title: Teatime Threats. Choking Incidents at the Evening Meal.
abstract: OBJECTIVE
  To explore caregiver perceptions of the socio-environmental issues around evening meal ('teatime') which influence choking. Mealtime difficulties for people with intellectual disabilities and/or mental illness may be underdiagnosed. Difficulties affect quality of life with social aspects impacting on service-users and caregivers. Reporting of choking incidents has increased locally following widespread training. Analysis of reports showed most incidents were occurring around evening meal.
  
  
  METHODS
  A qualitative study of caregivers witnessing a choking incident was undertaken. Semi-structured interviews explored perceptions of the causes. Data were analysed using thematic analysis.
  
  
  RESULTS
  Thematic analysis elicited individual service user characteristics, and social and contextual factors implicated in choking. The findings will facilitate risk assessment for service-users and inform mealtime practice. Staff familiarity is a key factor. Further research involving service-users is indicated to complement these findings. This study widens the focus of recent studies which have considered physical more than socio-environmental aspects of mealtime difficulties.
authors.affiliation: Speech and Language Therapy, Lancashire Care Foundation Trust Whalley, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Guthrie
authors.affiliation: Manchester Metropolitan University, Manchester, UK.
authors.forename: Jois
authors.initials: J
authors.lastname: Stansfield
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000209:etiology; D001291:Attitude of Health Personnel; D017028:Caregivers; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008875:Middle Aged; D036301:Qualitative Research; D055815:Young Adult
keywords: care staff; choking; dysphagia; intellectual disability; mealtime environment; mental illness