Modifying Food Textures: Practices and Beliefs of Staff Involved in Nutrition Care

Modifying food texture is an important part of dysphagia management, yet less is known about the day-to-day practices that might impact the nutritional well-being of patients. This study surveyed staff involved in the service delivery of texture-modified foods with the objectives to gain information about roles and responsibilities, instruction and knowledge about modifying foods, and beliefs about the use of texture-modified foods in nutrition care.

We created a 21-item survey about texture-modified foods. Recruitment efforts focused on both professional and frontline staff involved in service delivery. Practice groups and organizations provided the means of recruiting professionals from different disciplines. Because frontline staff (e.g., certified nursing assistants, cooks) do not have similar membership groups, we recruited them through direct contacts with health care agencies.

A total of 175 individuals completed the survey. Respondents included 107 professionals (primarily certified dietary managers, registered dietitians, speech-language pathologists) and 68 frontline staff (mostly certified nursing assistants/home health aides). Although the frontline and professional staff showed generally similar patterns of opinions and beliefs about modified food textures, differences emerged in reported experiences, roles, and responsibilities in service delivery.

Survey respondents conveyed generally positive attitudes and opinions about the use of texture-modified foods, and respondents perceived them to be easy to execute and beneficial to the nutritional well-being of patients. Survey findings clearly highlight the contributions of frontline staff in the service delivery of modified food textures. Consideration must be given to continued reliance on informal, limited instruction about texture-modified foods and possible implications for safe nutrition care. Both professional and frontline staff convey a willingness to customize or alter food textures and the belief that patients should be able to choose the level of texture modification that they want to eat.