Mealtime Support by Direct Care Workers in Long-Term Care Facilities: Secondary Behavioural Analysis of Videos.

aimThis study aimed to address two objectives: (1) To analyse the meal support behaviours of direct care workers in long-term care facilities in South Korea and (2) to explore associations between mealtime support behaviours and caregiver characteristics.

designSecondary analysis of behavioural coding of cross-sectional video recordings.

methodsPositive and negative staff behaviours at mealtimes were coded using the Mealtime Engagement Scale and Cue Utilization and Engagement in Dementia tool, respectively. Statistical analyses, including t-tests and analysis of variance, were used to examine differences in mealtime support behaviours based on caregiver characteristics.

resultsThe average mealtime duration of residents was 19.03 ± 5.30 min. Positive meal support behaviours accounted for 91.1% of the observed interactions, whereas negative interactions accounted for 8.9%. The most frequent positive behaviour observed was 'providing one-on-one assistance', whereas the most frequent negative behaviour was 'leaving the resident alone'. Positive meal support behaviours were observed at significant higher frequencies among caregivers working during day shifts than those working during rotating shifts. Additionally, positive behaviours were associated with a higher carer-resident ratio.

conclusionPositive mealtime support behaviours were frequently observed but were concentrated in a few specific actions. Negative behaviours, such as leaving the resident alone, were still observed in a considerable portion of mealtime interactions. Training programmes focusing on diverse positive mealtime support behaviours should be developed to improve the quality of dementia care in long-term care facilities. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The findings emphasise the need for targeted training programmes to improve mealtime support and overall care quality in long-term care facilities. This approach signals a transformative shift in caregiver training, fostering more personalised and effective care for older adults with dementia. IMPACT: This study quantified positive and negative mealtime support behaviours. These findings contribute to understanding caregiver behaviours during mealtimes in dementia care, offering evidence-based insights for developing targeted training programmes and improving quality of care in long-term care facilities. REPORTING

methodWe adhered to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.