Abstract/Summary

Many people in hospital after stroke experience eating difficulties and are at risk of reduced food intake. Finger foods (foods that can be easily transferred from the plate to the mouth without the need for cutlery) have the potential to increase food intake and enable mealtime independence. However, there is little published evidence evaluating the use of finger foods in a hospital, and the components of a well-designed trial evaluating this intervention are unclear. This thesis aimed to develop a finger food menu and subsequently evaluate the feasibility and acceptability of using it for people in hospital after a stroke. A finger food menu was developed from menu items already offered in the hospital, consulting with clinical and catering teams and patient representatives. The menu was offered to patients over two lunchtime meals and compared with the standard lunchtime menu. A mixed-methods study was used to assess feasibility and acceptability. Quantitatively, expected recruitment rates were met, with thirty-one patients recruited (mean age 80, SD 8.5). Retention to the study was limited, with 40% of patient participants lost to follow-up. Attrition was attributed to participants being discharged from the ward. Dietary intake measures showed good interrater reliability. A cost consequence analysis was performed which identified the direct and indirect costs of delivering the finger food menu. Qualitatively, mealtime observations showed it was possible to deliver the finger food menu on the stroke rehabilitation ward, supported by an internal facilitator. Patient and staff interviews showed that, overall, participants found the finger food menu acceptable. Findings demonstrated that it was feasible and acceptable to develop and use a finger food menu on a stroke rehabilitation ward however, the limited sample size and high rate of missing data limit the ability to generalise the results. A future trial is warranted to evaluate the effectiveness of a finger food menu in hospitals. It should engage clinical and catering teams, and patient representatives to shape the intervention to the setting and develop a robust study design.