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

Liu, Wen; Chen, Yong

doi:10.1111/jocn.16411

Cited by 4 publications

(5 citation statements)

References 39 publications

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Section: Discussionmentioning

confidence: 99%

“…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 ).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…challenging utterances, functional impairments and resistive behaviours) compared to prior research. Notably, resident challenging behaviours should be interpreted beyond 'behaviors that are indicators of resistiveness to care/food and challenging to manage', but rather as 'responses to staff approaches that do not address resident needs and/or expressions attempting to communicating resident needs', which require careful attention, assessment and support(Fazio et al, 2020;Liu & Chen, 2022).While the videos captured mostly segments of mealtimes, this study identified varied occurrences of resident positive/neutral behaviours (nonverbal:1-17; verbal:1-54), functional impairments (1-25) and resistive behaviours (1-46). Findings indicated wider ranges of resident positive and challenging behaviours, compared to prior reports of agitation behaviours (0-26) during mealtimes(Gilmore- Bykovskyi et al, 2015).…”

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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: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

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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“…Although evidence is emerging on the importance of quality dyadic interactions during mealtime care, prior work has primarily focused on the associative (vs temporal) relationships between staff person- and task-centered care approaches and resident positive, neutral, and challenging behaviors and food intake, generating limited evidence to guide the development of effective interventions to improve mealtime care quality and resident outcomes. For example, recent mealtime research supported associative relationships of (a) staff person-centered approaches with resident positive and challenging behaviors ( 11 , 17 , 18 ), and (b) staff person-centered approaches and resident positive and challenging behaviors with resident food intake ( 12 , 22 ). Another study supported associative relationships between positive and negative/neutral interactions during care-related activities (not mealtime-specific) and interaction location and resident participation level, and suggests more research is needed on the role of resident and staff characteristics on quality of dyadic interactions in care of people with dementia ( 23 ).…”

Section: Background and Objectivesmentioning

confidence: 99%

Temporal Relationships Between Nursing Home Staff Care Approaches and Behaviors of Residents With Dementia During Mealtimes: A Sequential Analysis

Liu

Perkhounkova

Hein

et al. 2023

Innovation in Aging

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Background and Objectives Optimal dyadic interactions are critical to quality mealtime care and outcomes. Prior work supports associative relationships between staff approaches and individual mealtime behaviors, yet evidence on temporal relationships is limited. This study examined temporal associations between staff approaches and resident behaviors during mealtimes. Research Design and Methods Videotaped mealtime observations (N=160) involving 36 staff and 27 residents (53 staff-resident dyads) in 9 nursing homes were analyzed. Sequential analyses using 5-, 10-, and 15-second time windows were conducted for resident positive, neutral, and challenging behaviors as antecedents as well as consequences of staff person-centered and task-centered approaches. Results Residents exhibited positive verbal (35.0%) and positive/neutral nonverbal (12.6%) behaviors, as well as challenging behaviors including functional impairments (27.7%) and resistive behaviors (24.7%). Staff primarily used person-centered approaches (54.1% verbal, 40.3% nonverbal); task-centered approaches were less frequent (5.6%). Immediately (within 5-seconds) after staff person-centered approaches, resident positive/neutral and resistive behaviors were more likely and functional impairments less likely. After staff task-centered approaches, resident positive verbal and resistive behaviors were less likely. After resident positive/neutral behaviors, staff person-centered approaches were more likely. After resident functional impairments, staff person-centered verbal approaches were less likely and task-centered approaches more likely. After resident resistive behaviors, all staff approaches were more likely. The strength of temporal relationships diminished in 10-second and 15-second time windows. Discussion and Implications Staff-resident positive interactions were associated with more subsequent positive interactions. Person-centered care was associated with fewer subsequent resident functional impairments and more subsequent resistive behaviors. Resident resistive behaviors were associated with more subsequent person-centered and task-centered care. Findings confirm the importance of facilitating positive staff-resident interactions and managing functional impairments using person-centered care. Resistive behaviors require additional awareness and attention beyond commonly used person-centered care approaches. Further investigation of temporal relationships is needed using larger diverse samples.

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Mealtime interactions between nursing home staff and residents with dementia: a behavioral analysis of Language characteristics

Liu,

Jao,

Paudel

et al. 2023

BMC Geriatr

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Background Quality staff-resident communication is crucial to promote outcomes in nursing home residents with dementia requiring assistance during mealtimes. Better understanding of staff-resident language characteristics in mealtime interactions help promote effective communication, yet evidence is limited. This study aimed to examine factors associated with language characteristics in staff-resident mealtime interactions. Methods This was a secondary analysis of 160 mealtime videos involving 36 nursing staff and 27 residents with moderately severe to severe dementia in 9 nursing homes. Mixed-effects models was used to examine the relationships between factors and language characteristics in staff-resident mealtime interactions. The independent variables were speaker (resident vs. staff), utterance quality (negative vs. positive), intervention (pre- vs. post-communication intervention), and resident dementia stage and comorbidities. The dependent variables were expression length (number of words in each utterance) and addressing partner by name (whether staff or resident named their partner in each utterance). All models included staff, resident, and staff-resident dyad as random effects. Results Staff (utterance n = 2990, 99.1% positive, mean = 4.3 words per utterance) predominated conversations and had more positive, longer utterances than residents (utterance n = 890, 86.7% positive, mean = 2.6 words per utterance). As residents progressed from moderately severe to severe dementia, both residents and staff produced shorter utterances (z=-2.66, p = .009). Staff (18%) named residents more often than residents (2.0%; z = 8.14, p < .0001) and when assisting residents with more severe dementia (z = 2.65, p = .008). Conclusions Staff-resident communication was primarily positive, staff-initiated, and resident-oriented. Utterance quality and dementia stage were associated with staff-resident language characteristics. Staff play a critical role in mealtime care communication and should continue to initiate resident-oriented interactions using simple, short expressions to accommodate resident declining language abilities, particularly those with severe dementia. Staff should practice addressing residents by their names more frequently to promote individualized, targeted, person-centered mealtime care. Future work may further examine staff-resident language characteristics at other levels of language using more diverse samples.

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

Cited by 4 publications

References 39 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

Temporal Relationships Between Nursing Home Staff Care Approaches and Behaviors of Residents With Dementia During Mealtimes: A Sequential Analysis

Mealtime interactions between nursing home staff and residents with dementia: a behavioral analysis of Language characteristics

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