Patient Perspectives on Inpatient Mealtimes: Insights on Swallowing, Mental Wellbeing and Recovery.

Although the prevalence of swallowing difficulties in adults with mental health conditions has been highlighted in research, the relationship between swallowing difficulties and psychosocial aspects of mealtime experiences is not known. In the context of a need for person-centred and holistic approaches to nursing and healthcare, the paucity of research relating to the impact of mealtimes on hospital wards on patient wellbeing and safety reveals a significant gap in knowledge. To understand patient views and experiences of mealtimes on inpatient mental health wards, including both positive and negative aspects affecting their wellbeing and safety, this ethically-approved study was qualitative in design and involved collaboration with service-user groups who co-designed interview questions. Participants were 13 inpatients on mental health wards for working-age adults. Interviews were conducted in person, de-identified and analysed using thematic analysis. Themes were first constructed from transcripts and then verified with service-user groups and the research team. The overarching theme of 'heightened emotions associated with mealtimes' encapsulated four themes: 'experiencing anxiety and stress, connecting with others at mealtimes, loss of autonomy and choice, and experiences of swallowing difficulty'. Heightened emotions, anxiety and stress experienced during mental health ward mealtimes were counter to patients' wellbeing, which impacted on their wider recovery. Mealtime and swallowing safety, particularly when dysphagia is present, may be negatively affected by emotional pressures during mealtimes. These findings suggest a need to address barriers to wellbeing at mealtimes, and to raise awareness around integrating mealtimes into recovery pathways and person-centred care.