Dyadic interactions, physical environment, and social environment in dementia mealtime care: A systematic review of psychometric properties of instruments

Abstract

AbstractBackgroundIt is critical to use validated instruments to assess dyadic interactions, social environment, and/or physical environment during mealtime care of persons living with dementia to evaluate the process and efficacy of mealtime assistance and environmental interventions. However, the quantity and psychometric quality of such instruments are unknown. This systematic review aimed to synthesize the quantity and quality of instruments that assess dyadic interactions, physical environment, and/or social environment during mealtime care for persons living with dementia.MethodsWe searched Pubmed, CINAHL, AgeLine, PsychINFO, and Cochrane Library for records published between 1980 and 2020. Records were eligible if they included any instrument that measures concepts of interest (i.e., mealtime dyadic interactions, physical and/or social dining environment). From eligible records, eligible instruments originally developed or later modified to measure concepts of interest were identified. From eligible records, eight characteristics of eligible instruments were extracted: 1) development process, 2) concept/construct being operationalized, 3) sample and setting, 4) administration method, 5) description of items, 6) scoring format/interpretation, 7) reliability, and 8) validity. A newly developed psychometric quality assessment tool was used to evaluate the psychometric quality of eligible instruments.ResultsIn total, 26 eligible instruments were identified. Seventeen instruments assessed dyadic interactions, 1 assessed only physical environment, and 8 assessed physical and social environment. All instruments were observational tools and scored as having low psychometric quality. Reasons for low psychometric quality included use of small sample size compared to the number of items, limited psychometric testing, and inadequate estimates.ConclusionsA number of instruments were developed and/or used to assess dyadic interactions, physical and/or social environment in dementia mealtime care. All instruments warrant further testing to accumulate psychometric evidence in larger diverse samples in different care settings for use in research and practice.