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

Purpose: To explore how mealtime planning and delivery practices in inpatient rehabilitation influence therapeutic mealtime experiences. Methods: 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. Results: 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. Conclusion: 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.