The Hospital Food Experience Questionnaire Predicts Adult Patient Food Intake

Publication: Canadian Journal of Dietetic Practice and Research
22 November 2022

Abstract

Purpose: Describe food/beverage intake among all patients and those with low meal intake and determine if the Hospital Food Experience Questionnaire (HFEQ), or its shorter version (HFEQ-sv), predicts food intake while considering patient (e.g., gender) and hospital characteristics (e.g., foodservice model).
Methods: Cross-sectional study of 1087 adult patients from 16 hospitals in Ontario, Canada. The valid and reliable HFEQ assessed patients’ meal quality perceptions. Visual estimation determined overall meal and food/beverage intake using the Comstock method. Binary logistic regressions tested the association between patient and hospital characteristics and whether HFEQ or HFEQ-sv scores added utility in predicting overall meal intake (≤50% vs. ≥75%).
Results: Approximately 29% of patients consumed ≤50% of their meal. Models assessing patient and hospital characteristics and either the HFEQ or the HFEQ-sv were significant (LRT(43) = 72.25, P = 0.003; LRT(43) = 93.46, P < 0.001). Men and higher HFEQ or HFEQ-sv scores demonstrated significantly higher odds of ≥75% meal consumption. Considering HFEQ or HFEQ-sv scores explained greater variance in meal intake and resulted in better model fits.
Conclusions: The HFEQ and HFEQ-sv predict patient meal intake when adjusting for covariates and add utility in understanding meal intake. Either version can be confidently used to support menu planning and food delivery to promote food intake.

Résumé

Objectif. Décrire l’apport en aliments et boissons chez tous les patients et chez ceux dont l’apport est faible lors des repas, et déterminer si l’Hospital Food Experience Questionnaire [Questionnaire sur l’expérience alimentaire en milieu hospitalier, HFEQ] ou sa version abrégée (HFEQ-sv) permet de prédire l’apport, tout en tenant compte des caractéristiques des patients (p. ex. le sexe) et des hôpitaux (p. ex. le modèle de services alimentaires).
Méthodes. Étude transversale regroupant 1 087 patients adultes de 16 hôpitaux de l’Ontario, au Canada. Le HFEQ, un outil valide et fiable, a servi à évaluer la perception de patients quant à la qualité des repas. L’apport global lors des repas et en aliments/boissons a été déterminé grâce à une estimation visuelle selon la méthode Comstock. Des régressions logistiques binaires ont permis de tester l’association entre les caractéristiques des patients et des hôpitaux, et de déterminer si les scores du HFEQ ou du HFEQ-sv permettaient de prédire plus facilement l’apport global durant les repas (≤ 50 % vs ≥ 75 %).
Résultats. Environ 29 % des patients ont consommé ≤ 50 % de leur repas. Les modèles évaluant les caractéristiques des patients et des hôpitaux, et soit le HFEQ ou le HFEQ-sv, étaient significatifs (TRV [43] = 72,25, P = 0,003; TRV [43] = 93,46, P < 0,001). Les hommes et les scores plus élevés au HFEQ ou au HFEQ-sv étaient significativement plus associés à un apport alimentaire ≥ 75 % aux repas. La prise en compte des scores du HFEQ ou du HFEQ-sv a permis d’expliquer la plus grande variance dans l’apport aux repas et de mieux ajuster les modèles.
Conclusions. Le HFEQ et le HFEQ-sv permettent de prédire, et de mieux comprendre, l’apport alimentaire des patients lors des repas après ajustement des covariables. L’une ou l’autre des versions peut être utilisée en toute confiance pour aider à la planification des menus et à la livraison des aliments et ainsi promouvoir l’apport alimentaire.

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Funding statement: This project was funded by the Ontario Agri-Food Innovation Alliance [UofG2016-2558].
Conflict of interest: Heather Keller is a member of the Canadian Malnutrition Task Force (CMTF). Lisa Duizer and Vanessa Trinca have no conflicts of interest to declare.

References

1
Larby A, Roberts S, and Desbrow B. Accuracy and adequacy of food supplied in therapeutic diets to hospitalised patients: An observational study. Nutr Diet. 2016;73(4):342–7.
2
Rattray M, Desbrow B, and Roberts S. Comparing nutritional requirements, provision and intakes among patients prescribed therapeutic diets in hospital: An observational study. Nutrition. 2017;39–40:50–6.
3
Johns N, Hartwell H, and Morgan M. Improving the provision of meals in hospital. The patients’ viewpoint. Appetite. 2010;54(1):181–5.
4
Allard JP, Keller H, Teterina A, Jeejeebhoy KN, Laporte M, Duerksen DR, et al. Factors associated with nutritional decline in hospitalised medical and surgical patients admitted for 7 d or more: A prospective cohort study. Br J Nutr. 2015;114(10):1612–22.
5
Keller H, Allard J, Vesnaver E, Laporte M, Gramlich L, Bernier P, et al. Barriers to food intake in acute care hospitals: A report of the Canadian Malnutrition Task Force. J Hum Nutr Diet. 2015;28(6):546–57.
6
Allard JP, Keller H, Jeejeebhoy KN, Laporte M, Duerksen DR, Gramlich L, et al. Decline in nutritional status is associated with prolonged length of stay in hospitalized patients admitted for 7 days or more: A prospective cohort study. Clin Nutr. 2016;35(1):144–52.
7
Curtis LJ, Bernier P, Jeejeebhoy K, Allard J, Duerksen D, Gramlich L, et al. Costs of hospital malnutrition. Clin Nutr. 2017;36(5):1391–6.
8
Agarwal E, Ferguson M, Banks M, Bauer J, Capra S, and Isenring E. Nutritional status and dietary intake of acute care patients: Results from the Nutrition Care Day Survey 2010. Clin Nutr. 2012;31:41–7.
9
Agarwal E, Ferguson M, Banks M, Batterham M, Bauer J, Capra S, et al. Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: Results from the Nutrition Care Day Survey 2010. Clin Nutr. 2013;32:737–45.
10
Lim SL, Ong KCB, Chan YH, Loke WC, Ferguson M, and Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr. 2012;31:345–50.
11
Correia MITD and Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003;22(3):235–9.
12
Dupertuis YM, Kossovsky MP, Kyle UG, Raguso CA, Genton L, and Pichard C. Food intake in 1707 hospitalised patients: A prospective comprehensive hospital survey. Clin Nutr. 2003;22(2):115–23.
13
Byrnes A, Worrall J, Young A, Mudge A, Banks M, and Bauer J. Early post-operative diet upgrade in older patients may improve energy and protein intake but patients still eat poorly: an observational pilot study. J Hum Nutr Diet. 2018;31(6):818–24.
14
Watters CA, Sorensen J, Fiala A, and Wismer W. Exploring patient satisfaction with foodservice through focus groups and meal rounds. J Am Diet Assoc. 2003;103(10):1347–9.
15
Stanga Z, Zurflüh Y, Roselli M, Sterchi AB, Tanner B, and Knecht G. Hospital food: A survey of patients’ perceptions. Clin Nutr. 2003;23(3):241–6.
16
Mortensen MN, Larsen AK, Skadhauge LB, Høgsted RH, Beermann T, Cook ME, et al. Protein and energy intake improved by in-between meals: An intervention study in hospitalized patients. Clin Nutr. 2019;30:113–8.
17
Sorensen J, Holm L, Frøst MB, and Kondrup J. Food for patients at nutritional risk: A model of food sensory quality to promote intake. Clin Nutr. 2012;31(5):637–46.
18
Schindler K, Themessl-Huber M, Hiesmayr M, Kosak S, Lainscak M, Laviano A, et al. To eat or not to eat? Indicators for reduced food intake in 91,245 patients hospitalized on nutritionDays 2006-2014 in 56 countries worldwide: A descriptive analysis. Am J Clin Nutr. 2016;104(5):1393–402.
19
Heersink Titrud J, Brown CJ, Dimaria-Ghalili RA, and Locher JL. Undernutrition in hospitalized older adults: patterns and correlates, outcomes, and opportunities for intervention with a focus on processes of care. J Nutr Elder. 2010;29(1):4–41.
20
Thibault R, Chikhi M, Clerc A, Darmon P, Chopard P, Genton L, et al. Assessment of food intake in hospitalised patients: A 10-year comparative study of a prospective hospital survey. Clin Nutr. 2011;30(3):289–96.
21
Curtis LJ, Valaitis R, Laur C, McNicholl T, Nasser R, and Keller H. Low food intake in hospital: Patient, institutional, and clinical factors. Appl Physiol Nutr Metab. 2018;43(12):1239–46.
22
Sahin B, Demir C, Celik Y, and Teke AK. Factors affecting satisfaction level with the food services in a military hospital. J Med Syst. 2006;30:381–7.
23
Trinca V, Duizer L, and Keller H. Putting quality food on the tray: Factors associated with patients’ perceptions of the hospital food experience. J Hum Nutr Diet. 2022;35(1):81–93.
24
Sorensen J, Fletcher H, Macdonald B, Whittington-Carter L, Nasser R, and Gramlich L. Canadian hospital food service practices to prevent malnutrition. Can J Diet Pract Res. 2021;82(4):167–75.
25
Goeminne P, de Wit E, Burtin C, and Valcke Y. Higher food intake and appreciation with a new food delivery system in a Belgian hospital. Meals on Wheels, a bedside meal approach. Appetite. 2012;59:108–16.
26
MacKenzie-Shalders K, Maunder K, So D, Norris R, and McCray S. Impact of electronic bedside meal ordering systems on dietary intake, patient satisfaction, plate waste and costs: A systematic literature review. Nutr Diet. 2020;77(1):103–11.
27
Capra S, Wright O, Sardie M, Bauer J, and Askew D. The Acute Hospital Foodservice Patient Satisfaction Questionnaire: the development of a valid and reliable tool to measure patient satisfaction with acute care hospital foodservices. Food Res Int. 2005;16(1–2):1–14.
28
Dubé L, Trudeau E, and Bélanger MC. Determining the complexity of patient satisfaction with foodservices. J Am Diet Assoc. 1994;94(4):394–401.
29
Hartwell HJ, Shepherd PA, Edwards JSA, and Johns N. What do patients value in the hospital meal experience? Appetite. 2016;96:293–8.
30
Dall’Oglio I, Nicolò R, Di Ciommo V, Bianchi N, Ciliento G, Gawronski O, et al. A systematic review of hospital foodservice patient satisfaction studies. J Acad Nutr Diet. 2015;115(4):567–84.
31
Trinca V, Iraniparast M, Morrison-Koechl J, Duizer L, and Keller H. Hospital Food Experience Questionnaire (HFEQ): Reliable, valid and predicts food intake in adult patients. Clin Nutr. 2021;40(6):4011–21.
32
Allard JP, Keller H, Jeejeebhoy KN, Laporte M, Duerksen DR, Gramlich L, et al. Malnutrition at hospital admission - contributors and effect on length of stay: A prospective cohort study from the Canadian Malnutrition Task Force. J Parenter Enteral Nutr. 2016;40(4):487–97.
33
Charan J and Biswas T. How to Calculate Sample Size for Different Study Designs in Medical Research? Indian J Psychol Med. 2013;35(2):121–6.
34
Comstock EM, St Pierre RG, and Mackiernan YD. Measuring individual plate waste in school lunches. Visual estimation and children’s ratings vs. actual weighing of plate waste. J Am Diet Assoc. 1981;79(3):290–6.
35
McCullough J and Keller H. The My Meal Intake Tool (M-MIT): Validity of a patient self-assessment for food and fluid intake at a single meal. J Nutr Health Aging. 2018;22(1):30–7.
36
Akaike H. A new look at the statistical model identification. Springer, New York, NY; 1974.
37
Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff SC, et al. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2017;36(1):49–64.
38
Trinca V, Duizer L, Paré S, Keller H. Investigating the patient food experience: Understanding hospital staffs’ perspectives on what leads to quality food provision in Ontario hospitals. J Hum Nutr Diet. 2021.
39
Keller HH, Vesnaver E, Davidson B, Allard J, Laporte M, Bernier P, et al. Providing quality nutrition care in acute care hospitals: Perspectives of nutrition care personnel. J Hum Nutr Diet. 2014;27(2):192–202.
40
McCray S, Maunder K, Krikowa R, and MacKenzie-Shalders K. Room service improves nutritional intake and increases patient satisfaction while decreasing food waste and cost. J Acad Nutr Diet. 2018;118(2):284–93.
41
Maunder K, Lazarus C, Walton K, Williams P, Ferguson M, and Beck E. Energy and protein intake increases with an electronic bedside spoken meal ordering system compared to a paper menu in hospital patients. Clin Nutr ESPEN. 2015;10(4):e134–9.
42
Barrington V, Maunder K, and Kelaart A. Engaging the patient: Improving dietary intake and meal experience through bedside terminal meal ordering for oncology patients. J Hum Nutr Diet. 2018;31(6):803–9.
43
Hartwell HJ, Edwards JS, and Beavis J. Plate versus bulk trolley food service in a hospital: comparison of patients’ satisfaction. Nutrition. 2007;23:211–8.
44
Hannan-Jones M and Capra S. Developing a valid meal assessment tool for hospital patients. Appetite. 2017;108:68–73.
45
Fallon A, Gurr S, Hannan-Jones M, and Bauer JD. Use of the acute care hospital foodservice patient satisfaction questionnaire to monitor trends in patient satisfaction with foodservice at an acute care private hospital. Nutr Diet. 2008;65(1):41–6.
46
Porter J and Cant R. Exploring hospital patients’ satisfaction with cook-chill foodservice systems: a preliminary study using a validated questionnaire. J Foodserv. 2009;20(2):81–9.
47
Greig S, Hekmat S, and Garcia AC. Current practices and priority issues regarding nutritional assessment and patient satisfaction with hospital menus. Can J Diet Pract Res. 2018;79(2):48–54.
48
Holst M, Ofei KT, Skadhauge LB, Rasmussen HH, and Beermann T. Monitoring of nutrition intake in hospitalized patient: Can we rely on the feasible monitoring systems? J Clin Nutr Metab. 2017;1(1):1–6.

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cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 84Number 1March 2023
Pages: 17 - 27
Editor: Naomi Cahill

History

Version of record online: 22 November 2022

Key Words

  1. food intake
  2. patient experience
  3. food services
  4. meal quality
  5. adults

Mots-clés

  1. apport alimentaire
  2. expérience des patients
  3. services alimentaires
  4. qualité des repas
  5. adultes

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References

References

1
Larby A, Roberts S, and Desbrow B. Accuracy and adequacy of food supplied in therapeutic diets to hospitalised patients: An observational study. Nutr Diet. 2016;73(4):342–7.
2
Rattray M, Desbrow B, and Roberts S. Comparing nutritional requirements, provision and intakes among patients prescribed therapeutic diets in hospital: An observational study. Nutrition. 2017;39–40:50–6.
3
Johns N, Hartwell H, and Morgan M. Improving the provision of meals in hospital. The patients’ viewpoint. Appetite. 2010;54(1):181–5.
4
Allard JP, Keller H, Teterina A, Jeejeebhoy KN, Laporte M, Duerksen DR, et al. Factors associated with nutritional decline in hospitalised medical and surgical patients admitted for 7 d or more: A prospective cohort study. Br J Nutr. 2015;114(10):1612–22.
5
Keller H, Allard J, Vesnaver E, Laporte M, Gramlich L, Bernier P, et al. Barriers to food intake in acute care hospitals: A report of the Canadian Malnutrition Task Force. J Hum Nutr Diet. 2015;28(6):546–57.
6
Allard JP, Keller H, Jeejeebhoy KN, Laporte M, Duerksen DR, Gramlich L, et al. Decline in nutritional status is associated with prolonged length of stay in hospitalized patients admitted for 7 days or more: A prospective cohort study. Clin Nutr. 2016;35(1):144–52.
7
Curtis LJ, Bernier P, Jeejeebhoy K, Allard J, Duerksen D, Gramlich L, et al. Costs of hospital malnutrition. Clin Nutr. 2017;36(5):1391–6.
8
Agarwal E, Ferguson M, Banks M, Bauer J, Capra S, and Isenring E. Nutritional status and dietary intake of acute care patients: Results from the Nutrition Care Day Survey 2010. Clin Nutr. 2012;31:41–7.
9
Agarwal E, Ferguson M, Banks M, Batterham M, Bauer J, Capra S, et al. Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: Results from the Nutrition Care Day Survey 2010. Clin Nutr. 2013;32:737–45.
10
Lim SL, Ong KCB, Chan YH, Loke WC, Ferguson M, and Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr. 2012;31:345–50.
11
Correia MITD and Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003;22(3):235–9.
12
Dupertuis YM, Kossovsky MP, Kyle UG, Raguso CA, Genton L, and Pichard C. Food intake in 1707 hospitalised patients: A prospective comprehensive hospital survey. Clin Nutr. 2003;22(2):115–23.
13
Byrnes A, Worrall J, Young A, Mudge A, Banks M, and Bauer J. Early post-operative diet upgrade in older patients may improve energy and protein intake but patients still eat poorly: an observational pilot study. J Hum Nutr Diet. 2018;31(6):818–24.
14
Watters CA, Sorensen J, Fiala A, and Wismer W. Exploring patient satisfaction with foodservice through focus groups and meal rounds. J Am Diet Assoc. 2003;103(10):1347–9.
15
Stanga Z, Zurflüh Y, Roselli M, Sterchi AB, Tanner B, and Knecht G. Hospital food: A survey of patients’ perceptions. Clin Nutr. 2003;23(3):241–6.
16
Mortensen MN, Larsen AK, Skadhauge LB, Høgsted RH, Beermann T, Cook ME, et al. Protein and energy intake improved by in-between meals: An intervention study in hospitalized patients. Clin Nutr. 2019;30:113–8.
17
Sorensen J, Holm L, Frøst MB, and Kondrup J. Food for patients at nutritional risk: A model of food sensory quality to promote intake. Clin Nutr. 2012;31(5):637–46.
18
Schindler K, Themessl-Huber M, Hiesmayr M, Kosak S, Lainscak M, Laviano A, et al. To eat or not to eat? Indicators for reduced food intake in 91,245 patients hospitalized on nutritionDays 2006-2014 in 56 countries worldwide: A descriptive analysis. Am J Clin Nutr. 2016;104(5):1393–402.
19
Heersink Titrud J, Brown CJ, Dimaria-Ghalili RA, and Locher JL. Undernutrition in hospitalized older adults: patterns and correlates, outcomes, and opportunities for intervention with a focus on processes of care. J Nutr Elder. 2010;29(1):4–41.
20
Thibault R, Chikhi M, Clerc A, Darmon P, Chopard P, Genton L, et al. Assessment of food intake in hospitalised patients: A 10-year comparative study of a prospective hospital survey. Clin Nutr. 2011;30(3):289–96.
21
Curtis LJ, Valaitis R, Laur C, McNicholl T, Nasser R, and Keller H. Low food intake in hospital: Patient, institutional, and clinical factors. Appl Physiol Nutr Metab. 2018;43(12):1239–46.
22
Sahin B, Demir C, Celik Y, and Teke AK. Factors affecting satisfaction level with the food services in a military hospital. J Med Syst. 2006;30:381–7.
23
Trinca V, Duizer L, and Keller H. Putting quality food on the tray: Factors associated with patients’ perceptions of the hospital food experience. J Hum Nutr Diet. 2022;35(1):81–93.
24
Sorensen J, Fletcher H, Macdonald B, Whittington-Carter L, Nasser R, and Gramlich L. Canadian hospital food service practices to prevent malnutrition. Can J Diet Pract Res. 2021;82(4):167–75.
25
Goeminne P, de Wit E, Burtin C, and Valcke Y. Higher food intake and appreciation with a new food delivery system in a Belgian hospital. Meals on Wheels, a bedside meal approach. Appetite. 2012;59:108–16.
26
MacKenzie-Shalders K, Maunder K, So D, Norris R, and McCray S. Impact of electronic bedside meal ordering systems on dietary intake, patient satisfaction, plate waste and costs: A systematic literature review. Nutr Diet. 2020;77(1):103–11.
27
Capra S, Wright O, Sardie M, Bauer J, and Askew D. The Acute Hospital Foodservice Patient Satisfaction Questionnaire: the development of a valid and reliable tool to measure patient satisfaction with acute care hospital foodservices. Food Res Int. 2005;16(1–2):1–14.
28
Dubé L, Trudeau E, and Bélanger MC. Determining the complexity of patient satisfaction with foodservices. J Am Diet Assoc. 1994;94(4):394–401.
29
Hartwell HJ, Shepherd PA, Edwards JSA, and Johns N. What do patients value in the hospital meal experience? Appetite. 2016;96:293–8.
30
Dall’Oglio I, Nicolò R, Di Ciommo V, Bianchi N, Ciliento G, Gawronski O, et al. A systematic review of hospital foodservice patient satisfaction studies. J Acad Nutr Diet. 2015;115(4):567–84.
31
Trinca V, Iraniparast M, Morrison-Koechl J, Duizer L, and Keller H. Hospital Food Experience Questionnaire (HFEQ): Reliable, valid and predicts food intake in adult patients. Clin Nutr. 2021;40(6):4011–21.
32
Allard JP, Keller H, Jeejeebhoy KN, Laporte M, Duerksen DR, Gramlich L, et al. Malnutrition at hospital admission - contributors and effect on length of stay: A prospective cohort study from the Canadian Malnutrition Task Force. J Parenter Enteral Nutr. 2016;40(4):487–97.
33
Charan J and Biswas T. How to Calculate Sample Size for Different Study Designs in Medical Research? Indian J Psychol Med. 2013;35(2):121–6.
34
Comstock EM, St Pierre RG, and Mackiernan YD. Measuring individual plate waste in school lunches. Visual estimation and children’s ratings vs. actual weighing of plate waste. J Am Diet Assoc. 1981;79(3):290–6.
35
McCullough J and Keller H. The My Meal Intake Tool (M-MIT): Validity of a patient self-assessment for food and fluid intake at a single meal. J Nutr Health Aging. 2018;22(1):30–7.
36
Akaike H. A new look at the statistical model identification. Springer, New York, NY; 1974.
37
Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff SC, et al. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2017;36(1):49–64.
38
Trinca V, Duizer L, Paré S, Keller H. Investigating the patient food experience: Understanding hospital staffs’ perspectives on what leads to quality food provision in Ontario hospitals. J Hum Nutr Diet. 2021.
39
Keller HH, Vesnaver E, Davidson B, Allard J, Laporte M, Bernier P, et al. Providing quality nutrition care in acute care hospitals: Perspectives of nutrition care personnel. J Hum Nutr Diet. 2014;27(2):192–202.
40
McCray S, Maunder K, Krikowa R, and MacKenzie-Shalders K. Room service improves nutritional intake and increases patient satisfaction while decreasing food waste and cost. J Acad Nutr Diet. 2018;118(2):284–93.
41
Maunder K, Lazarus C, Walton K, Williams P, Ferguson M, and Beck E. Energy and protein intake increases with an electronic bedside spoken meal ordering system compared to a paper menu in hospital patients. Clin Nutr ESPEN. 2015;10(4):e134–9.
42
Barrington V, Maunder K, and Kelaart A. Engaging the patient: Improving dietary intake and meal experience through bedside terminal meal ordering for oncology patients. J Hum Nutr Diet. 2018;31(6):803–9.
43
Hartwell HJ, Edwards JS, and Beavis J. Plate versus bulk trolley food service in a hospital: comparison of patients’ satisfaction. Nutrition. 2007;23:211–8.
44
Hannan-Jones M and Capra S. Developing a valid meal assessment tool for hospital patients. Appetite. 2017;108:68–73.
45
Fallon A, Gurr S, Hannan-Jones M, and Bauer JD. Use of the acute care hospital foodservice patient satisfaction questionnaire to monitor trends in patient satisfaction with foodservice at an acute care private hospital. Nutr Diet. 2008;65(1):41–6.
46
Porter J and Cant R. Exploring hospital patients’ satisfaction with cook-chill foodservice systems: a preliminary study using a validated questionnaire. J Foodserv. 2009;20(2):81–9.
47
Greig S, Hekmat S, and Garcia AC. Current practices and priority issues regarding nutritional assessment and patient satisfaction with hospital menus. Can J Diet Pract Res. 2018;79(2):48–54.
48
Holst M, Ofei KT, Skadhauge LB, Rasmussen HH, and Beermann T. Monitoring of nutrition intake in hospitalized patient: Can we rely on the feasible monitoring systems? J Clin Nutr Metab. 2017;1(1):1–6.