Raising a beautiful swan: a phenomenological-hermeneutic interpretation of health professionals’ experiences of participating in a mealtime intervention inspired by Protected Mealtimes

Beck, Malene; Martinsen, Bente; Birkelund, Regner; Poulsen, Ingrid

doi:10.1080/17482631.2017.1360699

Cited by 11 publications

(10 citation statements)

References 41 publications

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“…However adequate positioning and mealtime disturbances remain as issues in the busy acute care setting where there are multiple competing activities. Addressing further improvements will require a more granular understanding of patient, staff and system perspectives than is provided by a questionnaire, and an improvement project has been commenced using a participatory co‐design approach to improving mealtimes 12,18,29,30 . The repeated use of the patient questionnaire may help evaluate these current improvement efforts.…”

Section: Discussionmentioning

confidence: 99%

Patient‐reported experiences of mealtime care and food access in acute and rehabilitation hospital settings: a cross‐sectional survey

Kozica-Olenski

Treleaven

Hewitt

et al. 2021

J Human Nutrition Diet

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Background Nutrition and mealtime interventions can improve nutritional intake amongst hospital inpatients; however, patient‐reported experience is rarely considered in their development and evaluation. The present study aimed to measure patient‐reported food and mealtime experience to evaluate and inform continuous quality improvement of hospital nutrition care. Methods A cross‐sectional survey with inpatients in seven acute care and rehabilitation wards was conducted. A 27‐item validated questionnaire measured five domains of patient experience: food choices, organisational barriers, feeling hungry, physical barriers to eating and food quality. Responses were summarised descriptively and compared between settings (acute versus rehabilitation), patient demographics (age, gender) and time in hospital. Results Responses from 143 participants (mean age 67 years, 57% male, 28% rehabilitation, median 6 days into hospitalisation) showed that 10% or fewer respondents reported difficulties with food choices, feeling hungry or food quality. The most common difficulties were opening packets (36%), insufficient menu information provided (29%), being interrupted by staff when eating (28%), being disturbed when eating (27%), being in an uncomfortable position when eating (24%) and difficulty reaching food (21%). There were no significant differences in domain patterns by sex, age group or time in hospital. Organisational barriers were reported less frequently amongst rehabilitation participants compared to acute care (P = 0.01). Conclusions This survey highlights areas of positive patient‐reported experience with nutrition care and suggests that local improvement efforts should focus on physical assistance needs and organisational barriers, especially in acute care wards. The questionnaire may be useful for informing and evaluating systematic nutrition care improvements.

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Section: Discussionmentioning

confidence: 99%

Patient‐reported experiences of mealtime care and food access in acute and rehabilitation hospital settings: a cross‐sectional survey

Kozica-Olenski

Treleaven

Hewitt

et al. 2021

J Human Nutrition Diet

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“…Data were analysed through phenomenological hermeneutical analysis entailing a naïve reading, constructing a structural thematic analysis and developing a comprehensive understanding [61,62]. Throughout the three stages, the metaphorical action of the hermeneutic circle is constantly applied, causing the researcher to move back and forth between the three stages, using each as a critical reflection and verification of the other [62].…”

Section: Discussionmentioning

confidence: 99%

“…Thereafter, to construct the thematic structural analysis, sections of meaningful text are identified and condensed in everyday language [62]. Condensed text is then reviewed, interpreted and clustered into sub-themes and main themes while continuously reflecting back on the naïve understanding and while constantly considering the research aim [61,62]. The comprehensive understanding is lastly constructed by reflecting on the holistic meaning in relation to the naïve reading, the thematic structural analysis, the research aim, the context of the study, the author's preunderstanding and relevant meta-theoretical literature [62].…”

Section: Discussionmentioning

confidence: 99%

Psychological Resilience of Volunteers in a South African Health Care Context: A Salutogenic Approach and Hermeneutic Phenomenological Inquiry

Barnard

Furtak

2020

IJERPH

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Volunteering in non-Western countries, such as South Africa, is subject to poor infrastructure, lack of resources, poverty-stricken conditions and often conducted by volunteers from lower socio-economic spheres of society. Sustaining the well-being of volunteers in this context is essential in ensuring their continued capacity to volunteer. To do so, it is important to understand the psychological resilience of these volunteers and the resistance resources they employ to positively adapt to their challenging work-life circumstances. The aim of this qualitative hermeneutic phenomenological study was to explore volunteers’ psychological resilience from a salutogenic perspective. In-depth interviews were conducted with eight volunteers servicing government-run hospitals. Data were analysed through phenomenological hermeneutical analysis. Findings show a characteristic work-life orientation to be at the root of volunteers’ resilience. Their work-life orientation is based on a distinct inner drive, an other-directedness and a “calling” work orientation. It is proposed that this work-life orientation enables volunteers in this study context, to cope with and positively adapt to challenging work-life circumstances and continue volunteering. The elements of their work-life orientation are presented as intrapersonal strength resources fundamental to their psychological resilience. It is suggested that organisations invest in developmental interventions that endorse and promote these intrapersonal strengths.

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“…These principles include changes to mealtime practices at the environmental (eg, closing the ward to visitors during mealtimes), staffing (eg, nursing staff will make food a priority during mealtimes; staff breaks to be organised to maximise mealtime staffing), and patient (patients needing assistance will be identified; patients will have an opportunity to wash their hands prior to meal service) levels. Acknowledging that the policy encouraged tailoring to the local context, Protected Mealtime policies have since extended to countries including Australia, 10 Denmark 11 and Canada. 12 The origins of the policy in the UK are found in the implementation of complex interprofessional strategies within the Essence of Care framework and the Productive Ward.…”

Section: Introductionmentioning

confidence: 99%

<p>Evidence-Based Analysis of Protected Mealtime Policies on Patient Nutrition and Care</p>

Porter¹,

Hanna²

2020

RMHP

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Malnutrition in hospitalized patients remains a significant problem. Protected Mealtimes is a complex, inter-professional ward-based intervention that was first introduced in the United Kingdom to address this issue. Now implemented internationally, the approach still remains in key policy documents including the National Health Service Essence of Care. This review aims to synthesize the nutrition, satisfaction and quality of life patient/resident outcomes that arise from the implementation of Protected Mealtimes in hospitals and residential aged care facilities and to consider fidelity issues that have been reported in previous research. A defined search strategy was implemented in seven databases to identify full text papers of original research that evaluated Protected Mealtimes implementation. After screening, data were extracted from eight studies (7 quantitative and 1 qualitative study) that were conducted in hospitals. There was no research identified from the aged care sector. There were few positive outcomes that resulted from Protected Mealtimes implementation, many fidelity issues with the intervention were reported. It is apparent that Protected Mealtimes provide few, if any, benefits for hospitalized patients. It is a complex, multi-pronged initiative that has limited fidelity and limited outcomes. As such, we recommend that disinvestment by policy makers for hospitals should be considered, with the implementation of other evidence based mealtime initiatives. We provide no recommendation for disinvestment in the aged care sector, since the approach has not been evaluated against any of the eligible outcomes of this review.

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Raising a beautiful swan: a phenomenological-hermeneutic interpretation of health professionals’ experiences of participating in a mealtime intervention inspired by Protected Mealtimes

Cited by 11 publications

References 41 publications

Patient‐reported experiences of mealtime care and food access in acute and rehabilitation hospital settings: a cross‐sectional survey

Patient‐reported experiences of mealtime care and food access in acute and rehabilitation hospital settings: a cross‐sectional survey

Psychological Resilience of Volunteers in a South African Health Care Context: A Salutogenic Approach and Hermeneutic Phenomenological Inquiry

<p>Evidence-Based Analysis of Protected Mealtime Policies on Patient Nutrition and Care</p>

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