title: Meal provision in a UK National Spinal Injury Centre: a qualitative audit of service users and stakeholders.
abstract: METHODS
  A single centre survey.
  
  
  OBJECTIVE
  The objective of this study is to (1) assess patients' food intake and (2) measure satisfaction with current food provision, as judged by patients and by stakeholders (medical and nursing staff, managers and catering staff).
  
  
  METHODS
  Standardised questionnaires were used to record food intake over a 24-h period, and to evaluate the quality, ordering, delivery and overall acceptability of food provided.
  
  
  RESULTS
  The food intake of 67 patients with spinal cord injury (SCI) was recorded (64% response rate) and 166 evaluations (50% response rate) were returned. Twenty-nine patients (48%) consumed three full meals a day, 17 (26%) received oral nutritional supplements, 22 (34%) received vitamin/mineral supplements, and 23 (35%) required assistance to eat. Some patients and stakeholders expressed satisfaction with the current food provision: taste good: 25 versus 17% (for patients and stakeholders, respectively); appropriate texture: 22 versus 21%; appropriate temperature: 55 versus 72% (P = 0.002); well presented: 43 versus 28%; good choice: 49 versus 59%; received meal ordered: 65 versus 37% (P < 0.001); meal served on time: 71 versus 58%; and no interruption during mealtimes: 62 versus 46%. Principal component analyses of item scores identified three main factors (food quality, food presentation and food delivery (logistics).
  
  
  CONCLUSIONS
  The present study identified some areas where there appeared to have been improvement in SCI hospital catering, but with much still to be achieved. Hospital-catering systems should be tailored to meet the demands of the different patient groups to optimise nutritional intake. Periodic quality control is essential to meet recommendations and patients' expectations.
authors.affiliation: Department of Nutrition and Dietetics, National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK. Samford.Wong@ucl.ac.uk
authors.forename: S
authors.initials: S
authors.lastname: Wong
authors.forename: A
authors.initials: A
authors.lastname: Graham
authors.forename: D
authors.initials: D
authors.lastname: Green
authors.forename: S P
authors.initials: SP
authors.lastname: Hirani
authors.forename: G
authors.initials: G
authors.lastname: Grimble
authors.forename: A
authors.initials: A
authors.lastname: Forbes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004435:Eating / Q000502:physiology / Q000523:psychology; D005260:Female; D063427:Food Quality; D005521:Food Service, Hospital / Q000592:standards*; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D008297:Male; D062407:Meals / Q000502:physiology / Q000523:psychology; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D036301:Qualitative Research; D013124:Spinal Injuries / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult