Optimizing mealtime care for people with dementia from the perspective of formal caregivers: A systematic review of qualitative research

Li, Yijing; Zhang, Xu; Su, Jie; Li, Huanhuan; Meng, Xiangyi; Zhang, Shuang; Fang, Shuyan; Wang, Wenxia; Bao, Lianwei; Sun, Jiao

doi:10.1016/j.ijnurstu.2021.104046

Cited by 12 publications

(10 citation statements)

References 50 publications

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“…At the staff level, mealtime engagement quality is correlated with resident behaviours and food intake, especially for those with functional impairments who eat slowly (Liu & Chen, 2022 ; Liu, Tripp‐Reimer, et al, 2020 ; Liu, Williams, et al, 2019 ; Mann et al, 2019 ). Person‐centred care is a recommended care philosophy for people with dementia that emphasises establishing interpersonal relationships, prioritises individual needs and preferences and focuses on completion of care with the individual through positive and tailored engagement (Fazio et al, 2018 ; Li et al, 2021 ). Person‐centred care approaches, including verbal and nonverbal facilitation tailored to resident preferences and functional abilities, are associated with improved engagement and intake (Liu, Williams, et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…Person-centred care is a recommended care philosophy for people with dementia that emphasises establishing interpersonal relationships, prioritises individual needs and preferences and focuses on completion of care with the individual through positive and tailored engagement (Fazio et al, 2018;Li et al, 2021). Person-centred care approaches, including verbal and nonverbal facilitation tailored to resident preferences and functional abilities, are associated with improved engagement and intake .…”

Section: Introductionmentioning

confidence: 99%

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Person‐centred and task‐centred care: Impact on mealtime behaviours in nursing home residents with dementia

Liu

Perkhounkova

Hein

2022

Int J Older People Nursing

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Introduction Mealtime is a critical daily activity to ensure nutrition, hydration, function and socialisation. Interactions between staff and residents during mealtimes are complex and dynamic processes including verbal and/or nonverbal communication that can be positive/neutral or challenging. This study examined characteristics of and relationships between person‐centred and task‐centred care and positive/neutral and challenging mealtime behaviours in persons with dementia. Methods This study was a secondary behavioural analyses of videotaped mealtime observations (n = 110) involving 42 unique staff‐resident dyads (29 staff and 25 residents with dementia) in nine nursing homes. The refined Cue Utilization and Engagement in Dementia mealtime video‐coding scheme was used to code videos during 2019–2020. Dependent variables representing resident mealtime behaviours included positive verbal behaviours, positive/neutral nonverbal behaviours, functional impairments (nonverbal) and resistive behaviours (verbal and nonverbal). Independent variables were staff person‐centred and task‐centred approaches (verbal and nonverbal). Relationships between resident mealtime behaviours and staff approaches were examined using bivariate analysis and logistic regression. Results Staff person‐centred verbal approaches were associated with resident positive verbal behaviours (OR = 1.38, 95% CI = 1.09–1.76), functional impairments (OR = 0.81, 95% CI = 0.66–1.00) and resistive behaviours (OR = 1.65, 95% CI = 1.18–2.31). Staff person‐centred nonverbal approaches were associated with resident functional impairments (OR = 1.33, 95% CI = 1.02–1.74). Staff task‐centred approaches were not associated with resident positive/neutral or challenging mealtime behaviours. Conclusion This study characterised staff approaches and resident behaviours during mealtime care and provided preliminary support on associations between staff person‐centred approaches and resident positive and challenging behaviours. Person‐centred mealtime care practice is recommended by focusing on support of common, challenging behaviours and reinforcement of positive behaviours with adequate consideration of individual needs and preferences.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Person‐centred and task‐centred care: Impact on mealtime behaviours in nursing home residents with dementia

Liu

Perkhounkova

Hein

2022

Int J Older People Nursing

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“…Despite the increased prevalence, risks and consequences of inadequate food intake, residents are not always provided with optimal mealtime care (Hammar et al, 2016; Lea et al, 2017). Direct care staff, who remain an unsupported and unprepared workforce that is critical to quality care (Booi et al, 2021), report a need for training on the use of resident ‐ and relationship ‐ centred , individualised care approaches integrating management of fluctuating mealtime challenging behaviours to achieve optimal care while minimising risks of inadequate food intake through building relational and emotional connections (Douglas et al, 2021; Li et al, 2021). Effective , multi‐level interventions that optimise mealtime care quality warrant fundamental components , including supportive organisational systems , foundational and interprofessional person‐centred cultures , and adequate staff training ( Brunner et al, 2021; Fazio et al, 2020; Villar et al, 2021).…”

Section: Relevance To Clinical Practicementioning

confidence: 99%

“…Mealtime is a complex, dynamic and interactive process, especially when dyadic interactions are involved, and therefore requires tailored (rather than standardised) care based on individual's preferences and needs (Li et al, 2021). A Markov Chain model, a useful approach to model a stochastic or random process of categorical variables (i.e.…”

Section: Directions For Future Researchmentioning

confidence: 99%

Sequential relationships of food intake in nursing home residents with dementia: Behavioural analyses of videotaped mealtime observations

Liu

Chen

2022

Journal of Clinical Nursing

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Aims and Objectives This study examined the sequential relationships of food intake and the moderating role of the characteristics of intake and resident conditions. Background Nursing home residents commonly experience insufficient food intake. While multilevel factors influence intake, evidence on sequential relationships is lacking. Design The study was an observational study using secondary, behavioural analyses following the STROBE Statement. Methods Videotaped observations (N = 160) collected from a dementia communication trial during 2011–2014 were coded using the refined Cue Utilisation and Engagement in Dementia Mealtime Video‐coding Scheme during 2018–2019. The 160 videos involved 27 residents living with dementia and 36 staff in 9 nursing homes. Independent variables were the state (solid intake, liquid intake, no intake) of an intake episode occurring during mealtime (current episode), eating technique (resident‐initiated, staff‐facilitated) used in the next episode occurring after the current episode (subsequent episode), interval between adjacent episodes, and resident comorbidities and dementia stage. The dependent variable was the state of subsequent episode. Results Successful liquid and solid intake increased odds of subsequent liquid and solid intake. Comorbidities were associated with decreased odds of subsequent liquid and solid intake for staff‐facilitated episodes. When liquid intake occurred, staff‐facilitation decreased odds of subsequent liquid intake; longer intervals between adjacent episodes increased odds of subsequent solid intake. Conclusion Food intake was strongly and sequentially associated, and such temporal relationships were dependent on characteristics of the intake process and resident conditions. Relevance to Clinical Practice The study findings supported that initiating successful intake facilitates continuity of successful intake during mealtime. Behavioural interventions tailored by comorbidities that modify characteristics of the food intake process may improve food intake.

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“…There have been some meta-analyses based on these articles, but most published meta-syntheses of dementia care focus on hospital25–27 or home settings 28–30. When focusing on long-term care facilities, most reviews about dementia care only focus on a single outcome, such as feeding,31 32 behavioural symptoms management,33 34 palliative care35 and others, which is limited. The dementia care is holistic but considering only one aspect of care is not comprehensive.…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to dementia care in long-term care facilities: protocol for a qualitative systematic review and meta-synthesis

Zhang,

Guan,

et al. 2023

BMJ Open

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IntroductionLong-term care needs for people with dementia are predicted to increase due to increased life expectancy and dementia diagnoses. Most published meta- syntheses of dementia care focus on hospitals or home settings. When focusing on long-term care facilities, most reviews about dementia care only focus on a single outcome, such as feeding, behavioural symptoms management, palliative care and others, which is limited. The present study aims to synthesise qualitative data and examine barriers and facilitators to caring for people with dementia in long-term care facilities.Methods and analysisThis is the protocol for our systematic review and meta-synthesis, which describes the design of this study, and we plan to complete the study from October 2023 to November 2024. The systematic review and meta-synthesis will follow the Joanna Briggs Institute (JBI) guidance for systematic reviews of qualitative evidence. Nine databases (five English and four Chinese) were searched, including Embase, Web of Science, Medline, CINAHL, PsycINFO and Wan Fang Data, China National Knowledge Infrastructure, VIP and Chinese Biomedical Medicine, from inception to August 2023. Qualitative and mixed-approach research about barriers and facilitators to caring for people with dementia in long-term care facilities, which are reported in English or Chinese, will be included. Covidence software will help with study selection, assessment and data extraction. The JBI Critical Appraisal Checklist for Qualitative Research (2020) will be used for included studies’ quality assessment. Data extraction will be based on the JBI Qualitative Assessment and Review Instrument Data Extraction Tool for Qualitative Research. The JBI aggregation approach will be used to synthesise data. We will use the JBI ConQual tool to assess the credibility and dependability of each synthesised finding to establish confidence in the synthesised findings. All review steps will be managed by two reviewers independently, and disparities will be discussed. If consensus cannot reach a resolution, a third reviewer will be consulted.Ethics and disseminationThe present study is a secondary analysis of published qualitative data. So ethical approval is not required. The findings may be disseminated through peer-reviewed publications, conference papers or elsewhere.PROSPERO registration numberThe protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) in May 2022, and the registration number is CRD42022326178.

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Optimizing mealtime care for people with dementia from the perspective of formal caregivers: A systematic review of qualitative research

Cited by 12 publications

References 50 publications

Person‐centred and task‐centred care: Impact on mealtime behaviours in nursing home residents with dementia

Person‐centred and task‐centred care: Impact on mealtime behaviours in nursing home residents with dementia

Sequential relationships of food intake in nursing home residents with dementia: Behavioural analyses of videotaped mealtime observations

Barriers and facilitators to dementia care in long-term care facilities: protocol for a qualitative systematic review and meta-synthesis

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