1、本科毕业设计（论文）外文翻译原文DININGEXPERIENCE,FOODSERVICESANDSTAFFINGAREASSOCIATEDWITHQUALITYOFLIFEINELDERLYNURSINGHOMERESIDENTSINTRODUCTIONALTHOUGHTODAYSNURSINGHOMERESIDENTSAREMOREFUNCTIONALLYANDCOGNITIVELYIMPAIREDTHANTHEYWERE20YEARSAGO15,NURSINGHOMESSTILLAIMTOPRESERVEANDPROMOTEGOODQUALITYOFLIFEFORTHEIRRESIDENT
2、S,HOWEVERCHALLENGINGTHISMAYBEWHILEBOTHPHYSICALANDSOCIALENVIRONMENTALFACTORS,SUCHASLEVELOFRECREATIONALACTIVITIESANDCONTROLOVERPHYSICALENVIRONMENT,HAVEFREQUENTLYBEENINCLUDEDINDETERMINANTSOFQUALITYOFLIFEAMONGFRAILELDERLYPEOPLE68,VERYFEWSTUDIESHAVEDETERMINEDWHETHERINSTITUTIONALFACTORS,SUCHASFOODANDNUTRI
3、TIONALSERVICESANDDININGEXPERIENCE,AREASSOCIATEDWITHQUALITYOFLIFEINLTCSEVERALOTHERFACTORSHAVEALREADYBEENIDENTIFIEDASCONTRIBUTINGTOTHEQUALITYOFLIFEOFTHEELDERLYINHEALTHCAREINSTITUTIONSFOREXAMPLE,CHRONICCONDITIONS,DRUGCONSUMPTION,FUNCTIONALABILITIES,SWALLOWINGDIFFICULTIES,ANDNUTRITIONALSTATUSHAVEALLBEEN
4、LINKEDTOTHEIRQUALITYOFLIFE912RISKOFMALNUTRITIONHASALSOBEENFOUNDTOBEASSOCIATEDWITHQUALITYOFLIFEINOLDERADULTS10,13,14WINZELBERGETAL9OBSERVEDASIGNIFICANTCORRELATIONBETWEENRESIDENTSQUALITYOFLIFESCORESANDTHEIRMENTALHEALTHSTATUSIE,SEVERITYOFCOGNITIVEDYSFUNCTIONANDDEPRESSIONTHEAMERICANDIETETICASSOCIATIONPU
5、TFORWARDAPOSITIONPAPERONNUTRITIONANDAGINGWHICHSTIPULATESTHAT,ALONGWITHENVIRONMENTALFACTORS,THEENJOYMENTOFFOODANDNUTRITIONALWELLBEINGPLAYAKEYPARTINANOLDERADULTSQUALITYOFLIFE1THEPSYCHOLOGICALANDSOCIALASPECTSSURROUNDINGMEALTIMECANIMPACTONELDERLYRESIDENTSQUALITYOFLIFEBYINFLUENCINGTHEPLEASUREOFEATINGMEAL
6、TIMESTENDTOGIVERESIDENTSASENSEOFSECURITY,BELONGING,STRUCTUREANDORDERTOTHEIRDAYTHEYCANALSOGIVERESIDENTSASENSEOFINDEPENDENCEANDCONTROLOVERDAILYCHOICES15APOTENTIALLINKBETWEENRESIDENTSQUALITYOFLIFEANDINSTITUTIONALFACTORS,SUCHASTHOSERELATEDTOFOODANDDININGEXPERIENCE,HASBEENINDICATEDBYSOMERESEARCHERS1619WE
7、STETAL17FOUNDTHATMANYRESIDENTSFEELPOWERLESSWHENITCOMESTOTHEIRSURROUNDINGS,SUCHASTHELIBERTYTOCHOOSEFOODANDDININGCOMPANIONSRESIDENTSINTHEIRSTUDYRANKEDAGREATERVARIETYOFFOODS,MEALSTHATAREAPPETIZING,COMFORTABLESEATINGDURINGMEALS,CALMMEALTIMEATMOSPHEREANDRESPECTFORFOODPREFERENCESASBEINGAMONGTHEIRTOPTENIMP
8、ORTANTFOODRELATEDCONCERNSSIMILARLY,KANEETAL19FOUNDTHAT,WHENASKEDTORATETHEIMPORTANCEOFCONTROLANDCHOICEOVERCERTAINAREASOFTHEIREVERYDAYNURSINGHOMELIFE,RESIDENTSPRIORITIZEDHAVINGCHOICEANDCONTROLOVERTHEIRFOODINANOTHERSTUDY,RESIDENTSQUALITYOFLIFESEEMEDTOIMPROVEFOLLOWINGTHEINTRODUCTIONOFABUFFETSTYLEMEALSER
9、VICE20THISTYPEOFSERVICEINCLUDEDADDITIONALASSISTANCEFORRESIDENTSDURINGMEALSANDABETTERDININGATMOSPHERERESIDENTSCOULDCHOOSEFROMAGREATERVARIETYOFFOODSANDCOULDRECEIVESECONDHELPINGSOFFAVOURITEFOODS20HIGHCORRELATIONSWEREALSOFOUNDBETWEENRESIDENTSQUALITYOFLIFEANDTHEIRENJOYMENTOFFOODANDMEALTIMES,ANDBEINGABLET
10、ORECEIVETHEIRFAVOURITEFOODS21ACCORDINGTOEVANSETAL22,RESIDENTSCOULDADAPTBETTERTONURSINGHOMELIFEIFTHEIRFOODANDFOODSERVICEPREFERENCESWEREBEINGMETDESPITESTUDIESTHATDEMONSTRATETHATFOODANDNUTRITIONSERVICESANDDININGENVIRONMENTAREIMPORTANTTOLTCRESIDENTS,FEWSTUDIESHAVEACTUALLYTESTEDWHETHERTHESEFACTORSARESIGN
11、IFICANTLYRELATEDTOTHEIRQUALITYOFLIFEUSINGAVALIDQUALITYOFLIFEMEASUREMENTTOOLDISCUSSIONMEASUREMENTOFQUALITYOFLIFEVERYFEWSTUDIESHAVEATTEMPTEDTOUSEASINGLEMEASUREOFQUALITYOFLIFEFORBOTHCOGNITIVELYIMPAIREDANDCOGNITIVELYINTACTSENIORSYET,FORRESEARCHERSCONCERNEDWITHIMPROVINGTHEQUALITYOFLIFEOFALLLTCRESIDENTSTH
12、ISISANEXTREMELYIMPORTANTISSUETHEQOLDINSTRUMENTWASDEVELOPEDFORUSEAMONGCOGNITIVELYIMPAIREDSENIORS,ANDTHOUGHITSINTERNALCONSISTENCYWASHIGHERINCOGNITIVELYIMPAIREDRESIDENTS,ITDIDHAVEACCEPTABLERELIABILITYFORUSEWITHCOGNITIVELYINTACTRESIDENTSFORCOGNITIVELYIMPAIREDRESIDENTS,RELIABILITYRESULTSFORALLTHREESUBSCA
13、LESWEREQUITESIMILARBETWEENSLOANEETALS31STUDYANDOURS57TO79UNFORTUNATELY,SLOANEETAL34DIDNOTREPORTONTHERELIABILITYOFTHECOMBINEDQOLDSCALEMEANSCORESFORQOLDANDITSSUBSCALESWERESIGNIFICANTLYHIGHERINCOGNITIVELYINTACTRESIDENTS,WHICHREFLECTEDTHEIRHIGHERQUALITYOFLIFE,ESPECIALLYINTERMSOFACTIVITYLEVELSTWOPREVIOUS
14、STUDIESFOUNDTHATQUALITYOFLIFEDECREASESWITHINCREASINGLEVELOFCOGNITIVEIMPAIRMENT9,11HOWEVER,WINZELBERGETAL9USEDAMODIFIEDVERSIONOFTHELOGSDONETALS35QUALITYOFLIFEALZHEIMERSDISEASESCALEQOLADINTHEIRSTUDY,WHILEKERNERETAL11USEDTHEQUALITYOFWELLBEINGQWBSCALEHEALTHANDSOCIODEMOGRAPHICSOVERTWOTHIRDSOFTHERESIDENTS
15、INTHISSTUDYWERECOGNITIVELYIMPAIRED,WHICHISSIMILARTOPERCENTAGESFOUNDBYOTHERSTUDIESWITHINSTITUTIONALIZEDELDERLY3,36ASIGNIFICANTLYLARGERPERCENTAGEOFCOGNITIVELYIMPAIREDRESIDENTSCOMPAREDTOCOGNITIVELYINTACTRESIDENTSHADABMILOWERTHAN20268VS91OTHERSTUDIESINLTCSETTINGSHAVEALSOSHOWNTHATRESIDENTSWITHDEMENTIAREL
16、ATEDDISORDERSAREMOREPRONETOWEIGHTLOSSANDMALNUTRITION3,36LENGTHOFSTAYWASNOTSIGNIFICANTLYASSOCIATEDWITHQUALITYOFLIFEINEITHERCOGNITIVELYINTACTORIMPAIREDRESIDENTS,BUTANINCREASEINTHENUMBEROFMEDICALCONDITIONSWASNEGATIVELYASSOCIATEDWITHQUALITYOFLIFEINCOGNITIVELYINTACTRESIDENTSTHEREWASNOSIGNIFICANTDIFFERENC
17、EINTYPESOFCONDITIONSREPORTEDFORCOGNITIVELYINTACTVERSUSIMPAIREDRESIDENTSTHISISSOMEWHATSURPRISINGSINCEDIFFERENTCONDITIONSSHOULDHAVELEADTOTHEINSTITUTIONALIZATIONOFBOTHGROUPSOFRESIDENTSINADDITION,KEMPENETAL12ALSOFOUNDTHATCHRONICMEDICALCONDITIONSWERENEGATIVELYASSOCIATEDWITHQUALITYOFLIFEINCOGNITIVELYINTAC
18、TOLDERADULTSINBOTHCOMMUNITYANDINSTITUTIONALIZEDSETTINGSDININGEXPERIENCESANDQUALITYOFLIFENUMBEROFDININGCOMPANIONSWASPOSITIVELYASSOCIATEDWITHQUALITYOFLIFEINBOTHCOGNITIVELYIMPAIREDANDCOGNITIVELYINTACTRESIDENTSTHISASSOCIATIONMAYREFLECTTHEFACTTHATDININGWITHOTHERSINCREASESSOCIALINTERACTION,WHICHHASBEENFOU
19、NDTOBEAKEYCOMPONENTOFQUALITYOFLIFE37NUMBEROFDININGCOMPANIONSMAYALSOBERELATEDTOPHYSICALSURROUNDINGSKAYSERJONESDF1P000INDEPENDENCEINEATINGCANGIVERESIDENTSASENSEOFCONTROLOVERTHEIRFOODINTAKETHISSENSEOFCONTROLINCREASESPLEASUREANDENJOYMENTASSOCIATEDWITHMEALTIMEWHICHCANIMPACTTHEIRQUALITYOFLIFERESIDENTSWHON
20、EEDASSISTANCEWITHEATINGOFTENHAVEFUNCTIONALDISABILITIES,SWALLOWINGDIFFICULTIESORSEVEREDEMENTIAS,WHICHAFFECTTHEIRQUALITYOFLIFE9,12FOODSERVICESANDQUALITYOFLIFETHREEOFTHEFOURFOODSERVICEFACTORSWEREFOUNDTOBEASSOCIATEDWITHQUALITYOFLIFEAMONGCOGNITIVELYINTACTRESIDENTS,BUTONLYTWOWEREASSOCIATEDWITHQUALITYOFLIF
21、EAMONGTHECOGNITIVELYIMPAIREDTRAYMEALDELIVERYSYSTEMS,COMPAREDTOBULK,WEREPOSITIVELYASSOCIATEDWITHQUALITYOFLIFEINBOTHGROUPSOFRESIDENTSTHISFINDINGCONTRADICTSONEPREVIOUSSTUDYAMONGLTCRESIDENTSTHATSUGGESTEDTHEREISAPOSITIVEASSOCIATIONBETWEENBUFFETSTYLEDININGANDQUALITYOFLIFE20WHILETHISSTUDYDIDNOTMEASUREQUALI
22、TYOFLIFE,QUALITYOFLIFESEEMEDTOBEENHANCEDTHROUGHINCREASEDENJOYMENTOFBOTHTHEFOODANDTHEDININGENVIRONMENT20FUTURESTUDIESMUSTFURTHEREXPLORETHEASSOCIATIONBETWEENMEALDELIVERYSYSTEMSANDRESIDENTSQUALITYOFLIFECLOSETO70OFMENUSHADBEENREVISEDWITHINTHELASTYEARMEAN130169MONTHSMORERECENTMENUREVISIONHADAPOSITIVEASSO
23、CIATIONWITHTHEQUALITYOFLIFEOFCOGNITIVELYIMPAIREDRESIDENTSPERIODICMENUREVISIONLIKELYDECREASESFOODITEMSTHATARELESSLIKEDBYRESIDENTSANDINCREASESITEMSTHATAREMOREENJOYEDBYRESIDENTS,SUCHTHATFOODSERVICEPERSONNELANDINSTITUTIONALCAREGIVERSCANMOREOFTENSATISFYTHEPREFERENCESANDTASTESOFCOGNITIVELYIMPAIREDRESIDENT
24、SIMPROVEDMEALSATISFACTIONONTHEPARTOFBOTHRESIDENTSANDSTAFFWOULDTHENENHANCEQUALITYOFLIFEINCOGNITIVELYIMPAIREDRESIDENTSTHERAPEUTICMENUSWASPOSITIVELYASSOCIATEDWITHQUALITYOFLIFEINCOGNITIVELYINTACTRESIDENTS,ANDMORECOGNITIVELYINTACTRESIDENTSWEREONTHERAPEUTICMENUS545THANCOGNITIVELYIMPAIRED39927598DF1P006THE
25、MOSTCOMMONTHERAPEUTICDIETSAMONGCOGNITIVELYINTACTRESIDENTSWEREDIABETIC,REDUCEDSALTANDLOWFATDIETSTHESEMENUSMAYMAKECOGNITIVELYINTACTRESIDENTSFEELSPECIAL,SINCETHEYREQUIREMOREFOLLOWUPSFROMDIETARYANDNURSINGSTAFFACCORDINGTOEVANSETAL22,MANYNURSINGHOMERESIDENTSYEARNFORPERSONALIZEDNUTRITIONCAREANDINDIVIDUALIZ
26、EDATTENTIONITSHOULDBENOTED,HOWEVER,THATVERYRESTRICTIVEDIETSMAYSIGNIFICANTLYREDUCETHEPLEASUREOFEATING1CHINADISHESWEREALSOASSOCIATEDWITHQUALITYOFLIFEINCOGNITIVELYINTACTRESIDENTSHACKESETAL40FOUNDTHATSERVINGMEALSONCHINADISHESDECREASEDFOODWASTEINLTC,POSSIBLYINDICATINGGREATERSATISFACTIONWITHMEALTIMEFURTHE
27、RMORE,CHINADISHESMAYGIVECOGNITIVELYINTACTRESIDENTSTHEFEELINGOFBEINGATHOME,WHILEINSULATEDPLASTICDISHESCOULDHAVETHEOPPOSITEEFFECT,MAKINGTHEMFEELLIKEAPATIENTINAHOSPITALCOGNITIVELYIMPAIREDRESIDENTSAREPROBABLYMUCHLESSAWAREOFWHATTYPESOFDISHESAREUSEDATMEALTIMESTAFFINGANDQUALITYOFLIFETHERATIOOFRESIDENTSPERR
28、AWASPOSITIVELYRELATEDTOQUALITYOFLIFEINBOTHCOGNITIVELYINTACTANDCOGNITIVELYIMPAIREDRESIDENTSTHISFINDINGISSOMEWHATSURPRISING,SINCETHEASSUMPTIONHASALWAYSBEENTHATHAVINGAGREATERNUMBEROFSTAFFTOASSISTRESIDENTSSHOULDIMPROVETHEIRQUALITYOFLIFE41HOWEVER,AHIGHERRATIOOFRESIDENTSPERRADOESNOTNECESSARILYMEANINADEQUA
29、TESTAFFINGTHEAVERAGERATIOOFRESIDENTSPERRAINTHISSTUDYWAS53,WHICHIS,ACCORDINGTOSIMMONSETAL4,QUITESUFFICIENTTOENSUREQUALITYCAREWEALSOFOUNDTHATTHERATIOOFRESIDENTSTORASWASNEGATIVELYCORRELATEDWITHSIZEOFINSTITUTIONR419P000THISINDICATESTHATSMALLERINSTITUTIONSTENDEDTOHAVEHIGHERRATIOSOFRESIDENTSPERRATHANLARGE
30、RINSTITUTIONSRESIDENTSINSMALLERHOMESMAYDEVELOPSTRONGERANDMOREINTIMATERELATIONSHIPSWITHSTAFFANDOTHERRESIDENTSTHEYMAYALSOSIMPLYFEELMORE“ATHOME”INSMALLERFACILITIESPERHAPSRESIDENTSLIVINGINSMALLERHOMESWITHAHIGHERRATIOOFRESIDENTSPERRAFEELMOREAUTONOMOUSANDLESS“LOOKEDAFTER”,WHICHMAYINCREASEPOSITIVEAFFECTAND
31、DECREASENEGATIVEAFFECTTHEQOLDWASONEOFTHEBESTMEASUREMENTTOOLSAVAILABLEWHENTHISRESEARCHWASINITIATED,ANDITSRELIABILITYRESULTSWITHCOGNITIVELYINTACTRESIDENTSREFLECTTHEFACTTHATITWASDEVELOPEDPRIMARILYFORUSEWITHTHECOGNITIVELYIMPAIREDTHEQOLDMEASURESTHREEDIMENSIONSOFQUALITYOFLIFEACTIVITYANDPOSITIVEANDNEGATIVE
32、AFFECT,WHILEOTHERINSTRUMENTSMEASUREADDITIONALDIMENSIONSOFQUALITYOFLIFE,SUCHASPHYSICALCONDITIONS,INTERPERSONALRELATIONSHIPSANDMOBILITYFUTURERESEARCHERSSHOULDCONTINUEEXAMININGTHEVALIDITYOFTHEQOLDANDOTHERQUALITYOFLIFEINSTRUMENTS,INBOTHCOGNITIVELYIMPAIREDANDCOGNITIVELYINTACTLTCRESIDENTSDININGEXPERIENCES
33、,FOODANDNUTRITIONALSERVICES,ANDNURSINGPERSONNELEACHPLAYIMPORTANTROLESINPROMOTINGANDIMPROVINGQUALITYOFLIFEAMONGNURSINGHOMERESIDENTSRESULTSFROMTHISSTUDYSUGGESTTHATQUALITYOFLIFEMAYBEENHANCEDFORBOTHCOGNITIVELYINTACTANDCOGNITIVELYIMPAIREDRESIDENTSBYENCOURAGINGTHEMTODINEWITHOTHERSANDINCREASINGTHEIRAUTONOM
34、YINRELATIONTOFOODNEWLTCFACILITIESORTHOSEUNDERMAJORRENOVATIONMIGHTALSOCONSIDERIMPLEMENTINGTRAYBASEDMEALDELIVERYSYSTEMS,THOUGHFURTHERSTUDIESARENEEDEDTOCONFIRMTHEBENEFITSOFTHESESYSTEMSWHILESERVINGMEALSONCHINADISHES,INSTEADOFPLASTICORINSULATEDDISHES,MIGHTIMPROVEQUALITYOFLIFEOFCOGNITIVELYINTACTRESIDENTS,
35、THEPROACTIVEDIAGNOSISANDREHABILITATIONOFEATINGDIFFICULTIESMIGHTIMPROVETHEQUALITYOFLIFEOFCOGNITIVELYIMPAIREDRESIDENTSFUTURESTUDIESSHOULDCONTINUETOSEPARATELYEXAMINETHEWAYSINWHICHDININGEXPERIENCES,FOODANDNUTRITIONALSERVICES,ANDOTHERINSTITUTIONALFACTORSHELPDETERMINEQUALITYOFLIFEAMONGCOGNITIVELYINTACTVER
36、SUSCOGNITIVELYIMPAIREDRESIDENTSINLTCSETTINGSSOURCENCARRIER,GEWEST,DOUELLET，THEJOURNALOFNUTRITION,HEALTHDF1P006。认知功能完整的居住者使用的这种有治疗效果的食谱最普遍的是糖尿病患者，这种食谱可以减少盐含量降低脂肪。这些食谱可以使认知功能完整的居住者感觉到特别，因为他们可以从食谱和护理人员获得后续服务。根据EVANS等人的研究发现，很多疗养院的居住者渴望获得个性化的营养护理和具有个人特色的关照。然而，众所周知，限定太多的饮食会明显的减少进食时的乐趣。另外，瓷质餐具也同认知功能完整的居住者的
37、生活质量有着关联。HACKES等人发现，在接受长期护理的人中，使用瓷质餐具上餐会减少食物浪费，这也可以理解为是由于居住者在进食时间享受了更多乐趣。另外，瓷质餐具可以带给认知功能完整的居住者家的感觉，而绝缘塑料质餐具会有相反效果，会使居住者觉得自己是住在医院的病人。而认知功能受损的居住者可能对进餐时使用的餐具是何质地并没有太多关注。人员编制和生活质量患类风湿性关节炎的居住者的比例与认知功能完整或者认知功能受损的居住者都有积极影响。这个发现从某种程度讲十分令人震惊，因为更多的人来护理居住者会提高居住者的生活质量的假设一直存在，然而，每患类风湿性关节炎的居住者的比例增多，不完全代表不恰当的人员安排。
38、在SIMMONS等人的研究中，每患类风湿性关节炎居住者的平均比例是53，这个比例对于确保护理质量是足够的。我们还发现，居住者与患类风湿性关节炎的比例与机构的大小有着消极关联R419P000。这说明，越小的机构，每患类风湿性关节炎居住者的比例就越高。在更小的房子里，居住者越可以与职工和其他居住者建立更坚定更亲近的关系。在更小的设施中，他们更能简单的感受到在家的感觉。也许对于某些居住者来讲，他们同每患类风湿性关节炎更高比例的居住者住在更小的房间里感到更多自主以及更少的“被照看”的感觉，这会使人员安排对生活质量的积极影响增加并减少其消极影响。自这项调查开始以来，患痴呆症的病人的生活质量测量仪器是最先
39、进的测量仪器之一，并且，它与认知功能完整的居住者的可靠性结果反映出最初发明它的目的是为认知功能受损的居住者所用的事实。测量患痴呆症的病人的生活质量的仪器测量出三种生活质量的维度（活动，积极影响以及消极影响），同时，其他仪器则测量额外的生活质量的维度，例如身体状况，人际关系和移动性。对于测量认知功能完整和受损的接受长期护理的居住者，这种仪器和其他测量生活质量的工具的准确性，是未来的调查应该继续检测的内容。餐饮体验，食品和营养服务，以及个性化护理，这三个因素对于提高私人疗养院的居住者的生活质量都起着重要作用。这项研究得出的结论表明，认知功能完整和认知功能受损的的居住者生活质量的提高，可以通过鼓励他们同他人一起进餐或是提高他们在有关食品方面的自主权等方式实现。新的长期护理设施以及那些正在革新的设施或许也在考虑实行以托盘为载体的送餐系统，尽管更多的研究仍需确定这些系统的益处。用瓷质餐具替换塑料或是绝缘的餐具来送餐也许会提高认知功能完整的居住者的生活质量，至于认知功能受损的居住者，对饮食困难的预先诊断和复原也会使他们的生活质量得以提高。未来的研究应该继续分开检测餐饮体验、食品和营养服务以及其他制度因素这三种方式对接受长期护理的认知功能完整以及认知功能受损的居住者生活质量的提高是如何起到了决定作用。出处卡里尔，韦斯特，韦莱，营养、健康和老化杂志，2009，P565570
