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      Person‐centred and task‐centred care: Impact on mealtime behaviours in nursing home residents with dementia

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          Abstract

          Introduction

          Mealtime is a critical daily activity to ensure nutrition, hydration, function and socialisation. Interactions between staff and residents during mealtimes are complex and dynamic processes including verbal and/or nonverbal communication that can be positive/neutral or challenging. This study examined characteristics of and relationships between person‐centred and task‐centred care and positive/neutral and challenging mealtime behaviours in persons with dementia.

          Methods

          This study was a secondary behavioural analyses of videotaped mealtime observations ( n = 110) involving 42 unique staff‐resident dyads (29 staff and 25 residents with dementia) in nine nursing homes. The refined Cue Utilization and Engagement in Dementia mealtime video‐coding scheme was used to code videos during 2019–2020. Dependent variables representing resident mealtime behaviours included positive verbal behaviours, positive/neutral nonverbal behaviours, functional impairments (nonverbal) and resistive behaviours (verbal and nonverbal). Independent variables were staff person‐centred and task‐centred approaches (verbal and nonverbal). Relationships between resident mealtime behaviours and staff approaches were examined using bivariate analysis and logistic regression.

          Results

          Staff person‐centred verbal approaches were associated with resident positive verbal behaviours (OR = 1.38, 95% CI = 1.09–1.76), functional impairments (OR = 0.81, 95% CI = 0.66–1.00) and resistive behaviours (OR = 1.65, 95% CI = 1.18–2.31). Staff person‐centred nonverbal approaches were associated with resident functional impairments (OR = 1.33, 95% CI = 1.02–1.74). Staff task‐centred approaches were not associated with resident positive/neutral or challenging mealtime behaviours.

          Conclusion

          This study characterised staff approaches and resident behaviours during mealtime care and provided preliminary support on associations between staff person‐centred approaches and resident positive and challenging behaviours. Person‐centred mealtime care practice is recommended by focusing on support of common, challenging behaviours and reinforcement of positive behaviours with adequate consideration of individual needs and preferences.

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          Most cited references56

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          The Fundamentals of Person-Centered Care for Individuals With Dementia

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            Functional Assessment Staging (FAST) in Alzheimer's Disease: Reliability, Validity, and Ordinality

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              Person-centred care of people with severe Alzheimer's disease: current status and ways forward.

              When caring for people with severe Alzheimer's disease (AD), the concept of the person being central is increasingly advocated in clinical practice and academia as an approach to deliver high-quality care. The aim of person-centred care, which emanates from phenomological perspectives on AD, is to acknowledge the personhood of people with AD in all aspects of their care. It generally includes the recognition that the personality of the person with AD is increasingly concealed rather than lost; personalisation of the person's care and their environment; offering shared decision-making; interpretation of behaviour from the viewpoint of the person; and prioritising the relationship as much as the care tasks. However, questions remain about how to provide, measure, and explore clinical outcomes of person-centred care. In this Review, we summarise the current knowledge about person-centred care for people with severe AD and highlight the areas in need of further research.
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                Author and article information

                Contributors
                Role: Associate Professorwen-liu-1@uiowa.edu
                Role: Statistician
                Role: Data Manager
                Journal
                Int J Older People Nurs
                Int J Older People Nurs
                10.1111/(ISSN)1748-3743
                OPN
                International Journal of Older People Nursing
                John Wiley and Sons Inc. (Hoboken )
                1748-3735
                1748-3743
                14 November 2022
                January 2023
                : 18
                : 1 ( doiID: 10.1111/opn.v18.1 )
                : e12512
                Affiliations
                [ 1 ] The University of Iowa College of Nursing Iowa City Iowa USA
                Author notes
                [*] [* ] Correspondence

                Wen Liu, The University of Iowa College of Nursing, 432 CNB, 50 Newton Road, Iowa City, IA, 52242, USA.

                Email: wen-liu-1@ 123456uiowa.edu

                Author information
                https://orcid.org/0000-0002-1491-7384
                https://orcid.org/0000-0001-6315-4873
                https://orcid.org/0000-0002-3544-3480
                Article
                OPN12512 OPN-2022-2304.R2
                10.1111/opn.12512
                9976786
                36374224
                a5520fd8-dd45-4e83-8d5a-cef16c2793d7
                © 2022 The Authors. International Journal of Older People Nursing published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 16 August 2022
                : 03 February 2022
                : 22 October 2022
                Page count
                Figures: 0, Tables: 9, Pages: 16, Words: 9177
                Funding
                Funded by: American Nurses Foundation , doi 10.13039/100005233;
                Funded by: National Institutes of Health , doi 10.13039/100000002;
                Funded by: National Institute of Nursing Research , doi 10.13039/100000056;
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                January 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.7 mode:remove_FC converted:06.04.2023

                behavioural coding,dementia,dyadic interactions,mealtimes,nursing home,person‐centred care,task‐centred care

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