Abstract
BackgroundRefeeding and normalizing eating behaviour are main treatment aims for individuals admitted to inpatient eating disorder units. Consequently, mealtime activities are specific, everyday activities, serving a clear therapeutic purpose, despite numerous challenges for both staff and patients. Few studies have specifically addressed staff involvement, interactions, and management activities to structure mealtimes. In this study, we investigated the structure of mealtime activities on inpatient eating disorder units, and identified associated staff behaviour.MethodsDescriptive and exploratory qualitative study using video observations to investigate the structure of mealtimes and staff management of mealtime activities. Forty main meals were video recorded and the observational data were analysed using interaction analysis.ResultsAn initial analysis during data screening identified three main parts of the meal: ‘pre-eating’, ‘eating’, and ‘meal completion’. For each part, a regular pattern of activities occurred which were associated with staff behaviour.ConclusionsIncreased awareness amongst staff regarding how they manage the meal and act through a clear internal structure can help staff members to further explore their behaviours and collaboration during mealtimes, and also contribute to improved interaction with patients during the various phases of the meal.
Highlights
Refeeding and normalizing eating behaviour are main treatment aims for individuals admitted to inpatient eating disorder units
We identified three main structuring events within each meal: Pre-eating: Staff members facilitate and assist patients to take their food and bring it to the table
An enhanced awareness amongst staff members concerning which scripts are in play, and whether they are in agreement about the main tasks during a meal should be further explored
Summary
Refeeding and normalizing eating behaviour are main treatment aims for individuals admitted to inpatient eating disorder units. Mealtime activities are specific, everyday activities, serving a clear therapeutic purpose, despite numerous challenges for both staff and patients. Few studies have addressed staff involvement, interactions, and management activities to structure mealtimes. We investigated the structure of mealtime activities on inpatient eating disorder units, and identified associated staff behaviour. Interventions targeting weight gain and normalized eating behaviour are still key treatment goals. It is well known that eating is an anxiety-producing activity for individuals admitted to an eating disorder unit (EDU). Weight gain is often associated with negative emotions like fear and anxiety [4,5] and eating is a challenging activity for ED patients. The staffs’ main responsibilities include food preparation, monitoring the client’s food
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