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系統識別號 U0026-1305201810160400
論文名稱(中文) 失智者飲食功能評估表初步發展及失智者飲食功能和營養狀態的關係探討
論文名稱(英文) The initial development of the diet functional scale and the relationship between eating function and nutritional status of patients with dementia
校院名稱 成功大學
系所名稱(中) 護理學系
系所名稱(英) Department of Nursing
學年度 106
學期 1
出版年 107
研究生(中文) 陳怡如
研究生(英文) Yi-Ju Chen
學號 T26021144
學位類別 碩士
語文別 中文
論文頁數 84頁
口試委員 指導教授-王靜枝
口試委員-范聖育
召集委員-蕭華岑
中文關鍵字 失智症  主照顧者  飲食功能  營養狀態 
英文關鍵字 Dementia  caregiver  dietary function  nutrition status 
學科別分類
中文摘要 背景:失智者的各項飲食功能障礙常困擾許多家庭照顧者,目前國內外鮮少有針對居住於社區的失智者進行飲食功能評估,即便有,評估的內容亦缺乏失智者執行能力及居住在社區失智者進行飲食功能與營養狀態的關係探討。
目的:本研究期望藉由發展台灣本土版失智飲食功能評估表並測量其信效度。
方法:本研究使用工具發展研究法,其中工具發展的第一階段發展問卷內容及內容效度檢定、第二階段採立意取樣,選取台灣南部三所區域性以上醫院神經科門診與一所地方性失智症協會的失智症主照顧者參與評估表測試。以Cronbach’s α與探索性因子分析檢測信效度,再另與迷你營養評估量表以Pearson積差相關進行同時效度分析。
結果:失智者飲食能力評估表初擬題項為10題,經探索性因素分析縮減至7題,依題意歸為自我進食能力及餐食執行力等兩個因素,總解釋變異量67.256%。題數縮減後,內在一致性為.87,顯示具可信度。且與迷你營養評估量表之同時效度r = - .540, p= 0.01顯示中度的同時效度。
結論:失智者飲食能力評估表經檢驗除題目精簡外,亦具良好的信效度,期能提供評估居家照顧者早期鑑別失智者飲食功能缺失,並理解需援助的項目,從而增加照顧者的照顧品質及失智者飲食質量。
英文摘要 Background: Impaired eating function in patients with dementia (PwD) often troublesomes many domestic caregivers. Few studies have been conducted on the assessment of eating function for PwD living in the community. Even if there is, the contents are not focused on the executive function; nor the relationship between eating function and nutritional status of PwD living in the community.
Purpose: The purpose of this study was to develop a Taiwanese version of dementia dietary functional scale and then to test its validity and reliability.
Method: The instrumental development design was used. Items of the scale were developed and expert content validity was carried out in the first phase. Secondly, the internal consistency reliability was tested by Cronbach’s α and construct validity was tested by exploratory factor analysis. The relationship between Mini-Nutritional Assessment (MNA) and this scale was analyzed by using Pearson correlation coefficient to present the current validity. Purposive sampling was used. This research was conducted in the outpatient clinics of three regional and teaching hospitals and one local dementia association in southern Taiwan.
Results: The dietary functional scale consisted 10 items initially which was condensed to seven items through Exploratory factor analysis (EFA) and two factors were extracted which were named “self-eating ability” and “dietary executive function” respectively. The 7 items explained a total variance of 67.256%. The reassessed internal consistency reliability was .87. Significant correlation with the Mini-Nutritional Status was found (r = -0.540, p= 0.01), yielding a moderate concurrent validity.
Conclusion: This scale not only presents with simple items but good reliability and validity to assess the eating function of PwD. It is expected that caregivers can use this scale as an aid to identify the eating needs of PwD and improve the care quality and eating quality for PwD.
論文目次 第一章 緒論 1
第一節 背景與重要性 1
第二節 研究目的 5
第三節 研究問題 6
第四節 名詞解釋 7
第二章 文獻查證 8
第一節 失智症與行為精神問題 8
第二節 失智者飲食行為改變與相關因素 9
第三節 失智者自我照顧與飲食能力 11
第四節 失智者營養狀態 14
第五節 失智者飲食與營養相關評估量表 15
第三章 研究方法 25
第一節 研究設計 25
第二節 研究過程 26
第三節 研究對象與收案流程 28
第四節 研究工具 29
第五節 資料分析 32
第四章 研究結果 35
第一節 研究對象之基本人口學屬性 36
第二節 效度檢測 42
第三節 失智者飲食功能評估表信度檢測 52
第四節 失智者各失智分期的飲食能力狀態 53
第五節 失智者飲食能力與營養狀態之間的關係 56
第五章 討論 57
第一節 人口學特性 58
第二節 效度分析 59
第三節 信度分析 61
第四節 失智者各失智分期的飲食能力和營養狀態 62
第五節 失智者飲食能力與營養狀態之間的關係 64
第六章 結論與建議 65
第一節 研究限制與未來建議 65
第二節 結論 66
第三節 建議 67
參考文獻 68
附錄 74
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