Heather Keller, Schlegel -University of Waterloo Research Institute for Aging, 250 Laurelwood Dr, Waterloo, ON, N2J0E2, Canada,
J Nutr Health Aging. 2019;23(7):623-627. doi: 10.1007/s12603-019-1210-1.
The Mealtime Scan (MTS) was developed to assess the dining environment in Long Term Care (LTC). MTS has been reviewed and updated to ensure its standardization and responsiveness to changes in the dining environment. The objectives of this paper are to provide an overview of the changes made in the new MTS+ tool and to describe its inter-rater reliability.
The observational and scoring methods used to evaluate the physical, social, and relational-centered dining environments in LTC homes were reviewed and updated into MTS+ and an overall quality of dining rating derived. Two trained assessors were evaluated for the inter-rater reliability. Nine dining rooms in three LTC homes at different meals were observed for a total of 45 observations. Interclass Correlation Coefficient (ICC) was used to assess reliability.
MTS+ demonstrated good reliability on the orientation cues, social environment, and relationship-centered activities (orientation cues ICC: 0.75, social ICC: 0.78, relational ICC: 0.78). However, the tool's reliability was poor for the physical environment, ICC: 0.48 and moderate for the overall rating of the quality of the dining environment, ICC: 0.67. Discussion and Implications: Although deemed more effective and practical for use in intervention studies, MTS+ has some limitations with respect to its reliability, particularly in assessing the physical environment. It is hypothesized that more extensive training of the assessors may lead to improvements in the reliability of MTS+. MTS+ can be used in intervention research when one assessor completes repeat observations of a dining area.
用餐扫描（MTS）是为了评估长期护理（LTC）中的用餐环境而开发的。MTS 已经经过审查和更新，以确保其标准化和对用餐环境变化的响应能力。本文的目的是提供新的 MTS+ 工具所做更改的概述，并描述其评分者间信度。
用于评估长期护理院用餐环境的物理、社会和以关系为中心的观察和评分方法进行了审查和更新，纳入 MTS+，并得出整体用餐质量评分。对两名受过培训的评估员进行评分者间信度评估。在三个不同的 LTC 住宅的三顿饭时观察了 9 个用餐室，共观察了 45 次。使用组内相关系数（ICC）评估可靠性。
MTS+在定位提示、社会环境和以关系为中心的活动方面表现出良好的可靠性（定位提示 ICC：0.75、社会 ICC：0.78、关系 ICC：0.78）。然而，该工具在物理环境方面的可靠性较差，ICC：0.48，整体用餐环境质量的评级中等，ICC：0.67。
尽管 MTS+ 在干预研究中被认为更有效和实用，但它在可靠性方面存在一些限制，特别是在评估物理环境方面。据推测，对评估员进行更广泛的培训可能会提高 MTS+的可靠性。当一名评估员完成对用餐区的重复观察时，可以在干预研究中使用 MTS+。
