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Menon A, Schroth RJ, Hai-Santiago K, Yerex K, Bertone M. The Canadian dental care plan and the senior population. FRONTIERS IN ORAL HEALTH 2024; 5:1385482. [PMID: 38933118 PMCID: PMC11199732 DOI: 10.3389/froh.2024.1385482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Affiliation(s)
- Anil Menon
- Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Childrens Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Robert J. Schroth
- Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Childrens Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Shared Health Manitoba, Winnipeg, MB, Canada
| | | | - Katherine Yerex
- School of Dental Hygiene, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, MB, Canada
| | - Mary Bertone
- Childrens Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
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Idris S, Aghanwa S, O'Halloran J, Durey A, Slack-Smith L. Homebound oral care for older adults: A qualitative study of professional carers' perspectives in Perth, Western Australia. Gerodontology 2024; 41:94-100. [PMID: 37454389 DOI: 10.1111/ger.12704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To examine professional support workers and case managers' (professional carers) perspectives of what promoted or compromised oral health care in homebound adults aged over 65 years in Perth, Western Australia and identify professional carers' need for support in this context. BACKGROUND Accessing dental services can be difficult to navigate and unaffordable for homebound older adults. Paid carers often play a substantial role in facilitating access to services yet there is limited qualitative evidence of the perspectives of these stakeholders. METHODS Given limited evidence in this area, this simple qualitative study was informed by constructivist grounded theory. Participants comprised 15 professional carers of homebound older adults. Transcripts were analysed to identify participant perceptions of key barriers and enablers to providing oral health care. RESULTS Barriers to clients accessing dental care included participants' uncertainty around navigating the dental system, low priority of oral health care, affordability and confusion around who was responsible to provide oral care. Enablers included participants supporting clients' autonomy around oral care, better integration of oral care into primary health care and education and opportunity for training for professional carers. CONCLUSION Ensuring oral health is part of primary health plans, clarifying roles and responsibilities around delivering oral health care to homebound older adults and training carers were key findings. Inter-sectoral collaboration between the dental and aged care sectors can benefit dental practitioners and professional carers in shared learning and has likely flow-on effects for homebound older adults.
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Affiliation(s)
- Safaa Idris
- UWA Dental School, University of Western Australia, Perth, WA, Australia
| | - Somto Aghanwa
- UWA Dental School, University of Western Australia, Perth, WA, Australia
| | | | - Angela Durey
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
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Christian B, George A, Veginadu P, Villarosa A, Makino Y, Kim WJ, Masood M, Martin R, Harada Y, Mijares-Majini MC. Strategies to integrate oral health into primary care: a systematic review. BMJ Open 2023; 13:e070622. [PMID: 37407034 PMCID: PMC10367016 DOI: 10.1136/bmjopen-2022-070622] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/04/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVES Integration of oral health into primary care has been proposed as a primary healthcare approach for efficient and sustainable delivery of oral health services, and the effective management of oral diseases. This paper aimed to synthesise evidence on the effectiveness of strategies to integrate oral health into primary care. DESIGN Systematic review. DATA SOURCES MEDLINE, CINAHL, Embase, Scopus, ProQuest, Cochrane and Google Scholar were searched without date limits until the third week of June 2022. Reference lists of eligible studies were also searched. Experts in the field and existing professional networks were consulted. ELIGIBILITY CRITERIA Only studies that evaluated integration strategies were included in the review. Eligibility was restricted to English language studies published in academic peer-reviewed journals. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data and performed the risk of bias assessments. A narrative synthesis approach was used to report review findings. Heterogeneity among included studies precluded a meta-analysis. RESULTS The search identified 8731 unique articles, of which 49 were included in the review. Majority of the studies explored provision of oral healthcare by primary care professionals in primary care settings, where integration was primarily via training/education and/or policy changes. Most studies reported results favouring the integration strategy, such as improvements in referral pathways, documentation processes, operating efficiencies, number of available health staff, number of visits to non-dental primary care professionals for oral health issues, proportion of children receiving fluoride varnish applications/other preventive treatment, proportion of visits to an oral health professional and dental caries estimates. CONCLUSION The findings from this review demonstrate that the majority of identified strategies were associated with improved outcomes and can be used to inform decision-making on strategy selection. However, more research and evaluation are required to identify best practice models of service integration. PROSPERO REGISTRATION NUMBER CRD42020203111.
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Affiliation(s)
- Bradley Christian
- Population Oral Health, School of Dentistry, The University of Sydney, Sydney, New South Wales, Australia
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
| | - Ajesh George
- Population Oral Health, School of Dentistry, The University of Sydney, Sydney, New South Wales, Australia
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Prabhakar Veginadu
- Menzies School of Health Research, Alice Springs, Northern Territory, Australia
| | - Amy Villarosa
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Yuka Makino
- Noncommunicable Diseases Team, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Warrick Junsuk Kim
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Mohd Masood
- Department of Rural Clinical Sciences, La Trobe University - Bendigo Campus, Bendigo, Victoria, Australia
| | - Rachel Martin
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yuriko Harada
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
- Oral Health Programme, Noncommunicable Diseases Department, World Health Organization, Geneva, Switzerland
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Chang SH, Chang YY, Jeng WJ, Wai JPM. Efficacy of a multidimensional self-management intervention on low-education women with metabolic syndrome: a cluster randomized controlled trial. Sci Rep 2023; 13:10358. [PMID: 37365208 DOI: 10.1038/s41598-023-36971-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 06/13/2023] [Indexed: 06/28/2023] Open
Abstract
Low-education women, a substantially older population, are subject to increased risks of metabolic syndrome and consequent cardiometabolic diseases; early detection and effective management were urgently needed. Ninety-nine women with metabolic syndrome, age 61 and education ≤ 6 years, from four community units were randomly assigned to either a self-management intervention (n = 51) or a control arm (n = 48). The intervention consisted of five dimensions, physical activity and diet modifications (daily exercise classes and two nutrition courses), goal setting, coaching and peer support, problem-solving, and self-monitoring. The control arm received an education leaflet. Assessments were performed at baseline, six months, and 18 months. Compared with the control, the intervention participants improved the overall rate of meeting the recommended servings for six health foods, including vegetables, dairy products, and nuts (except whole grains, fruits, and protein); the rate of meeting regular leisure-time physical activity; and criteria biomarkers-waist circumference, fasting blood glucose, high-density lipoprotein cholesterol (except blood pressure and triglycerides); as well as body weight and body mass index; consequently decreased the number of risk factors and rate of metabolic syndrome. In conclusion, the multidimensional self-management intervention improved physical activity, healthy eating, and metabolic syndrome risks among low-education women with metabolic syndrome.
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Affiliation(s)
- Shu-Hung Chang
- Graduate Institute of Gerontology and Health Care Management, Geriatric and Long-Term Care Research Center, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Department of Gastroenterology and Hepatology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Ya Chang
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Wen-Juei Jeng
- Department of Gastroenterology and Hepatology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jackson Pui Man Wai
- Department of Nutrition Science, Fu Jen Catholic University, New Taipei City, Taiwan.
- Graduate Institute of Sport Science, National Taiwan Sport University, Taoyuan, Taiwan.
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Oral health clinical training and dental referral program for nurses: An interprofessional collaborative project. Geriatr Nurs 2021; 42:880-886. [PMID: 34090234 DOI: 10.1016/j.gerinurse.2021.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The overall objective of this study was to establish an interprofessional oral health training program for nursing personnel at Oregon Health & Science University. METHODS Fifteen registered nurses participated in didactic and clinical training and screened the oral health of patients. Nurses completed confidence assessments and patients completed satisfaction surveys. Data analysis included descriptive statistics and non-parametric tests for comparisons of mean scores. RESULTS Pre- and post-training surveys demonstrated significant increases in nurses' knowledge, confidence in discussing dental problems, performing dental screenings, and referring patients to dentists (p < 0.05). Patient satisfaction surveys (n = 89) denoted satisfaction with oral screenings and willingness for nurses to perform them. CONCLUSIONS Nurses participating in oral health and clinical screening training programs supervised by dentists significantly increased their confidence in providing dental referrals. Longitudinal studies are needed to determine the impact of such training programs on patient health.
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Hartshorn JE, Cowen HJ, Comnick CL. Cluster randomized control trial of nursing home residents' oral hygiene following the Mouth Care Matters education program for certified nursing assistants. SPECIAL CARE IN DENTISTRY 2021; 41:372-380. [PMID: 33587781 PMCID: PMC8248067 DOI: 10.1111/scd.12577] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 12/16/2022]
Abstract
Aims The purpose of this study was to determine if the number of certified nursing assistants (CNAs) trained with the Mouth Care Matters (MCM) oral health educational program had an impact on nursing facility (NF) resident oral health. Materials and methods Three NFs participated in a cluster randomized control trial. In NF‐A: all CNAs were offered the MCM program, NF‐B: 3 CNAs were offered the MCM program, and NF‐C: Control (no CNAs were offered the MCM program). Demographic information, systemic health data, and oral health data at baseline, 3‐month, and 6‐month intervals were collected and analyzed using Kruskal‐Wallis, Wilcoxon signed‐rank and Wilcoxon rank‐sum tests. A total of 24 dentate residents participated in this study. Plaque control record scores for NF‐A were significantly reduced compared to NF‐B and NF‐C (P < .001 and P = .002 respectively) and gingival bleeding index for NF‐A were significantly reduced compared to NF‐B and NF‐C (P = .002 and P < .001 respectively). Conclusion Increasing the number of CNA's trained in the Mouth Care Matters educational program positively impacted NF residents’ oral hygiene.
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Affiliation(s)
| | - Howard J Cowen
- Preventive and Community Dentistry, University of Iowa, Iowa City, Iowa
| | - Carissa L Comnick
- Division of Biostatistics and Computational Biology, University of Iowa, Iowa City, Iowa
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Pawluk DL, Dale C, Lai JY, Villacorta-Siegal N, Smith J, Joseph K, Lawrence HP. The impact of oral health education taken by personal support workers caring for a geriatric population in a long-term care facility: A mixed-methods study. Gerodontology 2021; 38:373-386. [PMID: 33529440 DOI: 10.1111/ger.12532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 12/03/2020] [Accepted: 12/15/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the impact of an online oral health education module on personal support workers' (PSW) knowledge and beliefs in their care for long-term care (LTC) residents in one Canadian LTC residence. BACKGROUND LTC residents are dependent on PSWs for their oral health needs. However, PSWs receive minimal to no oral health education placing residents at risk for poor oral health. METHODS A mixed-methods convergent design comprising a before-and-after questionnaire (N = 88), focus groups (N = 23) and interviews (N = 4) exploring module learning. Analysis of each data set was followed by their amalgamation and comparison. RESULTS The online module had limited impact on the PSWs' knowledge and beliefs regarding resident oral health care. The quantitative results demonstrated knowledge improvements in two domains and changes in two belief domains. However, the qualitative results demonstrated new knowledge was not developed or sustained in practice. Themes that emerged include the following: lack of module recall, unmet learning needs and methods for oral care delivery, and timing of oral care in a busy clinical environment. CONCLUSION Online oral health education alone has limited impact on PSWs' knowledge and beliefs. Research evaluating multifaceted education interventions including hands-on training with a dental expert is warranted.
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Affiliation(s)
- Debra L Pawluk
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Craig Dale
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Tory Trauma Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Sunnybrook Research Institute, Toronto, ON, Canada
| | - Jim Yuan Lai
- Periodontology, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | | | | | - Karen Joseph
- Kunin-Lunenfeld Centre for Applied Research and Evaluation, Baycrest, Toronto, ON, Canada
| | - Herenia P Lawrence
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
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Kistler CE, Scott J, Ward K, Zeigler R, Sullivan L, Tomlinson SE, Wretman CJ, Zimmerman S. Mouth Care in Assisted Living: Potential Areas for Improvement. J Am Med Dir Assoc 2020; 22:1190-1193.e2. [PMID: 33385333 DOI: 10.1016/j.jamda.2020.11.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Poor oral care may lead to systemic disease, and there is evidence that assisted living (AL) residents lack quality oral care; in AL, poor care may be due to staff knowledge and attitudes, as well as organizational barriers to providing care. OBJECTIVES Determine AL staff knowledge and attitudes regarding mouth care and barriers to changing care. DESIGN Self-administered repeated-measures questionnaires completed before and after oral care training. SETTING AND PARTICIPANTS A total of 2012 direct care staff and administrators from 180 AL communities. METHODS Nine knowledge questions and 8 attitude and practice intention questions, and open-ended questions regarding training and obstacles to providing oral care. RESULTS Overall, 2012 participants completed pretraining questionnaires, and 1977 completed posttraining questionnaires. Baseline knowledge was high, but staff were not uniformly aware of the systemic-oral link whereby mouth care affects pneumonia and diabetes. Almost all staff reported learning a new technique (96%), including for residents who resist care (95%). Suggested areas to improve mouth care included having more hands-on experience. The primary perceived obstacles to care centered around residents who resist care and a lack of time. CONCLUSIONS AND IMPLICATIONS Based on reports of having benefitted from training, AL staff overwhelmingly noted that new knowledge was helpful, suggesting the benefit of skills-based training, especially in dementia care. Mouth care in AL has been sorely understudied, and merits additional attention.
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Affiliation(s)
- Christine E Kistler
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Jessica Scott
- Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Kimberly Ward
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robin Zeigler
- Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Louise Sullivan
- College of Nursing, Salve Regina University, Newport, RI, USA
| | - Sarah E Tomlinson
- Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Christopher J Wretman
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sheryl Zimmerman
- The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Ashour AA. Knowledge, Attitudes and Practices Regarding Oral Health and Oral Care Among Nursing Staff at a Mental Health Hospital in Taif, Saudi Arabia: A Questionnaire-based Study. JOURNAL OF ADVANCED ORAL RESEARCH 2020. [DOI: 10.1177/2320206820910300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background and Aim: Nurses are the principal oral healthcare providers for hospitalized patients. The purpose of this study was to assess the knowledge, attitudes, and practices of nurses at a mental health hospital in Saudi Arabia regarding oral health care of the hospitalized patients. Materials and Methods: A cross-sectional survey design was used in which 247 nursing staff completed a questionnaire that collected sociodemographic information, knowledge, and practices regarding oral health maintenance of patients and their attitudes toward oral health care of psychiatric patients. The chi-square and Kruskal-Wallis H tests were used to examine group differences. Results: A total of 247 (136 males and 111 females) nursing staff were involved in the survey with the mean age of 26 ± 32 years. Results showed significant gender differences in knowledge and practices, but no gender differences in attitudes. Male nurses were more likely to look at teeth and gums for signs of a healthy mouth (male = 97.8%, female = 95.5%, P = .04), used toothpaste to clean the patient’s teeth (male = 52.9%, female = 50.5%, P = .03), and believed that HIV/AIDS patients are at risk of developing oral health problems (male = 50.7%, female = 43.2%, P = .04). Nurses had more knowledge than nurse technicians regarding gum disease and dental abscesses ( P = .0001). Nursing staff with over five years of experience were more likely to agree about the need for the oral health care of hospitalized patients. Conclusion: The results emphasize the need for training of healthcare workers about the importance of oral health and considering oral health care as a patient’s rights rather than privilege.
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Affiliation(s)
- Amal Adnan Ashour
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Taif University, Tarif, Saudi Arabia
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Rafi J, Ivanova E, Rozental A, Lindfors P, Carlbring P. Participants' Experiences of a Workplace-Oriented Problem Gambling Prevention Program for Managers and HR Officers: A Qualitative Study. Front Psychol 2019; 10:1494. [PMID: 31333538 PMCID: PMC6616087 DOI: 10.3389/fpsyg.2019.01494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 06/13/2019] [Indexed: 12/02/2022] Open
Abstract
Workplace health promotion programs (WHPPs) refer to a set of health promotion and protection strategies implemented at a worksite and designed to meet the health and safety needs of employees. One important question for WHPPs is how middle management experience their participation in a WHPP. This study aims to explore this question further by applying a qualitative content analysis to interviews with thirteen managers and ten human resource officers participating in a WHPP focusing on problem gambling. The WHPP consisted of two components: policy implementation and skills-development training. The participants were interviewed about their experiences of these two components and the implementation process. The qualitative content analysis resulted in six themes: (1) Expectations of the skills-development training, (2) Experiences of and prior beliefs about problem gambling, (3) A good foundation, (4) The difficult conversation, (5) Appreciated aspects of the training sessions, and (6) Remaining obstacles. The results suggest that the presentation of cases, facts, and general knowledge was appreciated by most participants. However, participants also expressed that they would benefit from tailored interventions, more support in the policy implementation process, and following up on the results.
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Affiliation(s)
- Jonas Rafi
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | | | - Alexander Rozental
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Petra Lindfors
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Department of Psychology, University of Southern Denmark, Odense, Denmark
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11
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Wu S, Morrison JM, Dunn-Ridgeway H, Vucea V, Iuglio S, Keller H. Mixed methods developmental evaluation of the CHOICE program: a relationship-centred mealtime intervention for long-term care. BMC Geriatr 2018; 18:277. [PMID: 30424725 PMCID: PMC6234643 DOI: 10.1186/s12877-018-0964-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 10/24/2018] [Indexed: 02/02/2023] Open
Abstract
Background Mealtimes are important to quality of life for residents in long-term care (LTC). CHOICE (which stands for Connecting, Honouring dignity, Offering support, supporting Identity, Creating opportunities, and Enjoyment) is a multi-component intervention to improve relationship-centred care (RCC) and overall mealtime experience for residents. The objective of this developmental evaluation was to determine: a) if the dining experience (e.g. physical, social and RCC practices) could be modified with the CHOICE Program, and b) how program components needed to be adapted and/or if new components were required. Methods A mixed methods study conducted between April–November 2016 included two home areas (64 residents; 25 care staff/home management) within a single LTC home in Ontario. Mealtime Scan (MTS), which measures mealtime experience at the level of the dining room, was used to evaluate the effectiveness of CHOICE implementation at four time points. Change in physical, social, RCC dining environment ratings and overall quality of the mealtime experience over time was determined with linear mixed-effects analyses (i.e., repeated measures). Semi-structured interviews (n = 9) were conducted with home staff to identify what components of the intervention worked well and what improvements could be made. Results Physical and overall mealtime environment ratings showed improvement over time in both areas; one home area also improved social ratings (p < 0.05). Interviews revealed in-depth insights into the program and implementation process: i) Knowing the context and culture to meet staff and resident needs; ii) Getting everyone on board, including management; iii) Keeping communication lines open throughout the process; iv) Sharing responsibility and accountability for mealtime goals and challenges; v) Empowering and supporting staff’s creative mealtime initiatives. Conclusions This developmental evaluation demonstrated the potential value of CHOICE. Findings suggest a need to: extend the time to tailor program components; empower home staff in change management; and provide increased coaching. Electronic supplementary material The online version of this article (10.1186/s12877-018-0964-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sarah Wu
- University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Jill M Morrison
- University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Hilary Dunn-Ridgeway
- Research Institute for Aging, 250 Laurelwood Drive, Waterloo, Ontario, N2J 0E2, Canada
| | - Vanessa Vucea
- University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Sabrina Iuglio
- University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Heather Keller
- University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada. .,Research Institute for Aging, 250 Laurelwood Drive, Waterloo, Ontario, N2J 0E2, Canada.
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12
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Dentistry and nursing working together to improve oral health care in a long-term care facility. Geriatr Nurs 2018; 40:197-204. [PMID: 30528781 DOI: 10.1016/j.gerinurse.2018.10.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 10/05/2018] [Accepted: 10/08/2018] [Indexed: 01/06/2023]
Abstract
Inadequate oral care in long-term care (LTC) facilities compromises the quality of life of residents. This study assessed oral care knowledge of, and challenges experienced by, nurses and allied nursing staff (ANS) in a LTC facility in Canada. Dentists and nursing staff used the findings to implement strategies for improved care. Using a sequential mixed method design, data on oral care knowledge and practices were collected using self-administered questionnaires (n = 114) and focused groups (n = 39). Data were analyzed using descriptive statistics and thematic analysis. While participants (>80%) felt knowledgeable and confident in providing oral care, they desired improved skills to overcome resistive behavior, communication, and wanted adapted oral care materials. Implemented strategies included skills-acquisition workshop, oral care posters, and oral health champion. Overall, our interprofessional collaboration increased awareness of the need for oral care training, and implemented strategies to help nursing staff overcome barriers in providing care.
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Marchini L, Ettinger R, Chen X, Kossioni A, Tan H, Tada S, Ikebe K, Dosumu EB, Oginni FO, Akeredolu PA, Butali A, Donnelly L, Brondani M, Fritzsch B, Adeola HA. Geriatric dentistry education and context in a selection of countries in 5 continents. SPECIAL CARE IN DENTISTRY 2018; 38:123-132. [DOI: 10.1111/scd.12281] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Leonardo Marchini
- Department of Preventive and Community Dentistry; University of Iowa College of Dentistry and Dental Clinics; Iowa City United States of America
| | - Ronald Ettinger
- Department of Prosthodontics; University of Iowa College of Dentistry and Dental Clinics; Iowa City United States of America
| | - Xi Chen
- Department of Preventive and Community Dentistry; University of Iowa College of Dentistry and Dental Clinics; Iowa City United States of America
| | - Anastassia Kossioni
- Division of Gerodontology; Faculty of Dentistry; National and Kapodistrian University of Athens; Greece
| | - Haiping Tan
- Australian Research Centre for Population Oral Health; Adelaide Dental School; The University of Adelaide; Adelaide Australia
| | - Sayaka Tada
- Division of Preventive Dentistry; Department of Oral Health Dentistry; Niigata University Graduate School of Medical and Dental Science; Niigata Japan
| | - Kazunori Ikebe
- Department of Prosthodontics; Gerodontology and Oral Rehabilitation Osaka University Graduate School of Dentistry; Osaka Japan
| | - Elizabeth Bosede Dosumu
- Department of Periodontology & Community Dentistry; Faculty of Dentistry; University of Ibadan; Ibadan Nigeria
| | - Fadekemi O. Oginni
- Department of Oral and Maxillofacial Surgery; Faculty of Dentistry; Obafemi Awolowo University; Ile-Ife Nigeria
| | | | - Azeez Butali
- Department of Oral Pathology; Radiology and Medicine College of Dentistry, University of Iowa,; USA
| | - Leeann Donnelly
- Department of Oral Biological & Medical Sciences; University of British Columbia; Vancouver Canada
| | - Mario Brondani
- Department of Oral Health Sciences; University of British Columbia; Vancouver Canada
| | - Bernd Fritzsch
- Director, Center of Aging & Aging Mind and Brain Initiative, Department of Biology, College of Liberal Arts and Science; University of Iowa
| | - Henry A. Adeola
- Division of Dermatology, Department of Medicine, Faculty of Health Sciences and Groote Schuur Hospital; University of Cape Town; Cape Town South Africa
- Department of Oral and Maxillofacial Pathology; Faculty of Dentistry; University of the Western Cape at Tygerberg Hospital; Cape Town South Africa
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Kohli R, Nelson S, Ulrich S, Finch T, Hall K, Schwarz E. Dental care practices and oral health training for professional caregivers in long-term care facilities: An interdisciplinary approach to address oral health disparities. Geriatr Nurs 2017; 38:296-301. [DOI: 10.1016/j.gerinurse.2016.11.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 11/21/2016] [Accepted: 11/22/2016] [Indexed: 11/30/2022]
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15
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Accuracy of Teledentistry for Diagnosing Dental Pathology Using Direct Examination as a Gold Standard: Results of the Tel-e-dent Study of Older Adults Living in Nursing Homes. J Am Med Dir Assoc 2017; 18:528-532. [DOI: 10.1016/j.jamda.2016.12.082] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 12/30/2016] [Indexed: 11/19/2022]
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16
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Coker E, Ploeg J, Kaasalainen S, Carter N. Nurses' oral hygiene care practices with hospitalised older adults in postacute settings. Int J Older People Nurs 2016; 12. [PMID: 27353475 DOI: 10.1111/opn.12124] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 05/08/2016] [Indexed: 11/29/2022]
Abstract
AIM AND OBJECTIVE The purpose of this study was to explore how nurses provide bedtime oral hygiene care, how they decide on interventions provided, and what factors influence their ability to provide oral care. BACKGROUND Current evidence links poor oral hygiene to systemic and infectious diseases such as pneumonia. Hospitalised patients, who now retain their teeth into older adulthood, often rely on nurses to provide oral hygiene care. Nurses have the potential to impact oral health outcomes and quality of life by controlling plaque. However, oral hygiene care practices of nurses in postacute hospital settings are relatively unknown. DESIGN A qualitative, exploratory multiple-case study was conducted with 25 nurses working on five inpatient units at different hospitals. METHODS Nurses were accompanied on their evening rounds to observe oral care practices, the physical environment and workflow. Thematic analysis was used to analyse the case study data including transcripts of guided conversations, field notes and documents. Within-case analysis was followed by cross-case analysis. RESULTS Findings indicate that (i) nurses often convey oral hygiene care to their patients as being optional; (ii) nurses are inclined to preserve patient autonomy in oral hygiene care; (iii) oral hygiene care is often spontaneous and variable, and may not be informed by evidence; and (iv) oral hygiene care is not embedded into bedtime care routines. CONCLUSIONS Oral hygiene care is discretionary and often missed care. IMPLICATIONS FOR PRACTICE Nurses need knowledge of the health benefits of oral care, and skills related to assessment and approaches to oral care. Availability of effective products and supplies facilitates provision of oral care. The evidence for oral hygiene care practices, outcomes of nurse-administered oral care and nursing's role in influencing the oral health literacy of patients require further study.
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Affiliation(s)
| | - Jenny Ploeg
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | | | - Nancy Carter
- School of Nursing, McMaster University, Hamilton, ON, Canada
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