Identification and Critical Appraisal of Food Service Satisfaction Questionnaires for Use in Nursing Homes: A Systematic Review.

BACKGROUND

Food service provision in nursing homes is a complex, adaptive system through which multiple stakeholders interface. Organizational stakeholders include staff involved in preparing and delivering meals. Consumer stakeholders are the end users including residents and family. Questionnaires can be an economical and efficient method of measuring food service satisfaction in nursing homes and a powerful quality improvement tool.

OBJECTIVE

(1) To identify questionnaires that measure food service satisfaction of various stakeholders in a nursing homes and (2) to critically appraise the psychometric properties of identified questionnaires.

METHODS

Five electronic databases were searched (Cumulative Index to Nursing and Allied Health Literature, Medline, ProQuest, Scopus, and Cochrane) in April 2020. Data from the eligible studies were extracted, and the psychometric properties were critically appraised using the Consensus-Based Standards for the Selection of Health Measurement Instruments.

RESULTS

This review identified 129 studies that used a questionnaire to measure food service satisfaction in nursing homes. Of those, 107 studies representing 75 unique general nursing home satisfaction questionnaires were excluded for failing to adequately explore aspects related to food service. From the remaining 22 studies, 7 food service satisfaction questionnaires were identified; 5 intended for consumers (residents) and 2 intended for organizational stakeholders (staff). Using the Consensus-Based Standards for the Selection of Health Measurement Instruments quality criteria, most questionnaires had flaws in content validity and construct validity, primarily due to small sample sizes. No questionnaires explored food service satisfaction from the family perspective.

CONCLUSIONS

Nursing homes collect satisfaction information for accreditation, marketing, benchmarking, and quality improvement. Although questionnaires are easy to administer, the quality of the data they collect is impacted by the validity and reliability of the questionnaires used. Using unreliable satisfaction data may mean that nursing homes are not accurately able to understand the impact of changes in the system on stakeholder satisfaction.