Till Örebro universitet

The overall aim of this thesis was to explore how the notion of hospitality could be used as a perspective to understand the meal provision within a hospital frame. Of interest was how patients (>65 years of age) experience their mealtimes together with perspectives from the ones serving the meals. This is motivated by older adult patients being more affected by malnutrition and having more challenges during mealtimes than other patient groups. Previous research has identified the importance of assistance during mealtimes and the implications that staff can have for patients’ food intakes. However, few studies have been found that focus on older adult patients’ own experiences of meal provision from a qualitative approach, nor studies that have focused on the practical doings by the staff.

The thesis is grounded in an interpretive perspective viewing social reality as constructed and experienced in relation to how one interacts with other subjects as well as objects, by applying the theory of symbolic interactionism together with Goffman’s dramaturgical theory. In addition, the FAMM was used to understand the entirety of the meal experience, and the person-centred care approach to understand the study setting of interest.

The fieldwork was conducted across four wards at two Swedish public hospitals, and interviews were conducted at three of these wards. In total, 20 mealtime observations together with 11 interviews with patients and 20 interviews with staff in different categories were conducted. The wards differed in relation to the dining room environment, the role of the meal host and how the meal service was conducted.

The overall findings reflect these differences by suggesting that the meal provision needs to be understood as a balancing act, where the staff perform in front of the patients in relation to the hospitability provided by the organisational host. The patients experienced hospitality through being acknowledged and recognised together with unexpected moments of hospitality. In turn, the staff were found to be knowing and caring in their performances towards the patients as well as showing professional knowledge when reading between the lines and offering what not always was voiced.

The findings identify a need by the staff to be able to have more time with the patients, having the ability to perform a meal service in a timely manner as well as the ability to navigate within the organisational frames. Demonstrating the need for, as well as the presence of, the “ity” factor in hospital meals.