“Time’s up” – staff’s management of mealtimes on inpatient eating disorder units

BACKGROUND: Refeeding and normalizing eating behaviour are main treatment aims for individuals admitted to inpatient eating disorder units. Consequently, mealtime activities are specific, everyday activities, serving a clear therapeutic purpose, despite numerous challenges for both staff and patients. Few studies have specifically addressed staff involvement, interactions, and management activities to structure mealtimes. In this study, we investigated the structure of mealtime activities on inpatient eating disorder units, and identified associated staff behaviour. METHODS: Descriptive and exploratory qualitative study using video observations to investigate the structure of mealtimes and staff management of mealtime activities. Forty main meals were video recorded and the observational data were analysed using interaction analysis. RESULTS: An initial analysis during data screening identified three main parts of the meal: ‘pre-eating’, ‘eating’, and ‘meal completion’. For each part, a regular pattern of activities occurred which were associated with staff behaviour. CONCLUSIONS: Increased awareness amongst staff regarding how they manage the meal and act through a clear internal structure can help staff members to further explore their behaviours and collaboration during mealtimes, and also contribute to improved interaction with patients during the various phases of the meal.