The nature of feeding completely dependent persons: A meta-ethnography

Figures & data

Table I.  Overview of primary research reports in the present study.

Author	Aim	Participants/setting	Method
Athlin, Norberg, and Jansson (1989)	Understanding of feeding problems in severely demented patients cared for in a task assignment care system	15 patients with dementia, 45 nurses, nurses aides and untrained staff in one long-term care institution and one mental hospital in Sweden	Observations
			Interviews with practitioners
Athlin, Norberg, and Asplund (1990)	Understanding of practitioners’ perceptions and interpretation of patients’ (with dementia) behaviour and experiences during feeding	23 patients with dementia, 62 nurses, nurse's aide and untrained staff in three hospital wards in Sweden	Observations
			Interviews with practitioners
Kayser-Jones, and Scheel (1997)	Description and analysis of how an inadequate number of poorly supervised staff affects the mealtime experience of nursing home residents	36 physicians, 50 nursing staff, 58 residents, 50 relatives of residents in two nursing homes in USA.	Observations
			Interviews with physicians, nursing staff, residents and relatives
			Event analysis of 100 meals
Kumlien, and Axelsson (2002)	Exploring eating, feeding and nutrition among stroke patients as described by nurses and in an assessment of ADL and swallowing	40 patients with stroke and 30 registered nurses in five nursing homes in Sweden	Interviews with registered nurses
			Review of nursing records Assessment of patients’ state of health
Michaelsson, Norberg, and Norberg (1987)	Description of patients’ eating difficulties and nurses’ activities to nourish and hydrate them	30 ward nurses/ mental nurses and 69 residents in 30 nursing homes in Sweden	Interviews
			Questionnaires
			Documentation in residents’ chart
Pasman, Mei The,Onwuteaka-Philipsen, Ribbe, and Wall (2003)	Description of the feeding problems nurses face when feeding patients with severe dementia and how they dealt with these problems	60 residents and 46 nurses in two nursing homes in The Netherlands.	Field notes
			Observation
			Interviews with nurses
			Analysis of nursing and medical records
			Analysis of diaries
			The researchers
Pearson, Fitzgerald, and Nay (2003)	Description of staff's view and experience of mealtimes in nursing homes	40 residents (11 completely dependent), 31 nurses, care assistants and nursing directors in 10 nursing homes in Australia	Ethnographic descriptions of the nursing homes
			Observations
			Interviews with staff
Pelletier (2005)	Exploration of feeding beliefs among certified nurse assistants and how the beliefs influenced their feeding practices	20 certified nurse assistants from five nursing homes in USA.	Interviews
Pierson (1999)	Description of the self-organizing activities and the unspoken knowledge that nursing assistants use in performing the work of feeding as a routine part of their activities	Demented residents and nursing assistants in one long-term care unit in USA.	Observations and field notes
van Ort, and Phillips (1992)	Description of:	10 residents with Alzheimer's disease, 11 nursing assistants, licensed nurses, and registered nurses in a special dementia-care facility in USA.	Video records
	• the range of nursing activities that are effective or ineffective during feeding
	• the range of residents behaviours during feeding
	• the nature of interactions during feeding

Table II.  Key metaphors found in the analysis of data in the present study.

Metaphor	Source
Feeding as technical	Athlin et al. (1989); Athlin et al. (1990); Kayser-Jones and Scheel (1997); Kumlien and Axelsson (2002);
	Michaelsson et al. (1987); Pasman et al. (2003); Pearson et al. (2003); Pelletier (2005); Pierson (1999); van Ort and Philips (1992)
Feeding as efficient	Athlin et al. (1989); Athlin et al. (1990); Kayser-Jones and Shell (1997); Kumlien and Axelsson (2002);
	Michaelsson et al. (1987); Pasman et al. (2003); Pelletier (2005); Pierson 1999; van Ort and Philips (1992)
Feeding as a chore	Athlin et al. (1989); Kayser-Jones and Schell (1997); Michaelsson et al. (1987); Pearson et al. (2003); Pellitier (2005); van Ort and Phillips (1999)
Feeding as connection	Athlin et al. (1990); Kayser-Jones and Shell (1997); Pearson et al. (2003); Pellitier (2005); van Ort and Phillips (1992)
Feeding as spending time with the person	Athlin et al. (1990); Kayser-Jones and Shell (1997); Pasman et al. (2003); Pearson et al. (2003); Pierson (1999)
Feeding as acknowledging the person	Athlin et al. (1990); Kayser-Jones and Schell (1997); Kumlien and Axelsson (2002); Pasman et al. (2003); Pearson et al. (2003); Pelletier (2005); Van Ort and Phillips (1992)

*Pellitier C. A. Feeding beliefs of certified nurse assistants in the nursing home. A factor influencing practice. Journal of Gerontological Nursing 2005; 31(7)5–10

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*Athlin E., Norberg A., Jansson L. Feeding problems in severely demented persons seen from task and relationship aspect. Scandinavian Journal of Caring Science 1989; 3(3)113–121

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*Athlin E., Norberg A., Asplund K. Caregivers’ perceptions and interpretations of severely demented persons during feeding in a task assignment system. Scandinavian Journal of Caring Science 1990; 4(4)147–155

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*Kayser-Jones J., Schell E. The effect of staffing on the quality of care at mealtime. Nursing Outlook 1997; 45(2)64–72

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*Kumlien S., Axelsson K. Stroke persons in nursing homes: eating, feeding, nutrition and related care. Journal of Clinical Nursing 2002; 11: 498–509

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*Michaelsson E., Norberg A., Norberg B. Feeding methods for demented persons in end stage of life. Geriatric Nursing 1987; 8(2)69–73

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*Pasman H. R. W., Mei The B. A., Onwuteaka-Philipsen B. D., Wal B. van der, Ribbe A. M. W. Feeding nursing home persons with severe dementia: a qualitative study. Journal of Advanced Nursing 2003; 42(3)304–313

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*Pearson A., Fitzgerald M., Nay R. Mealtimes in nursing homes: The role of nursing staff. Journal of Gerontological Nursing 2003; 29(6)40–47

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*Pierson C. A. Ethnomethodologic analysis of accounts of feeding demented residents in long-term care. Image: Journal of Nursing Scholarship 1999; 31(2)127–131

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*van Ort S., Phillips L. Feeding nursing home residents with Alzheimer's Disease. Geriatric Nursing 1992; 13: 249–253

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