社區失智患者過度進食行為、體重及其相關因素之探討

The exploration of overeating behaviours, body weight and related factors in community-dwelling patients with dementia

張淑華(Shu-Hua Chang)

指導教授 ： 吳樺姍

中山醫學大學/醫學院/護理研究所/碩士(2013年)

摘要

背景：失智患者會出現進食行為改變，但多數研究均重於進食困難行為之調查，僅少數研究探討過度進食行為。
目的：調查社區失智患者過度進食行為之盛行率，並檢測過度進食行為、體重及其他相關因素之關係。
方法：採橫斷式相關性研究設計，研究對象來自台灣中部地區教學醫院級以上精神科、神經內科及記憶門診、醫院附設居家護理部門及日間照顧中心，102年1月至5月期間共收集83位失智患者及其家屬之基本屬性、簡易智能狀態測驗(MMSE)、巴氏量表(Barthel index)、過度進食子量表等資料。
結果：社區失智患者過度進食行為的盛行率約佔43.4%，且『失智患者之錯認症狀』及『照顧者之性別』為過度進食行為之預測因子，可解釋16.2%左右的變異量(R2=0.162 , F=6.078, p=0.016)。
結論/實務應用：社區失智患者在病程中有錯認精神病徵，且主要照顧者為女性時，可能發生較高頻率之過度進食行為。所以，建議個案管理師或居家護理師可提醒女性照顧者，如果失智患者合併有錯認症狀時，需特別注意患者平時進食狀況。且需予女性照顧者衛教，認識過度進食行為症狀，協助其即早識別，並能使患者接受妥善治療。

關鍵字

社區 ； 失智症 ； 過度進食行為 ； 體重

並列摘要

Background: People with dementia appear the change of eating behaviours. Most of studies focused on the survey of eating difficulty behaviours. However, few studies explored overeating behaviours.
Aims: To survey the prevalence of overeating behaviours, and to examine the relationship of the overeating behaviours, body weight, and related factors in people with dementia.
Methods: A cross-sectional and correlational research design was used. The participants were recruited from psychiatric, neurological, and memory clinics, home care departments in teaching hospital, and day care centers in central Taiwan. The data ,involving demographic characteristics, and the scores for the Mini-mental status exam, Barthel index, and overeating subscale, were collected from 83 patients with dementia and their families from January to May 2013.
Results: The prevalence of overeating behaviours in community-dwelling patients with dementia was 43.4%.. "The misidentification symptoms of patients with dementia (r = -0.24, p = 0.029)" and "caregiver gender (r = 0.31, p = 0.004)" were significantly predictors of overeating behaviour, explaining 16.2% of the variance (R2 = 0.162, F = 6.078, p = 0.016).
Conclusions: Community-dwelling patients with dementia with misidentification symptoms who are cared by female caregivers may have a higher frequency of overeating behaviours . Therefore, we recommend that case managers or home care nurses should remind female caregivers of paying special attention to patients' usual eating conditions if patients with dementia have misidentification symptoms. Female caregivers also need to be educated to recognise the symptoms of overeating behaviours. Thus, the overeating behaviors of patients with dementia can be identified earlier and be properly treated.

並列關鍵字

community ； dementia ； overeating behaviours ； body weight

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