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超越床边的餐饮:对亚急性护理中员工共同用餐的观点和体验的民族志探索。

Meals beyond the bedside: An ethnographic exploration of staffs' perspectives and experiences of communal dining in subacute care.

机构信息

Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Victoria, Australia.

Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.

出版信息

Nurs Health Sci. 2021 Jun;23(2):372-380. doi: 10.1111/nhs.12812. Epub 2021 Jan 26.

Abstract

Communal dining offers multiple benefits for hospital patients, yet dining rooms may be underutilized in practice. This study aimed to understand and explore staffs' perspectives and experiences of communal dining in subacute care, and the impacts on staff mealtime practice. Using qualitative, ethnographic methodology, 94 hours of fieldwork were conducted across two subacute care wards. Participants were staff involved in nutrition care or present on the ward at mealtimes. Ninety-one semistructured and ethnographic interviews were conducted with 59 staff, and 54 episodes of observation captured more than 190 staff. Interviews and field notes were thematically analyzed using an inductive approach. Three themes were identified: (i) benefits to patients; (ii) logistical and practical challenges; and (iii) supportive cultural factors. While staff recognized how communal dining benefited patients, logistical and practical challenges impacted their ability to facilitate it in practice. Healthcare organizations seeking to embed communal dining into the mealtime routine should recognize that clear delineation of staff roles and responsibilities, and cultural change involving normalization, setting expectations, and collective advocacy may be needed to optimize benefits for patients.

摘要

集体用餐为住院患者带来了多种益处,但在实践中,餐厅的利用率可能较低。本研究旨在了解和探讨工作人员在亚急性护理中对集体用餐的看法和体验,以及其对工作人员用餐时间实践的影响。本研究采用定性、民族志方法,在两个亚急性护理病房进行了 94 小时的实地工作。参与者为参与营养护理的工作人员或在就餐时间在病房的工作人员。对 59 名工作人员进行了 91 次半结构化和民族志访谈,并观察了 54 个场景,记录了 190 多名工作人员的用餐情况。使用归纳法对访谈和实地记录进行了主题分析。确定了三个主题:(i)对患者的益处;(ii)后勤和实际挑战;和(iii)支持性文化因素。虽然工作人员认识到集体用餐如何使患者受益,但后勤和实际挑战影响了他们在实践中促进集体用餐的能力。寻求将集体用餐纳入用餐常规的医疗机构应认识到,可能需要明确界定工作人员的角色和责任,并进行文化变革,包括规范化、设定期望和集体倡导,以优化患者的受益。

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