Sinicization And Preliminary Application Of The Meaningful And Enjoyable Activities Scale In Mild Dementia

Objective:1.To translate the Meaningful and Enjoyable Activities Scale(MEAS)for mild dementia into Chinese,following cross-cultural adaptation guidelines,and examine its reliability and validity.2.To use the Chinese version of MEAS to assess the current activity levels of mild dementia patients in Shenyang City and analyze the factors influencing these levels,providing a reference for meeting the needs of meaningful and enjoyable activities for mild dementia patients.Method:1.First,with authorization from the original scale authors,cross-cultural adaptation was conducted following the guidelines recommended by the American Academy of Orthopaedic Surgeons Evidence Based Medicine Committee.The process included forward translation,back-translation,expert committee evaluation,and pre-testing,resulting in the Chinese version of MEAS.Next,using the Chinese version of MEAS,the Mini-Mental State Examination(MMSE),and a general information questionnaire,a convenience sampling method was used to conduct a formal survey on 330 mild dementia patients visiting the neurology outpatient departments of two tertiary hospitals in Shenyang City from October 2021 to August 2022.Item analysis was performed using correlation analysis and Cronbach’s alpha coefficient to assess the internal consistency of the scale.Item Content Validity Index(I-CVI),Scale Content Validity Index(S-CVI),exploratory factor analysis,and confirmatory factor analysis were used to evaluate the content and structural validity of the scale.2.In the second part,a convenience sampling method was used to select 115 mild dementia patients visiting the neurology outpatient departments of two tertiary hospitals in Shenyang City from September 2022 to December 2022.They were given a general information questionnaire and the Chinese version of MEAS to investigate the current status of enjoyable activities in mild dementia patients and analyze the influencing factors.Statistical analysis was performed using SPSS 25.0 software,and univariate analysis employed independent samples t-test,analysis of variance(ANOVA),and Kruskal-Wallis H test.Variables showing statistically significant differences(P < 0.05)in univariate analysis were included in multiple linear regression analysis.Results:1.The Chinese version of the Meaningful and Enjoyable Activities Scale(MEAS) suitable for the cultural context in China was developed.The Chinese version of MEAS consists of three dimensions and 20 items.The dimensions are named as follows: Leisure Physical Activities(6 items),Mental Activities(8 items),and Social Activities(6 items).All items showed significant positive correlations with the total score(r = 0.390 to 0.700,P < 0.01).The internal consistency of the total scale was measured using Cronbach’s alpha coefficient,which was found to be 0.860,and the Cronbach’s alpha coefficients for each dimension ranged from0.839 to 0.919.The item content validity index ranged from 0.86 to 1,and the scale content validity index was 0.96.The results of the structural validity showed that the Chinese version of MEAS had a Bartlett’s test of sphericity value of 1092.525(P < 0.001),a Kaiser-Meyer-Olkin(KMO)measure of sampling adequacy of 0.809,and exploratory factor analysis extracted three common factors with a cumulative variance contribution rate of 61.097%.Confirmatory factor analysis was performed on the three-factor structure obtained from exploratory factor analysis,resulting in a good fit: X2/df = 2.307,RMSEA = 0.076,CFI = 0.905,GFI = 0.870,IFI = 0.906.2.The results of the second part showed that the total score of the Meaningful and Enjoyable Activities Scale for mild dementia patients was(46.61±10.53),with the scores for the dimensions as follows: Leisure Physical Activities(18.31±3.90),Mental Activities(15.32±7.03),and Social Activities(12.97±4.37).The results of univariate analysis showed significant statistical differences(P < 0.05)in the scores of meaningful and enjoyable activities among mild dementia patients with respect to age,education level,caregiver’s education level,and MMSE score.Multiple linear regression analysis showed that age,education level,caregiver’s education level,and MMSE score of mild dementia patients entered the regression equation,explaining a total of 75.1% of the total variation(P < 0.01).Conclusion:1.The Chinese version of the Meaningful and Enjoyable Activities Scale for mild dementia patients demonstrates good reliability and validity and can effectively assess the levels of meaningful and enjoyable activities among mild dementia patients in China.2.The age,education level,cognitive impairment level of the patient and caregiver’s education level are the main influencing factors for meaningful and enjoyable activities in mild dementia patients.