Table 2 Open-Ended Questions Guide for Conducting Each Focus Group

First phase

 Aims: collecting demographic and professional data

 Questions: Can you report your professional profile, age, education, and professional experience?

Second phase

 Aims: stimulating the emersion of interventions perceived as effective throughout conversation

 Questions: By considering your experience here in this NH … please focus your attention on those interventions that you perform on a daily basis with the intent of maintaining eating independence of residents.

  1) Can you describe what kind of intervention(s) works better in terms of effectiveness in maintaining eating independence in residents with dementia? Can you describe in detail what condition (e.g., context, time) this/these intervention(s) are most effective according to your daily practice?

  2) Can you describe the degree of adaptation required of these interventions on a daily basis, considering the needs of each resident and the needs of the entire group of residents cared for by you and the team?

  3) Can you describe the order, if any, in which this/these intervention(s) should be implemented to aim for maximising their effectiveness on eating performance?

  4) Can you describe the roles of family caregivers in the process of feeding assistance with regard to its effectiveness according to your experience?

  5) Can you describe if the above-mentioned interventions are standardised or flexible across (a) residents, (b) time, (c) day (lunch vs. dinner), and (d) healthcare workers?

  6) Can you describe the entire process of meal service from the beginning to the end by highlighting what intervention(s) should be carefully considered due to its capability to make a difference in resident eating independence?

Third phase

 Aims: stimulating further discussion on interventions witnessed by researchers during lunchtime observation

 Question(s) anchored on the data emerged from the observations performed by researchers during lunchtime and reported in a diary. For example:

  ‘During lunchtime, we observed that you offered a specific seat to a resident and left him alone for the entire meal … can you explain the reason(s) for this decision and its impact on eating independence?’

Fourth phase

 Aims: accommodating new insights and data into what has already been collected by discussing those interventions that emerged in the previous focus groups

 Question(s) anchored on the interventions that emerged in the previous focus groups. For example:

  ‘In the previous focus group(s), colleagues reported that television and music used to be avoided during mealtimes to limit distractions…What is your experience with regard to this intervention? Is this an effective intervention to maintain eating performance?

Focus group conclusion

 Do you have further comments or other points to add?