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Table 3 Coherence—real and ideal conditions for making sense of nutrition guidelines

From: Implementing nutrition guidelines for older people in residential care homes: a qualitative study using Normalization Process Theory

Real conditions Ideal conditions Strategies to promote coherence
Value of external guidelines questioned Recognition that external guidelines may be a useful resource Shift from implementing the nutrition guidelines to moving towards the guidelines
Perceived incompatibility with existing goals and priorities Understanding of ways of improving nutrition while still offering choice and recognizing the emotional and cultural aspects of food and mealtimes Change study title (from Healthier Eating in Care Homes to Eating for Well-being in Care Homes)
   Keep local and traditional dishes on the menu (adapting recipes rather than menus)
   Focus on occasional treats
Scepticism over the value of changing the diet of care home clients Recognition of potential benefits to clients Provide data emphasizing the short-term benefits to clients
   Briefing meetings to introduce the nutrition guidelines to all staff