In-depth exploration of ‘therapeutic mealtime experiences’ in inpatient rehabilitation: mixed-methods multiple case studies

To explore how mealtime planning and delivery practices in inpatient rehabilitation influence therapeutic mealtime experiences. This multiple case study used convergent mixed methods analysis of case-specific data across two metropolitan general rehabilitation sites. Interviews, patient reported experience measures, and a chart audit were conducted at two timepoints for participants. Within-case analysis involved descriptive and qualitative analysis, and across-case analysis involved identifying patterns and differences across cases, with findings organised to Donabedian’s structure-process-outcome model. The dining room was the most discussed mealtime structure to promote therapeutic mealtime experiences, enabling access to care, therapy activity, and social engagement. Mealtime structures with built-in flexibility and staff knowing their patients supported tailoring of experiences and enabled person-centred care. Compassionate and attentive interactions with staff created a genuine approach to care, positively influencing patients’ psychosocial well-being. Most patients self-initiated using mealtimes for additional therapeutic activity, but mealtimes were also a time of rest and an opportunity to maintain personhood. Mealtimes have substantial potential to contribute positively to patients’ rehabilitation and offer clinicians opportunities to engage patients in rehabilitation. Flexible mealtime systems enable staff to provide person-centred care, but improvements are needed to ensure this is delivered consistently for all patients. Patients often self-initiate using mealtimes as therapeutic activity, particularly around upper limb therapy with self-feeding and meal preparation or mobilisation to dining rooms, indicating this concept is acceptable and should be supported by cliniciansMeal service times for main and mid meals are important to promote nutritional intake, person-centred care, and a sense of routineDining rooms can support increased therapeutic activity, independence, social engagement, and access to assistance and supportsPatients conceptualise mealtimes as therapeutic for different reasons, including nutrition, functional recovery and independence, social engagement, rest for healing, or opportunities to maintain personhood Patients often self-initiate using mealtimes as therapeutic activity, particularly around upper limb therapy with self-feeding and meal preparation or mobilisation to dining rooms, indicating this concept is acceptable and should be supported by clinicians Meal service times for main and mid meals are important to promote nutritional intake, person-centred care, and a sense of routine Dining rooms can support increased therapeutic activity, independence, social engagement, and access to assistance and supports Patients conceptualise mealtimes as therapeutic for different reasons, including nutrition, functional recovery and independence, social engagement, rest for healing, or opportunities to maintain personhood