Abstract
Objectives
To determine if (1) number of staff or residents, when considering home-level factors
and presence of family/volunteers, are associated with relationship-centered care
practices at mealtimes in general and dementia care units in long-term care (LTC);
and (2) the association between number of staff and relationship-centered care is
moderated by number of residents and family/volunteers, profit status or chain affiliation.
Design
Secondary analysis of the Making the Most of Mealtimes (M3) cross-sectional multisite
study.
Setting and Participants
Thirty-two Canadian LTC homes (Alberta, Manitoba, Ontario, and New Brunswick) and
639 residents were recruited. Eighty-two units were included, with 58 being general
and 24 being dementia care units.
Methods
Trained research coordinators completed the Mealtime Scan (MTS) for LTC at 4 to 6
mealtimes in each unit to determine number of staff, residents, and family or volunteers
present. Relationship-centered care was assessed using the Mealtime Relational Care
Checklist. The director of care or food services manager completed a home survey describing
home sector and chain affiliation. Multivariable analyses were stratified by type
of unit.
Results
In general care units, the number of residents was negatively (P = .009), and number of staff positively (P < .001) associated with relationship-centered care (F9,48 = 5.48, P < .001). For dementia care units, the associations were nonsignificant (F5,18 = 2.74, P = .05). The association between staffing and relationship-centered care was not moderated
by any variables in either general or dementia care units.
Conclusion and Implications
Number of staff in general care units may increase relationship-centered care at mealtimes
in LTC. Number of residents or staff did not significantly affect relationship-centered
care in dementia care units, suggesting that other factors such as additional training
may better explain relationship-centered care in these units. Mandating minimum staffing
and additional training at the federal level should be considered to ensure that staff
have the capacity to deliver relationship-centered care at mealtimes, which is considered
a best practice.
Keywords
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Article info
Publication history
Published online: December 15, 2020
Footnotes
The authors declare no conflicts of interest.
The original data collection for M3 was funded by the Canadian Institutes of Health Research, Canada (201403MOP-326892-Nut-CENA-25463). This secondary analysis did not receive any funding from agencies in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
