title: Experiences of food access in hospital. A new questionnaire measure.
abstract: OBJECTIVE
  People in hospital experience problems gaining access to food. We aimed to develop an experience-based measure of access to food.
  
  
  METHODS
  The 27-item questionnaire has five domains: feeling hungry, physical barriers, organisational barriers, food choice and food quality. A survey was implemented on 29 wards in four hospitals using both self-completion and interview administration formats.
  
  
  RESULTS
  Questionnaires were analysed for 764/1154 (66%) eligible participants. Values for Cronbach's alpha were: feeling hungry 0.886; physical barriers 0.809; organisational barriers 0.632; food choice 0.414; and food quality 0.738. The proportions of compromised patients in each domain were: hunger 30%; physical barriers 24%; organisational barriers 29%; food choice 24%; and food quality 21%. Poor self-rated health was associated with increased problems from feeling hungry (adjusted odds ratio 2.39, 95% confidence interval 1.10-5.18); older age was associated with increased difficulties with physical problems (2.67, 1.31-5.42) as were admission to a stroke ward (16.8, 5.09-55.3) or elderly care ward (3.50, 1.08-11.40). Problems with food access varied between hospitals and wards.
  
  
  CONCLUSIONS
  We have developed a reliable and valid questionnaire measure of hospital food access. The measure reveals widespread problems of food access in hospital.
authors.affiliation: Department of Public Health Sciences, King's College London, Capital House, 42 Weston Street, London SE1 3QD, UK.
authors.forename: Smriti
authors.initials: S
authors.lastname: Naithani
authors.forename: Jane E
authors.initials: JE
authors.lastname: Thomas
authors.forename: Kevin
authors.initials: K
authors.lastname: Whelan
authors.forename: Myfanwy
authors.initials: M
authors.lastname: Morgan
authors.forename: Martin C
authors.initials: MC
authors.lastname: Gulliford
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D004435:Eating / Q000523:psychology; D005260:Female; D005518:Food Preferences; D005521:Food Service, Hospital / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D006304:Health Status; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D006815:Hunger; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011786:Quality Control; D011795:Surveys and Questionnaires