Minimal Eating Observation Form (MEOF)
MEOF is an instrument that one can use for structured observations of eating in any setting and among any patients. It has been used in hospital settings as well as in special accommodations (nursing homes).
MEOF-II includes three components of eating. Ingestion includes "manipulation of food on the plate", "transport of food to the mouth" and "sitting position". Deglutition includes "ability to chew", "manipulation of food in the mouth" and "swallowing". Energy includes "alertness", "appetite" and "eating <3/4 of served food".
Besides a widespread use in Sweden, MEOF and MEOF-II have also been used internationally, for instance at:
- Maastricht University, the Netherlands
- University of Antwerp, Belgium
- Ghent University, Belgium
- University of Alabama at Birmingham, United States
- Herlev Hospital in Denmark
- Hammel Hospital in Denmark
- Dr.Everett Chalmers Hospital in Fredericton, NB. Canada
Further on, the instruments have been used by:
- Registered nurses
- Dietitians
- Occupational therapists
- Physiotherapists
- Speech language therapists
Main reference to Minimal Eating Observation Form – Version I
Westergren A., Unosson M., Ohlsson O., Lorefält B. & Hallberg IR. (2002) Eating Difficulties, Assisted Eating and Nutritional Status in Elderly (>65 years) Patients in Hospital Rehabilitation. International Journal of Nursing Studies 39(3):341-351.
Main reference to Minimal Eating Observation Form – Version II
Westergren A, Lindholm C, Mattsson A, Ulander K (2009) Minimal Eating Observation Form: Reliability and Validity. The Journal of Nutrition Health and Aging 13(1):6-12
To use the instrument
If you plan to use the instrument, please contact us.
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Evidence – Evaluation of tools to detect eating difficulties
Westergren A. (2006) Detection of eating difficulties after stroke: a systematic review. Int Nurs Rev. 2006 Jun;53(2):143-9.
BACKGROUND: It is highly important in nursing care for persons with stroke to screen for, assess and manage eating difficulties. The impact on eating after stroke can be of different types, comprising dysphagia as well as eating difficulties in a larger perspective. Eating difficulties can cause complications such as malnutrition, dehydration, aspiration, suffocation, pneumonia and death. There is a lack of systematic reviews about methods to be used by nurses in their screening for eating difficulties.
AIM: This review aims at systematically capturing and evaluating current peer-reviewed published literature about non-instrumental (besides pulse oximetry) and non-invasive screening methods for bedside detection of eating difficulties among persons with stroke.
METHODS: A search was performed in Medline and 234 articles were obtained. After a selection process 17 articles remained, covering seven screening methods and including about 2,000 patients.
CONCLUSION: Best nursing practice for detecting eating difficulties includes as the first step the Standardized Bedside Swallowing Assessment (SSA) to detect dysphagia (strong evidence). As the second step an observation should be made of eating including ingestion, deglutition and energy (moderate evidence). Applying pulse oximetry simultaneously to SSA can possibly add to the accuracy of aspiration detection, especially silent aspiration (limited evidence). The methods should be used as a complement to interviews.
Hansen T, Kjaersgaard A, Faber J. (2011) Measuring elderly dysphagic patients' performance in eating - a review. Disabil Rehabil. 2011 Feb 3. [Epub ahead of print]
Purpose: This review aims to identify psychometrically robust assessment tools suitable for measuring elderly dysphagic patients' performance in eating for use in clinical practice and research.
Method: Electronic databases, related citations and references were searched to identify assessment tools integrating the complexity of the eating process. Papers were selected according to criteria defined a priori. Data were extracted regarding characteristics of the assessment tools and the evidence of reliability, validity and responsiveness. Quality appraisal was undertaken using developed criteria concerning the study design, the statistics used for the psychometric evaluation and the reported values.
Results: Eight of fourteen identified assessment tools met the inclusion criteria. Three assessment tools were specific to dementia, two were specific to stroke and three targeted a range of neurological and geriatric conditions. The rigor of the assessment tools' psychometric properties varied from no evidence available to excellent evidence. Only two assessment tools were rated adequate to
excellent.
Conclusion: The Minimal Eating Observation Form-Version II, to be used for screening and The McGill Ingestive Skills Assessment to be used for treatment planning and monitoring appeared to be psychometrically robust for clinical practice and research. However, further research on their psychometric properties is needed.
Some papers in which the MEOF variables have been used
Westergren A., Unosson M., Ohlsson O., Lorefält B. & Hallberg IR. (2002) Eating Difficulties, Assisted Eating and Nutritional Status in Elderly (>65 years) Patients in Hospital Rehabilitation. International Journal of Nursing Studies 39(3):341-351.
Westergren A., Ohlsson O. & Hallberg IR. (2002) Eating Difficulties in Relation to Gender, Length of Stay, and Discharge to Institutional care, Among Patients in Stroke Rehabilitation. Disability and Rehabilitation 24(10): 523-533.
Pajalic Z., Karlsson S. & Westergren A. (2006) Functioning and subjective health among persons with stroke after discharge from hospital. Journal of Advanced Nursing 54(4): 457-466.
Westergren A, Lindholm C, Axelsson C & Ulander K. (2008) Prevalence of eating difficulties and malnutrition among persons within hospital care and special accommodations. The Journal of Nutrition Health and Aging 12(1): 39-43.
Westergren A. (2008) Nutrition and its relation to mealtime preparation, eating, fatigue and mood among stroke survivors after discharge from hospital – a pilot study. The Open Nursing Journal 2, 15-20.
Westergren A, Lindholm C, Mattsson A, Ulander K (2009) Minimal Eating Observation Form: Reliability and Validity. The Journal of Nutrition Health and Aging 13(1):6-12
Westergren A, Wann-Hansson C, Bergh Borgdal E, Sjolander J, Stromblad R, Klevsgard R, Axelsson C, Lindholm C, Ulander K (2009) Malnutrition prevalence and precision in nutritional care differed in relation to hospital volume – cross-sectional survey. Nutrition Journal 2009, 8:20 doi:10.1186/1475-2891-8-20
Westergren A, Torfadóttir Ó, Ulander K, Axelsson C, Lindholm C. (2010) Malnutrition prevalence and the precision in nutritional care – an intervention study in one teaching hospital in Iceland. Journal of Clinical Nursing, 19:1830-1837.
Westergren A, Hedin G. (2010) Do study circles and a nutritional care policy improve nutritional care in a short- and long term perspective in special accommodations? Food & Nutrition Research Sep 24;54. doi: 10.3402/fnr.v54i0.5402
Vallen C, Hagell P, Westergren A. (2011) Validity and user-friendliness of the The Minimal Eating Observation Form – Version II (MEONF-II) for undernutrition risk screening. Food & Nutrition Research. 55:5801, DOI: 10.3402/fnr.v55i0.5801.