Development of a Physical Environmental Observational Tool for Dining Environments in Long-Term Care Settings

Chaudhury, Habib; Keller, Heather; Pfisterer, Kaylen J.; Hung, Lillian

doi:10.1093/geront/gnw261

Cited by 22 publications

(16 citation statements)

References 17 publications

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“…The DEAP was developed to assess the physical environment during dementia mealtime care based on specific frameworks, existing instruments, and pilot testing 4,67–72 . The use of this instrument was reported in seven records, of which only three types of psychometric properties (inter‐rater reliability and predictive and convergent validity) were reported.…”

Section: Resultsmentioning

confidence: 99%

Dyadic interactions and physical and social environment in dementia mealtime care: a systematic review of instruments

Liu

Kim

2021

Annals of the New York Academy of Sciences

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Using valid instruments to measure dyadic interactions and physical and social environment during mealtime care of persons with dementia is critical to evaluate the process, fidelity, and impact of mealtime interventions. However, the characteristics and quality of existing instruments remain unexplored. This systematic review described the characteristics and synthesized the psychometric quality of instruments originally developed or later modified to measure mealtime dyadic interactions and physical and/or social dining environment for people with dementia, on the basis of published reports between January 1, 1980 and December 31, 2020. We identified 26 instruments: 17 assessed dyadic interactions, one assessed physical environment, and eight assessed physical and social environment. All instruments were used in research and none in clinical practice. All instruments were observational tools and scored as having low psychometric quality, except for the refined Cue Utilization and Engagement in Dementia (CUED) mealtime video‐coding scheme rated as having moderate quality. Reasons for low quality are the use of small samples compared with the number of items, limited psychometric testing, and inadequate estimates. All existing tools warrant further testing in larger diverse samples in varied settings and validation for use in clinical practice. The refined CUED is a potential tool for use and requires testing in direct on‐site observations.

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Section: Resultsmentioning

confidence: 99%

Dyadic interactions and physical and social environment in dementia mealtime care: a systematic review of instruments

Liu

Kim

2021

Annals of the New York Academy of Sciences

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“…The dining environment audit protocol (DEAP) was the observational tool used to assess the homelikeness and functional aspects of the dining room environment when residents were absent from the dining room (Chaudhury et al, 2017b). Homelikeness of the dining environment is assessed based on items that contribute to personally and culturally meaningful décor, non-institutional furniture and lighting, family-style dining tables, and smaller dining rooms.…”

Section: Dining Environment Audit Protocolmentioning

confidence: 99%

“…Homelikeness and functionality were rated on a scale of 1-8, with higher scores indicating increased homelikeness and functionality. The DEAP has good inter-rater reliability, with an intra-class correlation coefficient of 0.7 (Chaudhury et al, 2017b), and good construct validity, through significant correlations with measures theoretically correlated to homelikeness and function of dining spaces (Iuglio et al, 2018a). Each dining room was measured on one occasion using the DEAP.…”

Section: Dining Environment Audit Protocolmentioning

confidence: 99%

The association of eating challenges with energy intake is moderated by the mealtime environment in residential care homes

Slaughter

Morrison‐Koechl

Chaudhury

et al. 2020

Int. Psychogeriatr.

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Objectives: Given the increased risk of malnutrition in residential care homes, we studied how specific aspects of the mealtime environment are associated with residents’ eating challenges and energy intake in general and dementia care units of these homes. Design: Cross-sectional study. Participants: 624 residents and 82 dining rooms. Setting: 32 residential care homes across Canada. Measurements: Eating challenges were measured using the Edinburgh Feeding Evaluation in Dementia Questionnaire (Ed-FED-q). Energy intake was estimated over nine meals. Physical, social, person-centered, functional, and homelike aspects of the mealtime environment were scored using standardized, valid measures. Effects of interactions between dining environment scores and eating challenges on daily energy intake were assessed using linear regression. Results: More eating challenges were associated with decreased energy intake on the general (β = −36.5, 95% confidence interval [CI] = −47.8, −25.2) and dementia care units (β = −19.9, 95% CI = −34.6, −5.2). Among residents living on general care units, the functional (β = 48.5, 95% CI = 1.8, 95.2) and physical (β = 56.9, 95% CI = 7.2, 106.7) environment scores were positively and directly associated with energy intake; the social and person-centered aspects of the mealtime environment moderated the relationship between eating challenges and energy intake. Conclusions: Resident eating challenges were significantly associated with energy intake on both dementia care and general care units; however on general care units, when adjusting for eating challenges, the functional and physical aspects of the environment also had a direct effect on energy intake. Furthermore, the social and person-centered aspects of the dining environment on general care units moderated the relationship between eating challenges and energy intake. Dementia care unit environments had no measurable effect on the association between resident eating challenges and energy intake.

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“…For example, both the Therapeutic Environment Screening Survey for Nursing Homes7 and the Environmental Audit Tool8 have some items related to the five senses (ie, odour, lighting), however, these instruments are observational tools and do not include an all-inclusive list of items related to each of the five senses. More recently, another tool called Dining Environment Audit Protocol9 incorporates some important items related to the five senses, however, it is specifically focused on the dinning environments in LTC facilities. With the increased need for an age friendly environment in LTC facilities, an in-depth focus on assessing the five senses is essential and this focus must include considerations about the environment, the perspectives of staff and most importantly, the perspectives of residents.…”

Section: Introductionmentioning

confidence: 99%

Development and psychometric testing of the 5Senses screening tool for long-term care: a study protocol

Backman

Squires²

2019

BMJ Open

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IntroductionAs adults age, their senses tend to decline and a large portion of those most affected by sensory decline reside in long-term care. At present, the creation of a sense-sensitive environment in long-term care is a difficult task as there is minimal evidence or tools available to guide this process. The 5Senses screening tool was developed to measure the sense-sensitivity of a particular environment, with a focus on long-term care. The purpose of this paper is to describe a study protocol to assess the psychometric properties of the newly developed 5Senses screening tool.Methods and analysisWe will conduct a psychometric evaluation of the 5Senses screening tool in long-term care based on the Standards for Educational and Psychological Testing Framework. In phase I, we will seek input from international content experts (n=20) to assess the content validity of all sections of the tool. In phase II, we will invite auditors (n=3-9), residents (n=3-9) and staff (n=3-9) to partake in think-aloud sessions to assess response process validity. In phase III, we will conduct field testing of the revised 5Senses screening tool with auditors (n=100), residents (n=100) and staff (n=100) to evaluate additional measures including acceptability, inter-rater reliability, internal structure validity and internal consistency reliability, where possible.Ethics and disseminationEthical approval was obtained from the University of Ottawa Research Ethics Board. Findings will be disseminated through a peer-reviewed manuscript, through a dedicated website, through presentations in long-term care communities and through presentations at research conferences.

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Development of a Physical Environmental Observational Tool for Dining Environments in Long-Term Care Settings

Cited by 22 publications

References 17 publications

Dyadic interactions and physical and social environment in dementia mealtime care: a systematic review of instruments

Dyadic interactions and physical and social environment in dementia mealtime care: a systematic review of instruments

The association of eating challenges with energy intake is moderated by the mealtime environment in residential care homes

Development and psychometric testing of the 5Senses screening tool for long-term care: a study protocol

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