Food choice by older people: the use of semi-structured interviews with open and closed questions.

Objective: To evaluate difficulty chewing, consequent food choice and impacts using both open and closed questions within a semi-structured interview format.

Design: A cross-sectional study using a semi-structured interview (SSI) with open and closed questions.

Setting: Independently living people in South-West London interviewed in their own homes.

Subjects: A group of 54, edentate people (mean age 82, R = 60-93 years) were studied.

Results: Most subjects (69%) expressed difficulty eating at least one type of food, half were unwilling to eat the foods they found difficult, others were conscious of cooking longer or cutting smaller in order to manage these foods, although no one accepted that they overcooked food. There were dramatic differences in the number of subjects expressing difficulty to chew various foods when responding to open and closed questions. Roast beef proved a good discriminator in this group of predominantly English subjects. The importance of the questioning process was also shown by the discrepancy of responses between variously prepared apples and the inability of any subjects to bite an unpeeled apple.

Conclusions: For sensitive appraisal of food choice it is obviously essential to assess relevant foods, for the culture of the group being studied. Open questions provide a way of exploring which are the appropriate foods and food preparation as criteria to assess perceived chewing ability and treatment benefit. The semi-structured interview method is particularly valuable for the study of older people. Closed questions provide different information which is also necessary to secure recall by older people.