This thesis examines the construction and action of food evaluations in mealtime conversation. It takes a social constructionist approach to eating, arguing that `talking food' is inseparable from, and thus constructive of, the practices around food and drink consumption. This challenges current psychological thinking on eating, which is typically based on a cognitive-experimental model of attitudes and intentions to eat. I argue that this does not adequately take into account the social nature of food and the way in which food and eating is embedded in everyday interaction. The thesis examines instances of family mealtimes, as a way of looking at food in interaction. Data is taken from the tape-recorded conversations during these interactions. Conversation analytic and discursive psychological approaches were used to analyse the data corpus, with a focus on participants' usage of food and drink evaluations. These evaluations were examined as part of the situated activities of the meal such as offering or requesting food, and justifying eating habits. The analysis looks at different types of food evaluations: those that are associatedw ith the food and those associated with the person evaluating the food. These types are seen to be specific to either items or categories of food, and are rhetorically designed to counter challenges. Finally, the analysis considers how embodied eating sensations such as `gustatory pleasure' are constructed through evaluative expressions. It is argued that food and drink evaluations cannot be treated as separate mental or physical states (such as food attitudes or preferences) as they are bound up with the structure of interaction at the micro-level of speaker turn organisation. Instead, food evaluations can be regarded as part of, and as constructing, the practice of eating as well as contributing to our notions of food sensations and individual taste. The analysis and approach taken in this thesis therefore suggest that we need to reconceptualise eating and consumption in terms of discursive activities in interaction.

This study aims to develop an understanding of the lived experience of family carers of people with PIMD and dysphagia, in relation to mealtimes and food. Policy in recent years has begun to address the inequalities faced by people with learning disabilities and it is striving to improve their lives and the services offered to them. People with profound intellectual and multiple disabilities (PIMD) often have additional eating and drinking difficulties (dysphagia). People with dysphagia require ongoing support and guidance, to maximize their health, specifically their nutrition and hydration. In order to ensure that this support is appropriate, useful and sensitive to the needs of individuals and their families, it is important to try and view mealtimes through the eyes of these individuals and their families. The aims of this study emerged from observations made during my clinical work as a Speech & Language Therapist (SLT) and from engaging in discussion with family carers. In particular it has become increasingly clear from clinical practice that family carers often have different points of view about their son or daughter with profound intellectual and multiple disabilities, than those of professionals. These different points of view are often not clearly articulated by carers or professionals, and clinical interventions may become marked with conflict. This study is sited within a mental health and learning disability NHS trust in the north east of England. It utilises a phenomenological methodology and employs mixed methods to obtain data. Data collection took place between June 2013 and August 2014. Medical descriptions do not capture how it feels to live with impairment and resulting disability. Only when we examine this and allow individuals to tell their stories, as experts in their experiences, can we understand and offer support accordingly and ensure more functional and beneficial interactions and interventions. Findings are presented around four themes – the meaning of food and mealtimes, relationships, roles within the family and challenges. Findings are discussed in relation to the existing literature and recommendations are made for practice and for future research. During this study the adult child is mainly referred to as the ‘child’. For clarity, this is not in any way meant to convey the individual’s presentation as having PIMD as akin to being a child. The term is used to represent the relationship between the parents and the child. Despite the fact that the individuals are adults, they are still the children of the parents, and the relationship is a parent-son/daughter relationship. For brevity the term ‘child’ is used in preference to ‘adult child’. The use of the term has been agreed with the parents participating in the study. All names are assumed and have been chosen by the participants. In the course of this thesis the direct giving of food to the individuals with disabilities is termed ‘feeding’. I acknowledge this term may be associated with potentially negative connotations. The term ‘feeding’ has been used because it is the term used widely in the literature, because it was used by the family carers in their narratives and because there is no other suitable substitute which adequately describes the direct provision of food from one person in to the mouth of another.

Frequency of family mealtimes has been positively linked to dietary quality and weight status in children; however, there is a lack of research identifying what components of family mealtimes are associated with this positive effect. This study investigated family mealtime components that may impact dietary intake and weight status in children aged 5-11 years. Participants were 50 parent/child pairs (child: age = 7.3 ± 2.0 years, female = 44%, standardized body mass index (zBMI) = 0.55 ± 1.0, overweight/obese = 26.0%; parent: age = 36.8 ± 8.7 years, female = 76%, BMI = 29.0 ± 6.6 kg/m2, overweight/obese = 74.0%) recruited at local doctors’ offices, churches, and a daycare for this cross-sectional study. Children were weighed and measured while parents completed questionnaires on child dietary quality and family mealtimes. The family mealtime questionnaire assessed six mealtime components: which meal, who was present, what type of food was served and eaten, where the food in the meal was prepared and/or eaten, how food was served, and the atmosphere of the meal. Barriers to family mealtimes were also assessed. Parents reported that children’s daily servings consumed were: fruit = 2.1 ± 0.9; vegetables = 2.3 ± 1.1; low-fat dairy = 2.1 ± 1.3; sweetened drinks = 1.5 ± 1.6; and 100% fruit juice = 1.8 ± 1.3. Hierarchical regressions, with child and parent demographics controlled, found that greater frequency of dinner consumed at a restaurant/fast food establishment and limiting the child from eating too much were significantly (p < 0.001) related to greater sweetened drink intake. Not answering the phone or texting during the family meal was significantly (p < 0.05) related to lower fast food frequency. Limiting the child from eating too much was significantly (p < 0.01) related to greater child zBMI. This suggests that family mealtimes eaten within the home, free of distractions, and with set rules may impact on child dietary intake and weight status. Experimental studies are needed to understand the potential cause and effect relationships between these variables.

Person-centred care is a holistic care approach that aims to build up and support the personhood of residents with dementia, and thereby enhance quality of life. Through a review of the literature on mealtimes in long term care homes, four main aspects of person-centred mealtime care were identified: providing food choices and preferences, supporting residents’ independence, promoting the social side of eating, and showing respect. Using a critical realist lens, this descriptive qualitative study examined current implementation of person-centred mealtime care, the influences on its implementation, and steps to more fully adopt a person-centred approach. Semi-structured interviews were conducted with 52 staff from four diverse long term care homes in southern Ontario. Participants included frontline workers, registered health care professionals, and managers. Interviews were transcribed and analysed for themes. A conceptual framework was developed through analysis of the interview data, identifying five key ways to support staff to provide person-centred care: forming a strong team, working together to provide care, enabling staff to know the residents better, equipping staff with a toolbox of strategies, and creating flexibility to optimize care. Specific strengths and areas for improvement in implementation of person-centred mealtime care were identified and explained using this conceptual framework. Elements of the framework were also applied to explain important considerations for hiring staff, educating and training staff, developing a culture of good teamwork, and involving family members and volunteers in mealtime care. / Canadian Foundation for Dietetic Research; Alzheimer Society of Canada

Malnutrition and dehydration are prevalent health risks among older adults in skilled nursing facilities, particularly among those with cognitive impairments. Existing behavioral interventions do not consider social aspects of mealtimes, and there is limited research on social aspects of mealtimes in older adults. The current study introduces nonconscious behavioral mimicry as a social approach to supplement existing interventions. A repeated measures design examining the imitation of a confederate’s drinking and cup touching behaviors was employed to investigate whether these behaviors can be altered due to nonconscious behavioral mimicry in healthy older adults (N = 14; M = 71 years old). Findings indicate that behavioral mimicry increased drinking behaviors, while no significant effect was observed with cup touching behaviors. One plausible reason for this is the goal-directed nature of drinking behaviors. This thesis supports further studies to increase the magnitude of nonconscious behavioral mimicry in older adult populations with cognitive impairments.

This study applied conversation analysis for the first time to episodes in which children express pain and bodily sensations in the everyday setting of family mealtimes. It focuses on the components of children s expressions, the character of parents responses, and how the sequence is resolved. Three families who had a child with a long term health condition were recruited through voluntary support groups and agreed to film 15-17 mealtimes. In total 47 mealtimes were recorded totalling 23 hours of data. Each family had two children aged 15 months to nine years and included a heterosexual married couple. This data was supplemented by archives in the Discourse and Rhetoric Group: a further nine hours of mealtime recordings by two families each with two children aged three to seven years. The analysis describes four key components of children s expressions of bodily sensation and pain: lexical formulations; prosodic features; pain cries and embodied actions, revealing the way in which they can be built together to display different aspects of the experience. The results highlight the nature of these expressions as initiating actions designed in and for interaction. An examination of the sequence that follows demonstrates the negotiated character of pain. Descriptions of the nature of the child s pain and its authenticity are produced, amended, resisted or accepted in the turns that follow. During these sequences participant orientations reveal the pervasive relevance of eating related tasks that characterises mealtime interaction. The discussion concludes by describing the unique insights into the negotiated rather than private nature of a child s pain demonstrated by this study, and the way in which pain can be understood as produced and dealt with as part of the colourful tapestry of everyday family life in which everyday tasks are achieved, knowledge and authority is claimed and participants are positioned in terms of their relationship to one another.

No description available.

This study is a secondary analysis of data collected from a six-year longitudinal qualitative study called Eating Together (ET), which sought to better understand the mealtime experience of community dwelling persons with dementia and their primary partners in care. Findings from the primary study highlighted the importance of mealtimes for these families, and as persons with dementia moved into long-term care homes it was noted that the meaning of the mealtime experience was challenged. Data from select dyads in the primary study was thematically analyzed, to understand the mealtime experience of persons with dementia and their primary partners in care, when persons with dementia relocated to a “new place”; a long-term care home. Findings revealed five themes related to the new mealtime experience in the long-term care home, including: systemizing the meal, adjusting to dining with others, holding on to “home”, evolving roles, and becoming “at home”. / Social Sciences and Humanities Research Council of Canada

Mothering is a complex and multifaceted occupation that encompasses the nurturing work that women engage in. It addition, it has been established that ethnicity, class, and gender have effects on motherhood that need to be taken into account when looking at the occupations of motherhood across cultures. One important task that occurs within a mothers’ daily routine is that of making meals for their children. This dissertation sought to gain a rich, in-depth description of the phenomenon of the mealtime experience for African American mothers of low socioeconomic status and young children living in an inner-city environment in the Midwest. This study used a phenomenological approach with modified photovoice and photo-elicitation interviews to capture the essence of mealtime for African American mothers raising young children. Six mothers were recruited for the study and consented to two in-depth interviews. Individual interviewing occurred along with a second photo elicitation interview with the participant’s photographs. Phenomenological analyses were used for textual data; the photographs were analyzed separately and then together with the textual data from the photo-elicitation interviews. Results of this study indicated the intricate complexities of the occupation of mealtime and mothering with African American mothers. From the photo-elicitation interviews, five themes and three subthemes emerged: (a) Sometimes it doesn’t happen smoothly, (b) We’re all together, (c) We sit there and we talk, (d) It’s an accomplishment, and (e) We’re in the kitchen together. Three subthemes also emerged: (a) Putting in the effort, (b) It was kind of a teaching moment, and (c) It’s like déjà vu. This research (a) promotes a greater understanding of mothers’ perceptions around mealtime with their young children, especially those mothers who have varied cultural and socioeconomic backgrounds; and (b) suggests a need for increased family-centered and culturally aware training. This study demonstrates how photo techniques can enhance the depth of phenomenological analysis to explicate meaning around mealtime occupations with a diverse group of mothers.