THE EFFECT OF DIRECTED VERBAL PROMPTS AND POSITIVE REINFORCEMENT ON THE LEVEL OF EATING INDEPENDENCE OF ELDERLY NURSING HOME CLIENTS WITH DEMENTIA.
Contributors: Catholic University of America.
Published: 1988
Number of pages: 161
Subjects: Health Sciences, Nursing.; Gerontology.
Description: Utilizing Skinnerian theory, an experimental design study identified the difference in the level of eating independence (LEI) between nursing home clients with dementia who received directed verbal prompts (DVP) and positive reinforcement (PR) of verbal praise and a similar group not receiving this treatment. Twenty-four women, aged 68-96, from a dementia unit were randomly selected and randomly assigned to groups. The experimental and control group each comprised three groups of 4 subjects. All subjects had a diagnosis of dementia, severe cognitive impairment (SPMSQ-Pfeiffer, 1975), and independently ate half of meals.

Study phases conducted across all meals in a dining room included: (a) Pretreatment (T1): Days 1 & 2, (b) Treatment: Days 3, 4 & 5, (c) Posttreatment (T2): Days 7 & 8 (short term effects), and (d) Posttreatment (T3): Days 12 & 13 (long term effects). The LEI was measured at T1, T2, and T3. The LEI Scale (Adapted Klein-Bell ADL: Eating Section Scale) measured task performance when eating solids (5 tasks) and liquids (4 tasks) and frequency of eating solids and liquids. The scale identified assistance received during each task performance (no assistance, verbal guidance, physical support, total physical assistance). A time-event sampling method was used to observe LEI (2 observers recorded each subject's LEI and tallied frequencies at 6-1 minute time periods throughout meal). Treatment: DVP, standardized directions regarding solid and liquid tasks were administered to experimental groups at 6 intervals during each meal. PR was immediately given to subjects who completed eating tasks.

Hypotheses were tested using a 2 x 3 ANOVA with repeated measures, at p $<$.05. Significant findings revealed the experimental group: exhibited a higher task performance LEI for solids and liquids at T2 and T3 than the control group; did not exhibit a higher task performance and frequency LEI for solids or liquids at T2 than at T3 (retention of treatment); no significant difference between groups in frequency LEI for solids or liquids at T2 and T3. During treatment, experimental group exhibited daily improvement in task performance and frequency LEI. Day 3, 25% completed solid tasks and 16.7% liquid tasks. Day 6, 66.7% completed solid tasks and 75% liquid tasks. The dementia diagnosis should not preclude the possibility that eating skills may be reacquired when behavioral interventions are employed.
Notes: Source: Dissertation Abstracts International, Volume: 50-08, Section: B, page: 3396.

Thesis (D.N.SC.)--THE CATHOLIC UNIVERSITY OF AMERICA, 1988.

School code: 0043.