title: A systematic review of the use of volunteers to improve mealtime care of adult patients or residents in institutional settings.
abstract: OBJECTIVE
  The objective of this review was to locate and assess the evidence obtained from articles reporting empirical research that volunteers improve mealtime care of adults in institutional settings.
  
  
  BACKGROUND
  Malnutrition in adult patients or residents in institutional care settings is common. Poor standards of mealtime care have been suggested to contribute to the development of malnutrition.
  
  
  METHODS
  A systematic review of the literature was undertaken.
  
  
  METHODS
  Key words were identified and used separately and in combination to search the electronic databases MEDLINE, CINHAL, BNI and EMBASE and the internet for relevant articles. Searches were undertaken in August 2008, April 2009 and July 1010.
  
  
  RESULTS
  Ten studies fulfilled the criteria for inclusion. The methodologies of five of the 10 studies were unclear due to the brevity of the reports. The validity of the design of the other five studies varied. Generally the results suggested the use of volunteers in mealtime care increased satisfaction of patients, relatives, volunteers and staff concerning meal-time assistance (assessed using methods such as questionnaires and focus groups) and three studies found increased nutritional intake in groups assisted by volunteers. However, few well designed and reported studies were identified.
  
  
  CONCLUSIONS
  There is some evidence that volunteers can improve mealtime care of adult patients or residents in institutional settings, however few well designed studies are reported. Relevance to clinical practice.  This review demonstrates that there is limited evidence that the use of volunteers improves mealtime care of adult patients or relatives in institutional settings.
authors.affiliation: School of Health Sciences, University of Southampton, Southampton, UK. s.m.green@soton.ac.uk
authors.forename: Sue M
authors.initials: SM
authors.lastname: Green
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Martin
authors.forename: Helen C
authors.initials: HC
authors.lastname: Roberts
authors.forename: Avan Aihie
authors.initials: AA
authors.lastname: Sayer
mesh_terms: D000328:Adult; D005522:Food Services / Q000592:standards*; D006801:Humans; D007297:Inpatients; D014838:Volunteers