An Evaluation of Texture-Modified Diets Compliant with the International Dysphagia Diet Standardization Initiative in Aged-Care Facilities Using the Consolidated Framework for Implementation Research

Wu, Xiaojing Sharon; Miles, Anna; Braakhuis, Andrea

doi:10.1007/s00455-021-10393-2

Cited by 8 publications

(18 citation statements)

References 31 publications

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“…This study continued with the 5 aged care facilities recruited from the previous pre-intervention study ( 10 ). We conducted a 1-d TMD audit and self-administered surveys at pre-intervention and 6 mo postintervention.…”

Section: Methodsmentioning

confidence: 99%

“…Following the pre-intervention context assessment and identification of barriers and enablers at each site, a tailored intervention was designed corresponding to the identified enablers and barriers to facilitate IDDSI implementation ( 10 ). In order to encourage consistent terminology use by determinants and future researchers, incorporation of the common nomenclature for implementation strategies suggested by the Expert Recommendations for Implementing Change (ERIC) Study was utilized ( 28 , 29 ).…”

Section: Methodsmentioning

confidence: 99%

“…While the IDDSI framework clearly outlines the texture requirements of food and fluid for safe consumption, a previous review suggests the meal texture and nutrition intake of those with dysphagia is less than optimal ( 9 ). One of the main challenges in caring for individuals with dysphagia is the lack of knowledge of dysphagia and insufficient training in TMD and TF preparation ( 10–12 ). Without appropriately prepared meals and drinks, adverse events can occur, including aspiration, pneumonia, malnutrition, asphyxiation, and even death ( 2 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

“…The CFIR is a multifaceted framework consisting of 39 constructs from 5 domains, providing a systematic evaluation of determinants that influence implementation outcomes ( 25 ). Our research applied CFIR in the pre-intervention study, to guide a structured gap analysis and to evaluate the determinants associated with the initial stage of IDDSI implementation in aged care facilities ( 10 ). The conclusions from the pre-intervention study suggested that one-third of the aged care residents require TMDs, in concordance with earlier country-specific work ( 26 ).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the need to facilitate IDDSI implementation, particularly regarding IDDSI understanding and adherence of frontline staff (registered nurses, health care assistants, and foodservice staff), was deemed important to success. This study developed and delivered tailored intervention strategies to overcome the barriers identified from the pre-intervention study ( 10 ). In order to assess the effectiveness of the intervention, we conducted a postintervention appraisal assessing staff knowledge acquisition towards dysphagia, IDDSI, foodservice TMD provision, and adherence to IDDSI standards.…”

Section: Introductionmentioning

confidence: 99%

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The Effectiveness of International Dysphagia Diet Standardization Initiative–Tailored Interventions on Staff Knowledge and Texture-Modified Diet Compliance in Aged Care Facilities: A Pre-Post Study

Miles

Braakhuis

2022

Current Developments in Nutrition

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Background The International Dysphagia Diet Standardisation Initiative (IDDSI)1 have created global standardized definitions for texture-modified diets (TMDs)2 and thickened liquids to improve the safety and care for individuals with swallowing difficulties. The IDDSI framework guides healthcare facilities, such as aged care, to provide food to at-risk patients. Objectives This study aims to design, deliver and evaluate a tailored intervention to facilitate IDDSI implementation in aged care. Methods Five aged care facilities received tailored interventions, which were guided by the Expert Recommendation for Implementing Change process and used the corresponding barriers identified in the previous study: 1) tailored material, delivery and planning 2) opinion leaders and professional input 3) strategies to attract and involve staff 4) reflections and evaluations. Meal compliance against IDDSI standards and staff knowledge acquisition were the primary outcomes evaluating the impact of the intervention. Written consent was obtained from facility managers. Staff trainings were delivered by a dietitian, accompanied with electronic and printed materials. An audit was conducted on all items listed on the TMD daily menu (lunch, dinner and midmeals). TMD IDDSI audits and staff self-administered surveys were conducted pre-and 6 months post-intervention. Results Audits of 68 and 79 TMD meals/items were conducted pre-and post-intervention respectively. Significant improvement in meal compliance was found in all three levels of TMDs, including soft and bite-sized (50%, P = 0.0001), minced and moist (44%, P = 0.0024), and pureed (42%, P = 0.0024). The overall IDDSI-compliance increased by 46% post-intervention (P < 0.0001). Staff achieved higher scores in both dysphagia and IDDSI knowledge sections (P < 0.0001). Conclusions In conclusion, tailored interventions facilitated IDDSI implementation in aged care evidenced by increased TMDs compliance and staff knowledge which remained at 6 months post-intervention.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Effectiveness of International Dysphagia Diet Standardization Initiative–Tailored Interventions on Staff Knowledge and Texture-Modified Diet Compliance in Aged Care Facilities: A Pre-Post Study

Miles

Braakhuis

2022

Current Developments in Nutrition

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Effect of a texture‐modified and controlled bolus volume diet on all‐cause mortality in older persons with oropharyngeal dysphagia: Secondary analysis of a randomized controlled trial

et al. 2023

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BackgroundOropharyngeal dysphagia (OD) is common among older adults. Some studies have evaluated the efficacy of a texture‐modified diet on mortality but with short‐term follow‐up. We aimed to evaluate the effect of a texture‐modified diet and controlled bolus volume on all‐cause mortality after 12 months in older persons with OD.MethodsThis secondary analysis of a randomized clinical trial included patients aged ≥60 years with a diagnosis of OD. They were concurrently and randomly assigned to receive either a texture‐modified food diet and controlled bolus volume (intervention group) or standard treatment (control group) with 12 months of follow‐up. Secondary outcomes were oral intake, weight, handgrip strength, phase angle, and aspiration pneumonia. Kaplan‐Meier analysis and the Cox proportional hazards model were used for mortality analysis.ResultsA total of 127 participants (intervention group: 64 and control group: 63) were recruited, with a mean age of 76 years. The probability of all‐cause mortality was significantly lower in the intervention group (n = 8, 12%) than in the control group (n = 18, 29%) (hazard ratio = 0.36 [95% CI = 0.16–0.86]; P = 0.01). There were 5 (7.9%) and 10 (16.1%) aspiration pneumonia events in the intervention and control groups, respectively (not significant) in 12 months of follow‐up. Changes were observed in protein consumption (P = 0.01), body weight (P = 0.04), body mass index (P = 0.004), handgrip strength (P = 0.02), and phase angle (P = 0.04) between the treatment groups.ConclusionCompared with the standard treatment, the dietary intervention improved efficacy by limiting nutrition complications, aspiration pneumonia, and all‐cause mortality.

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Malnutrition in aged care: interplay between dysphagia and diet

Miles

Braakhuis

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review This review aims to deliver expert insights on the current advances and challenges in managing malnutrition in aged care settings, with a specific emphasis on the interaction between dysphagia and diet. Recent findings Several reviews identify the high prevalence of dysphagia in aged care facilities and highlight the correlation between dysphagia and malnutrition. Recent studies underscore the importance of nutrition and cancer screening and assessment, yet highlight the lack of consensus on the definitive tools to be used. There is a growth in employing innovative implementations for enhancing swallowing function and optimizing texture-modified foods. Summary Early identification and strategic interventions are vital for managing malnutrition and dysphagia in aged care facilities, as these conditions are widespread and lead to a higher risk of complications. Although nutritional strategies have shown potential in enhancing oral intake for residents requiring texture-modified foods, lack of investigation on functional outcomes and long-term impact have been highlighted, emphasizing the need for continued research and development of effective assessment tools and targeted interventions to optimize the care for this at-risk group.

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An Evaluation of Texture-Modified Diets Compliant with the International Dysphagia Diet Standardization Initiative in Aged-Care Facilities Using the Consolidated Framework for Implementation Research

Cited by 8 publications

References 31 publications

The Effectiveness of International Dysphagia Diet Standardization Initiative–Tailored Interventions on Staff Knowledge and Texture-Modified Diet Compliance in Aged Care Facilities: A Pre-Post Study

The Effectiveness of International Dysphagia Diet Standardization Initiative–Tailored Interventions on Staff Knowledge and Texture-Modified Diet Compliance in Aged Care Facilities: A Pre-Post Study

Effect of a texture‐modified and controlled bolus volume diet on all‐cause mortality in older persons with oropharyngeal dysphagia: Secondary analysis of a randomized controlled trial

Malnutrition in aged care: interplay between dysphagia and diet

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