consuming meals and evaluated with the instrument independently by nurses and caregivers.
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Affiliation(s)
| | - Juan Carlos Morilla Herrera
- Nursing Home Unit Málaga-Gualdalhorce Primary Health Care District Málaga Spain; Faculty of Health Sciences University of Málaga Málaga Spain
| | - Roberto Ramos Gil
- Nursing Home Unit Costa del Sol Primary Health Care District Málaga Spain
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17
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Nell D, Neville S, Bellew R, O'Leary C, Beck KL. Factors affecting optimal nutrition and hydration for people living in specialised dementia care units: A qualitative study of staff caregivers' perceptions. Australas J Ageing 2016; 35:E1-E6. [DOI: 10.1111/ajag.12307] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Debra Nell
- Institute of Food, Nutrition & Human Health; Massey University; Auckland New Zealand
| | | | - Roana Bellew
- Senior Living and Private Hospitals; Compass Group NZ Ltd; Auckland New Zealand
| | - Catherine O'Leary
- Senior Living and Private Hospitals; Compass Group NZ Ltd; Auckland New Zealand
| | - Kathryn Louise Beck
- Institute of Food, Nutrition & Human Health; Massey University; Auckland New Zealand
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18
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Lyngroth AL, Hernes SMS, Madsen BO, Söderhamn U, Grov EK. Nutritional screening of patients at a memory clinic - association between patients’ and their relatives’ self-reports. J Clin Nurs 2016; 25:760-8. [DOI: 10.1111/jocn.13093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2015] [Indexed: 01/27/2023]
Affiliation(s)
| | - Susanne Miriam Sørensen Hernes
- Department of Clinical Science, University of Bergen and Department of Geriatrics and Internal Medicine; Sorlandet Hospital Arendal; Arendal Stoa Norway
| | - Bengt-Ove Madsen
- The Memory Clinic; Sorlandet Hospital Arendal; Arendal Stoa Norway
| | - Ulrika Söderhamn
- Faculty of Health and Sports Sciences; University of Agder; Grimstad Norway
| | - Ellen Karine Grov
- Department of Nursing and Health
Promotion; Oslo and Akershus University of Applied Sciences; Oslo Norway
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19
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Malerba G, Pop A, Rivasseau-Jonveaux T, Mouchotte S, Fabbro J, N’Guyen A, Schmitt A, Quilliot D. Nourrir un patient atteint de troubles neurocognitifs à l’hôpital et à domicile ? Le manger-mains : aspects pratiques. NUTR CLIN METAB 2015. [DOI: 10.1016/j.nupar.2015.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Development and Psychometric Evaluation of the Chinese Feeding Difficulty Index (Ch-FDI) for People with Dementia. PLoS One 2015. [PMID: 26196126 PMCID: PMC4510378 DOI: 10.1371/journal.pone.0133716] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aims To develop and evaluate the psychometric properties of a Chinese Feeding Difficulty Index (Ch-FDI) which assesses feeding difficulties in people with dementia (PwD). Research Design and Method Scale items were developed using literature review based on Model of Feeding Difficulty. Content validity was evaluated and items were modified by expert panel. Following translation and back-translation, the Ch-FDI was piloted on residents with dementia. The reliability was tested by inter-rater reliability and test-retest reliability. Internal reliability was established by calculating Cronbach's α coefficient. The concurrent validity was evaluated by correlating with similar scale, the Edinburgh Feeding Evaluation in Dementia (EdFED). The exploratory factor analysis (EFA) with varimax rotation and parallel analysis (PA) was performed to test construct validity. Method Participants were recruited from long-term care facilities in Taiwan. A total of 213 residents with dementia participated in this study during May, 2010 to February, 2011. Results Content validation, translation and psychometric testing were completed on the 19 items of the Ch-FDI. The translated scale was piloted on 213 residents with dementia of feeding difficulty who were recruited from eight long-term care facilities in Taiwan. The reliability was supported by the internal consistency of Cronbach's α of 0.68 and a test-retest coefficient of 0.85. The content validity, face validity, concurrent validity, and construct validity were used. Conclusions The Ch-FDI is a newly developed scale with fair psychometric properties aimed to measure feeding difficulties among residents with dementia in long-term care facilities in Taiwan. Using this reliable and valid tool can help healthcare providers to assess feeding problems of PwD and provide feeding assistance in order to promote quality of care during mealtime in long-term care facilities.
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21
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Lee KM, Song JA. Factors influencing the degree of eating ability among people with dementia. J Clin Nurs 2015; 24:1707-17. [PMID: 25623819 DOI: 10.1111/jocn.12777] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore the degree of eating ability in people with dementia and identify what factors affect their eating ability. BACKGROUND Appropriate food consumption is important to human life. Although eating difficulties are common among people with dementia, little is known about what factors might influence their eating ability. DESIGN Descriptive, cross-sectional study. METHODS A total of 149 people with dementia residing in nursing facilities in Seoul or the Gyeonggi area of Korea were evaluated using the Korean Mini-Mental State Examination, Korean Activities of Daily Living Scale and Eating Behaviour Scale. Data were analysed using descriptive statistics, one-way analysis of variance, Pearson correlation coefficient and multiple regression analysis. RESULTS The participants showed a moderate level of dependency with respect to eating ability and were most dependent on the use of utensils. There were significant differences in eating ability according to general characteristics such as duration of residence, duration of illness, degree of visual impairment, eating place, and diet type. The eating ability of the participants was significantly correlated with cognitive function and physical function. Cognitive function, physical function, duration of illness, eating place (living room or dining room), and diet type (soft or liquid) significantly predicted eating ability in people with dementia. CONCLUSIONS The findings of this study suggest that it is necessary to thoroughly assess the eating ability of people with dementia and to develop appropriate training programs to maintain or improve their remaining eating ability. The creation of a pleasurable physical and social environment for eating might also be helpful. RELEVANCE TO CLINICAL PRACTICE These findings would be able to serve a useful basis in the development of materials for nursing intervention programs for people with dementia during mealtimes by improving the techniques and care qualities of nursing caregivers.
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Affiliation(s)
- Kyoung Min Lee
- Department of Nursing, DongKang University, Gwangju, South Korea
| | - Jun-Ah Song
- College of Nursing, Korea University, Seoul, South Korea
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22
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Menzel PT, Chandler-Cramer MC. Advance Directives, Dementia, and Withholding Food and Water by Mouth. Hastings Cent Rep 2014; 44:23-37. [DOI: 10.1002/hast.313] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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23
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Flynn EP, Smith CH, Walsh CD, Walshe M. Modifying the consistency of food and fluids for swallowing difficulties in dementia. Hippokratia 2014. [DOI: 10.1002/14651858.cd011077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Eadaoin P Flynn
- Trinity College Dublin; Clinical Speech and Language Studies; 7-9 South leinster Street Dublin 2 Ireland
| | - Christina H Smith
- University College London; Psychology and Language Sciences; London UK
| | - Cathal D Walsh
- Trinity College Dublin; Department of Statistics; Dublin Ireland
| | - Margaret Walshe
- Trinity College Dublin; Clinical Speech and Language Studies; 7-9 South leinster Street Dublin 2 Ireland
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Niezgoda H, Keller HH, Steele CM, Chambers LW. What should a case-finding tool for dysphagia in long term care residents with dementia look like? J Am Med Dir Assoc 2014; 15:296-8. [PMID: 24566448 PMCID: PMC4312009 DOI: 10.1016/j.jamda.2014.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 01/03/2014] [Indexed: 11/20/2022]
Affiliation(s)
- Helen Niezgoda
- Manager, Corporate Research Initiatives, Bruyère Research Institute, 43 Bruyère St., Ottawa ON K1N 5C8, 613 562-6262 (1276)
| | - Heather H. Keller
- Professor, Schlegel Research Chair, Nutrition & Aging, Dept. Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, ON N2L 3G1, 519 888-4567 (31761)
| | - Catriona M. Steele
- Toronto Rehabilitation Institute – University Health Network, Rm 12-101, 550 University Ave, Toronto, ON M5G 2A2, 416 597-3422 (7603)
| | - Larry W. Chambers
- Scientist, Bruyère Research Institute, 43 Bruyère St., Ottawa ON K1N 5C8, 613 562-6262 (1276)
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Jokinen N, Janicki MP, Keller SM, McCallion P, Force LT. Guidelines for Structuring Community Care and Supports for People With Intellectual Disabilities Affected by Dementia. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2013. [DOI: 10.1111/jppi.12016] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Nancy Jokinen
- University of Northern British Columbia; Prince George British Columbia Canada
| | | | - Seth M. Keller
- American Academy of Developmental Medicine and Dentistry; Lumberton NJ
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Anorexia of Aging: Can We Decrease Protein Energy Undernutrition in the Nursing Home? J Am Med Dir Assoc 2013; 14:77-9. [DOI: 10.1016/j.jamda.2012.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 11/19/2012] [Indexed: 12/29/2022]
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Edahiro A, Hirano H, Yamada R, Chiba Y, Watanabe Y, Tonogi M, Yamane GY. Factors affecting independence in eating among elderly with Alzheimer's disease. Geriatr Gerontol Int 2012; 12:481-90. [DOI: 10.1111/j.1447-0594.2011.00799.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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28
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Keller HH, Bocock MA. Nutrition and dementia: clinical considerations for identification and intervention. Neurodegener Dis Manag 2011. [DOI: 10.2217/nmt.11.61] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
SUMMARY Nutrition is linked in several ways to the diseases that cause dementia. The focus of this article is on nutrient-specific interventions, a healthy diet and management of bodyweight to delay dementia progression in individuals with mild-cognitive impairment or dementia, specifically living in the community. Epidemiological evidence suggests that a healthy plant-based diet is prudent. However, research is lacking on specific nutrient supplementation and pharmacological doses are unwarranted. Weight loss is common and potentially leads to further cognitive loss and needs to be avoided in patients presenting for diagnosis or being followed for dementia care. Nutrition screening and assessment as a means of identifying potential nutrition problems in an outpatient clinical environment are reviewed as well as interventions.
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Affiliation(s)
| | - Mary Ann Bocock
- Department of Family Relations and Applied Nutrition University of Guelph, Guelph, ON N1G 2W1, Canada
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