Mealtime Support by Direct Care Workers in Long-Term Care Facilities: Secondary Behavioural Analysis of Videos.

Only 10 residents and 24 direct care workers from two facilities were studied, so results may not apply to other settings. Cameras were present, and workers may have changed behaviour because they knew they were being filmed. Data were collected during the pandemic, and masks hid facial expressions that may matter for positive non-verbal communication. Residents had lived in the facility at least 6 months and needed mealtime support, so newly admitted residents or those eating independently were not represented. Staff were limited to those with direct care roles and at least 1 month experience, excluding new hires and indirect staff. The behaviour leaving residents alone combined necessary absences and inappropriate disengagement, so its meaning is unclear. The Korean MES had a Cronbach alpha of 0.60 in this study, while the reported Cronbach alpha at tool development was 0.84. The study observed behaviours at one time and did not test interventions, so it cannot show that changing workload or shift patterns would improve care quality.

Do not read the high percentage of affirmative behaviours as proof that mealtime care quality is good. The average affirmative score was 22.63 on a 0-54 scale, and the behaviours were concentrated in one-to-one assistance rather than spread across person-centred actions.