The Development of a Digital Dysphagia Guide with Care Homes: Co-Production and Evaluation of a Nutrition Support Tool

Abstract

Good nutrition is a recognised outcome in the health and well-being of older care home residents and dysphagia is a known risk factor associated with under nutrition and poor outcomes. The study co-produced a digital Dysphagia Guide with Care Homes using a consensus method with interviews and focus groups to prioritise the need for information and explore acceptability of an educational tool for care home workers. Evaluation of use, acceptability of design, and content of the guide were completed via remote monitoring. The workforce prioritised the need for training as well as the knowledge and skills in relation to planning resident-centred care and advice on textured diets. The technology was a means of offering ‘bite-size’ learning to enhance planning for nutrition across the whole organisation including managers, kitchen staff, and care workers. The Guide to Dysphagia was produced on a tablet and piloted in four care homes over 12 weeks, by 57 staff. Integrated analytics allowed user activity to be monitored. Findings showed that 73% of respondents reported the guide helped them in their job. Additionally, 88% of respondents stated they would recommend the guide to other staff, with 90% reporting it was easy to use. Engagement with staff and managers in four homes resulted in a co-designed, dysphagia guide.

Approaches to co-production of research in care homes: a scoping review

“…All studies were completed in high income countries and the lead author of most studies (n = 12) were based in the UK. 12 studies used qualitative research methods [17,18,[27][28][29][30][31][32][33][34][35][36], six used mixed methods [37][38][39][40][41][42] and one was a descriptive piece about a collaborative partnership approach [43]. 15 studies reported using participatory research methodologies, with nine using participatory action research approaches [17,18,28,29,31,35,37,38,41] and four using appreciative inquiry [27,30,33,39].…”

“…15 studies reported using participatory research methodologies, with nine using participatory action research approaches [17,18,28,29,31,35,37,38,41] and four using appreciative inquiry [27,30,33,39]. Collaborative enquiry [36], experienced-based co-design [42] and nominal group methods [42] were used once respectively.…”

“…All studies (n = 4) using co-production approaches provided a definition [17,18,38,41], as did most of the studies (n = 6) using co-creation [28,29,31,36,37,43]. However, only two out of eight studies using co-design approaches included a definition [29,42] and three studies used the term co-design interchangeably with co-production [32,33,42]. Co-design was described as an approach centred on valuing lived experiences at any or all stages of research in order to understand needs and develop a useful product.…”

“…These studies specifically focused on dementia care, implementing digital technology, artbased approaches, and individualised approaches. Six studies used co-production, co-creation or co-design to support care home workforce development [30,35,36,38,41,42], with five co-producing outputs aimed at developing capabilities and one addressing motivation at work.…”

“…Educational intervention based on the Caring Conversations framework [30] Sub-optimal mouth care for residents [38] Lack of oral care training for care home staff [41] Management of dysphagia [42] Embedding care home nursing in the student curriculum [36] Motivation: Workplace engagement of caregivers [35] Hallam-Bowles et al Research Involvement and Engagement (2022) 8:74 co-creation or co-design. Sometimes reporting of involvement seemed to be linked to the article's aim and the context and timelines of research programmes.…”