Me at mealtimes v1
Research type
Research Study
Full title
The mealtime experiences of adults with mental health conditions on inpatient wards: a qualitative exploratory study.
IRAS ID
270116
Contact name
John Baker
Contact email
Sponsor organisation
University of Leeds
Clinicaltrials.gov Identifier
270116, IRAS
Duration of Study in the UK
2 years, 2 months, 31 days
Research summary
Background: Recent reports have suggested that at least 19% of adults living with a mental health condition have swallowing difficulties (dysphagia). The nature of this dysphagia varies but it is acknowledged that it may lead to poor nutrition, dehydration, aspiration pneumonia, choking, and premature death. We reviewed the literature describing mealtime experiences and/or swallowing difficulties in adults with mental health conditions. We looked for research which included the perspective of the person with mental health condition, their family members, carers or staff. We found reports of dysphagia and choking written in a series of medical case studies over recent decades. There was only occasional mention of "self report" and overall there was little description of the personal experience of mealtime difficulties, for people with mental health conditions. Pilot work and patient consultations have suggested that the views of adults with mental health conditions themselves and their direct support staff offer important information for improving mealtime safety and quality of life.
Participants in this study will include adults with mental health conditions on inpatient wards, and ward staff. Interviews will lead to improved understanding of mealtime experience and preferences, of awareness regarding signs of swallowing difficulty, and how to support someone with mealtime difficulties.
Proposed research study: We will interview participants seeking their personal experience of mealtimes on inpatient wards, and their insights and concerns. The interviews will offer an informal and supportive opportunity for patients and staff to share their views supported by an experienced Speech and Language Therapist researcher.
Results: Information from this proposed PhD study will provide important, person centred insights informing better care and support for mealtimes on inpatient wards. Findings will be disseminated in at least one peer reviewed journal, also at conferences and patient groups.
Lay summary of study results: Background Dysphagia, its associated risk of choking, and impacts on quality of life, are serious concerns for people with mental illness and their caregivers. Prior research has highlighted the prevalence of premature, preventable death from choking on food and the consequences of dysphagia on physical health. However, there is little known about the lived experience of dysphagia and choking for people with non-organic mental illness.
The aim of this study was to explore patients’ perspectives of mealtime experiences on inpatient wards to improve understanding of dysphagia and risk of choking.
Method
This thesis presents an integrative literature review which drew attention to the medicalised perspectives in existing research regarding dysphagia and risk of choking in working age adults with non-organic mental illness. Thematic analysis highlighted a lack of information on patient experiences, insight and inclusion in the literature and confirming the need for further research.
Consultation with patients and caregivers involved discussing the literature review themes and then co-designing interviews to investigate patients’ perspectives of mealtime difficulties. The interviews included patients, staff, and speech and language therapists. Reflexive thematic analysis constructed themes relating to the heightened emotions associated with inpatient mealtimes.
Findings
Patient perspectives included themes of heightened emotions influencing mealtimes in hospital. Subthemes included the importance of connections, autonomy, and the impact of stressful mealtimes on swallowing. Staff and speech and language therapists also presented insights on negative mealtime experiences and the impact on mental health recovery.
Conclusions
Synthesis of the themes raised important questions for patients’ recovery and clinical practice. The stressful nature of mealtimes appeared counter to patients’ wellbeing and recovery and impacted negatively on staff’s and speech and language therapists’ practice. Inpatient mealtimes are a missed opportunity to promote mental health recovery, build patient skills, and raise staff morale. There is clear need for further research into adapting and improving mealtimes on mental health wards.REC name
Yorkshire & The Humber - Leeds West Research Ethics Committee
REC reference
21/YH/0038
Date of REC Opinion
25 Feb 2021
REC opinion
Favourable Opinion