title: Attitudes, perceptions and experiences of mealtimes among residents and staff in care homes for older adults: A systematic review of the qualitative literature.
abstract: Addressing problems associated with malnutrition in care home residents has been prioritized by researchers and decision-makers. This review aimed to better understand factors that may contribute to malnutrition by examining the attitudes, perceptions and experiences of mealtimes among care home residents and staff. Five databases were searched from inception to November 2015: Medline, Embase, PsychINFO, AMED, and the Cochrane Database. Forward and backward citation checking of included articles was conducted. Titles, abstracts, and full texts were screened independently by two reviewers and quality was assessed using the Wallace criteria. Thematic analysis of extracted data was undertaken. Fifteen studies were included in the review, encompassing the views and opinions of a total of 580 participants set in nine different countries. Four main themes were identified: (1) organizational and staff support, (2) resident agency, (3) mealtime culture, and (4) meal quality and enjoyment. Organizational and staff support was an over-arching theme, impacting all aspects of the mealtime experience. Mealtimes are a pivotal part of care home life, providing structure to the day and generating opportunities for conversation and companionship. Enhancing the mealtime experience for care home residents needs to take account of the complex needs of residents while also creating an environment in which individual care can be provided in a communal setting. PROSPERO Registration: CRD42015025890.
authors.affiliation: University of Exeter Medical School, College House, St Luke's Campus, Heavitree Road, Exeter EX1 2LU, UK; National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula. Electronic address: Ross.Watkins@exeter.ac.uk.
authors.forename: Ross
authors.initials: R
authors.lastname: Watkins
authors.affiliation: University of Exeter Medical School, College House, St Luke's Campus, Heavitree Road, Exeter EX1 2LU, UK; National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula.
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Goodwin
authors.affiliation: University of Exeter Medical School, College House, St Luke's Campus, Heavitree Road, Exeter EX1 2LU, UK; National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Abbott
authors.affiliation: University of Exeter Medical School, College House, St Luke's Campus, Heavitree Road, Exeter EX1 2LU, UK; National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula.
authors.forename: Amy
authors.initials: A
authors.lastname: Backhouse
authors.affiliation: University of Exeter Medical School, College House, St Luke's Campus, Heavitree Road, Exeter EX1 2LU, UK; National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula.
authors.forename: Darren
authors.initials: D
authors.lastname: Moore
authors.affiliation: University of Exeter Medical School, College House, St Luke's Campus, Heavitree Road, Exeter EX1 2LU, UK; National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula.
authors.forename: Mark
authors.initials: M
authors.lastname: Tarrant
mesh_terms: D000328:Adult; D000368:Aged; D001290:Attitude; D006282:Health Personnel / Q000523:psychology*; D006707:Homes for the Aged; D006801:Humans; D007398:Interpersonal Relations; D044342:Malnutrition / Q000517:prevention & control; D062407:Meals / Q000523:psychology*
keywords: Mealtimes; Older adults; Qualitative research; Residential care