Reliability Testing of the Team Member Mealtime Experience Questionnaire.

Team members influence the mealtime experience of residents. Their perspectives on their ability to provide resident- and relationship-centred care during mealtimes is limited. The aim of this study was to describe the development and determine the factor structure and internal and test-retest reliability of the Team member Mealtime Experience Questionnaire (TMEQ). A 23-item questionnaire was developed through several steps. A Likert scale of strongly disagree (score= 1) to strongly agree (score= 5) was used. A total of 137 team members from five diverse homes participated. Time and task-focused items had lower scores (indicating more negative perceptions), whereas knowledge and capability of how to provide resident- and relationship-centred mealtime care had higher scores. Exploratory factor analysis identified three factors; four items were eliminated based on this analysis. Test-retest reliability was completed with 103 participants. Intraclass correlation (ICC) for the total score and three subscales ranged from 0.72 -0.85 while Chronbach's alpha ranged from 0.81-0.92. The 19-item TMEQ is considered reliable for use in research and practice.

Modified Texture Food Use is Associated with Malnutrition in Long Term Care: An Analysis of Making the Most of Mealtimes (M3) Project.

OBJECTIVE: Modified texture food (MTF), especially pureed is associated with a high prevalence of under-nutrition and weight loss among older adults in long term care (LTC); however, this may be confounded by other factors such as dependence in eating. This study examined if the prescription of MTF as compared to regular texture food is associated with malnutrition risk in residents of LTC homes when diverse relevant resident and home-level covariates are considered. DESIGN: Making the Most of Mealtimes (M3) is a cross-sectional multi-site study. SETTING: 32 LTC homes in four Canadian provinces. PARTICIPANTS: Regular (n= 337) and modified texture food consumers (minced n= 139; pureed n= 68). MEASUREMENTS: Malnutrition risk was determined using the Mini Nutritional Assessment short-form (MNA-SF) score. The use of MTFs, and resident and site characteristics were identified from health records, observations, and standardized assessments. Hierarchical linear regression analyses, accounting for clustering, were performed to determine if the prescription of MTFs is associated with malnutrition risk while controlling for important covariates, such as eating assistance. RESULTS: Prescription of minced food [F(1, 382)=5.01, p=0.03], as well as pureed food [F(1, 279)=4.95, p=0.03], were both significantly associated with malnutrition risk among residents. After adjusting for age and sex, other significant covariates were: use of oral nutritional supplements, eating challenges (e.g., spitting food out of mouth), poor oral health, and cognitive impairment. CONCLUSIONS: Prescription of minced or pureed foods was significantly associated with the risk of malnutrition among residents living in LTC facilities while adjusting for other covariates. Further work needs to consider improving the nutrient density and sensory appeal of MTFs and target modifiable covariates.