Performance of Dietary Behaviors in Chronic Community-Dwelling Stroke Survivors: A Mixed-Methods Study

In order to gain a better understanding of post-stroke dietary behaviors (e.g., selecting, accessing, and preparing healthy foods) among chronic, community-dwelling stroke survivors, we conducted a mixed-methods study consisting of a quantitative online survey (n = 63) and follow-up focus groups with a subset of participants (n = 7). Perceived performance, assistance required, adaptive equipment and compensatory strategies used, and sources of education and training were examined. Results demonstrated (1) diminished post-stroke performance for most dietary behaviors (e.g., grocery shopping, meal preparation), (2) an increased desire to eat healthily to prevent recurrent stroke, (3) variable use of adaptive equipment and compensatory strategies, and (4) limited healthcare-based dietary behavior education and training. These results suggest that stroke survivors could benefit from increased dietary behavior intervention to improve dietary behavior performance. Findings can be used to guide clinical intervention and design future research studies.

Occupational therapy and cooking: A scoping review and future directions

BACKGROUND

Occupational therapy (OT) has historically used cooking as an intervention and assessment approach across settings. Current practices in OT and the emergence of the multidisciplinary field of culinary medicine highlight the relationship between cooking and health.

AIMS/OBJECTIVES

To map the current literature on OT and cooking and to identify key factors that may facilitate collaboration within culinary medicine.

MATERIALS AND METHODS

We conducted a scoping review using the Joanna Briggs Institute methodology to identify primary contexts and clinical settings. Publications were analysed using framework thematic analysis to identify OT themes and roles.

RESULTS

A total of 56 studies met the criteria for inclusion. The majority of studies (n = 29, 53%) represented home/community settings and brain injury was the largest clinical group (n = 15, 27%). Primary themes related to person (n = 47, 43%), occupation (n = 30 (28%), environment (n = 19, 17%), and psychosocial wellbeing (n = 13, 12%). The primary OT role identified was that of interventionist (n = 48, 86%).

CONCLUSIONS/SIGNIFICANCE

OT's holistic practice places cooking within a larger context that can help identify and overcome the barriers to participation. Findings support multiple pathways in which OT can contribute to cooking initiatives for health promotion and potentially expand OT practice in population health.

The Development and Validation of the Planning to Make Meals Performance Measure

The Planning to Make Meals Performance Measure (PMMPM) was initially created as an outcome measure for an occupation-based program dedicated to helping individuals living in poverty maximize their food resources. This article briefly describes the PMMPM and the results of a cross-sectional study examining construct validity. Forty-two participants completed the PMMPM, Food Skills Confidence Measure (FSCM), and Cooking Skills Confidence Measure (CSCM). Analysis using Spearman's correlations revealed that one or more PMMPM score significantly correlated with the FSCM (r = .37-.50, p ≤ .05) and the CSCM (r = .44-.49, p = .01). These findings add to the psychometric properties of the PMMPM, promoting its usefulness as an alternative to self-report measures for programs seeking to enhance food, cooking, or resource management skills. Creating authentic and direct performance measures that assess complex constructs or skills is another way occupational therapy can contribute to health and well-being.

Eating Experiences of People with Disabilities: A Qualitative Study in Spain

Background: Disability causes changes in the eating process, which is central to the definition of each individual’s social and psychological spaces. Methods: This is a qualitative study based on grounded theory. Interviews were carried out in clinical hospital settings and headquarters of several disability organisations. The study included 27 individuals, aged between 18–75 years. All participants had a disability that caused a functional deficiency in the occupational aspects of the eating process. Results: The respondents’ narratives were analysed through observations made in different contexts, allowing us to describe and understand the significance attributed by the participants to their reality and experiences. Three key themes emerged from the analysis: (1) waning bodies (assumption of a diminished corporality); (2) redefinition of food-related social spaces; and (3) perceived burdensomeness, shame, and loneliness. Conclusions: Assisted feeding tends to prioritise the nutritional component of food ingestion. However, cultural, social, and contextual factors have a critical impact on an individual’s well-being and quality of life. This study stresses the importance of re-addressing intervention models affecting differently-abled people and incorporating approaches that take into account the contextual aspects of occupational therapy.

The Occupational Therapy Approach to Addressing Food Insecurity among Older Adults with Chronic Disease

The older adult population is one of the fastest growing age groups in the United States. Various components influence productive aging, and current research has identified nutrition and healthy eating as key factors that impact older adults' overall health status. While consumption of nutritious meals can help minimize the risk of health decline, the growing rate of food insecurity inhibits older adults' abilities to access healthy food regularly. Additionally, the high prevalence of chronic disease and disability in older adults can also limit independent participation in food-related activities, such as shopping, self-feeding, and meal preparation. A lack of food access and difficulties engaging in food-related activities place older adults with chronic disease at an increased risk of malnutrition, disability, and losing independence, thereby threatening social participation, healthy aging, and quality of life. Due to their expertise in promoting health and independent living, occupational therapy practitioners may be uniquely positioned to enhance older adults' healthy eating behaviors through the use of client-centered interventions tailored to food-related activities. This position paper reviews the scope of the occupational therapy profession, the consequences of food insecurity among older adults with chronic conditions, and strategies to enhance food-related activity participation in later life.

Food Activities and Identity Maintenance Among Community-Living Older Adults: A Grounded Theory Study

OBJECTIVE. Engaging in food activities and maintaining identity are each important for productive aging. This study explored the role of food activities in identity maintenance among community-living older adults.

METHOD. We used a grounded theory approach to analyze data collected in semistructured interviews with 39 predominantly White, British older adults living in West London.

RESULTS. Two lifelong food identities—“food lover” and “nonfoodie”—were maintained in the processes of participation and maintenance and threat and compensation. The process change in meaning and identity explained the development of a third food identity—“not bothered”—when participants experienced being alone at the table, deteriorating health, and worry about the cost of food.

CONCLUSION. Food activities that are a pleasurable and important part of daily life contribute to the maintenance of important identities and mental well-being in older adults.