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

ABSTRACT:

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.

SUBMITTER: Liu W 

PROVIDER: S-EPMC9972876 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature