Impact Of Montessori-Based Intervention On The Eating Ability Of Elderly With Dementia

ObjectiveThis study is to develop a Montessori-Based Intervention and to evaluate the impact on eating ability of the elderly with dementia.Eating behavior scale(EBS)was translated and evaluated,so as to assess the eating ability of the elderly with dementia in mainland China.Methods1.EBS translation and evaluationAfter getting authorization from the author,EBS were translated following the Lee's model from forward translation to back-translation,and were adapted to the culture by consulting five experts and investigating thirty patients.One hundred old people with dementia were investigated conveniently by using the simplified Chinese version of EBS.The discrimination,reliability and validity of C-EBS were evaluated by item analysis,retest reliability and content validity and criterion-related validity,respectively.2.InterventionA quasi-experimental repeated measures design was conducted.Montessori-Based Intervention were designed on the basis of ICF and Montessori Method.Sixty-four old people with dementia were recruited from ten floors of the Nursing Home of Henan province and the Elderly Apartment of Zhengzhou,and randomly assigned into control group(CG,N=32)and Montessori-Based Intervention group(IG,N=32)according to the number of each floor.The IG were given Montessori-based Intervention twice a week for 8 weeks,and the CG received regular care.The effect of Montessori-based Intervention were assessed by the simplified Chinese version of EBS(C-EBS),simplified Chinese version of Edinburgh Feeding Evaluation in Dementia scale(C-EdFED)and stopwatch at pre-intervention,post-intervention,1-month and 3-month follow-up.Categorical data was described by frequency and constituent ratio,and quantitative data was described by mean,standard deviation.quantitative data used T test or rank sum test,categorical data used the chi-square test for two groups' baseline data.For the data of four time points,the repeated measurement of variance analysis or Generalized Estimation Equation were used.Results1.EBS translation and evaluationThe score correlation coefficient between the total and each item of C-EBS ranged from 0.420 to 0.729(P<0.001),and the CR value of each item ranged from 6.360 to 16.464(P<0.001),indicating the C-EBS has good discriminative power.The Cronbach's alpha,the split-half reliability and the retest reliability were 0.842,0.865 and 0.840,respectively,confirming the C-EBS has good reliability.The I-CVI and S-CVI were both 1.00,and a negative correlation between the C-EBS and the C-EdFED(r=-0.727,P<0.01)was found,demonstrating the C-EBS has good reliability.2.Intervention4 of the 64 subjects(6.25%)were lost owing to death or other reasons.As a result,the whole intervention was completed with sixty subjects(CG=31,IG=29).8 weeks after the Montessori-Based Intervention,the average scores of EBS(12.94 to 14.31)and the self-eating time(16.73 to 21.44)in IG increased,while the average scores of EdFED decreased(9.79 to 7.86).After intervention,differences of C-EBS scores,C-EdFED scores and self-eating time were significant between IG and CG.Though the effect was attenuated with the time passed,statistically significant differences between the two groups still existed in the 3-month after the intervention(P<0.05).The average scores of C-EBS and the self-eating time in IG increased first and then decreased,and the tendency of average scores of EdFED was definitely opposite.ConclusionThe simplified Chinese Version of EBS has good reliability and validity,and can be used in measurement of the eating ability of the elderly with dementia in Mainland China.The Montessori method intervention can improve the eating ability of elderly people with dementia,reduce eating difficulty and increase self-eating time.