The Effects of a hospital ward eating environment on patients' mealtime experience.

Abstract

The provision of adequate nutritional care to hospital patients continues to be an international problem, despite numerous initiatives and attempts by interested parties over several decades to make improvements. The focus of this research was to critically evaluate the effects a hospital ward eating environment can have on patients’ foodservice experience and to establish if providing an enhanced dining environment could improve outcomes. A case study approach was employed on two Orthopaedic wards in an Acute Care Hospital which considered the variables that concurred in the contextual environment of the foodservice provision, to provide an in depth appreciation of Orthopaedic patients’ dining experience. The study used a mixed methods, sequential, exploratory, research process, consisting of four phases incorporating; semi structured interviews with patients, patient questionnaires, exploratory interviews with stakeholders and measurement of patients’ food intake and mood. Following the empirical processes this study has engaged in, theoretical contributions have been made which include; (1) A conceptual model for factors affecting patients’ foodservice experience developed from a synthesis of literature and theories with regard to the provision of hospitality, mealtime experiences and nutritional care provision for patients; (2) A questionnaire to measure hospital patients’ overall food experiences has been developed; (3) An explanatory model for factors influencing hospital patients’ foodservice experience has been developed; (4) A comparison of the patients’ mean, daily, nutritional intakes with the recommended levels, provided updated evidence of poor nutrition in the research setting, whilst factors influencing reduced food intakes were established; (5) The provision of an enhanced group dining experience for the patients, established positive outcomes for patients and stakeholders; (6) A theoretical model was developed that establishes a hierarchy of factors influencing Orthopaedic patients’ foodservice experience and food intake. This research study makes a contribution to our understanding of how sociological and environmental factors can enhance patients’ dining experience which may ultimately lead to improved nutritional intake.