1
|
Krausch-Hofmann S, Palmers E, Declerck D, Duyck J. Development of practice guidelines for daily oral care in care-dependent older adults to complement the InterRAI suite of instruments using a modified Delphi approach. Int J Older People Nurs 2020; 16:e12351. [PMID: 33074589 PMCID: PMC7816227 DOI: 10.1111/opn.12351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/21/2020] [Accepted: 09/12/2020] [Indexed: 01/11/2023]
Abstract
Aim To develop practice guidelines for nursing assistants who provide daily oral care to older adults. Background The interRAI suite of instruments is internationally used in professional health care to assess the needs of care‐dependent older persons. An optimised oral health section was developed recently to identify care clients with poor oral health and hygiene. Internationally shared guidelines for daily oral care are needed to complement the optimised oral health section of the interRAI suite of instruments. Material and methods The modified Delphi approach started with the preparation of an initial draft. Subsequently, an online survey and a face‐to‐face discussion were conducted with international experts. Their feedback was used to revise the draft. Two additional online surveys were conducted with the experts to reach consensus agreement for each item of the revised version. The same group of experts was invited to the different study phases. Results The three surveys were completed by 26, 27 and 23 international experts, respectively. A group of 18 experts completed each survey, whereof a subgroup of 11 experts also took part in the face‐to‐face discussion. Experts were dental hygienists, dentists, nursing scientists, physicians and psychologists from 14 different countries. After the final survey, consensus agreement was reached for 54 of the 57 (94.7%) items, representing the final version of the guidelines. Conclusion Available evidence was combined with practical feedback from international experts to develop clear and concise practice guidelines for daily oral care in older adults. Implications for practice The guidelines will help to improve knowledge and reduce barriers of nursing assistants to provide daily oral care.
Collapse
Affiliation(s)
- Stefanie Krausch-Hofmann
- Department of Oral Health Sciences, Population Studies in Oral Health, KU Leuven, Leuven, Belgium
| | - Ellen Palmers
- Department of Oral Health Sciences, Population Studies in Oral Health, KU Leuven, Leuven, Belgium
| | - Dominique Declerck
- Department of Oral Health Sciences, Population Studies in Oral Health, KU Leuven, Leuven, Belgium
| | - Joke Duyck
- Department of Oral Health Sciences, Biomaterials/BIOMAT, KU Leuven, Leuven, Belgium
| |
Collapse
|
2
|
Krausch-Hofmann S, Tran TD, Declerck D, de Almeida Mello J, Declercq A, Lesaffre E, De Lepeleire J, Duyck J. Assessment of oral health conditions presented in photographs - is there a difference between dentists and non-dental professional caregivers? BMC Oral Health 2020; 20:188. [PMID: 32620115 PMCID: PMC7333316 DOI: 10.1186/s12903-020-01171-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/22/2020] [Indexed: 11/23/2022] Open
Abstract
Background Photographs can help non-dental professional caregivers to identify problems when inspecting the mouth of care-dependent older individuals. This study evaluated whether the assessment of oral health-related conditions presented in photographs differed between dentists and non-dental professional caregivers. Materials and methods One-hundred-and-seventy-nine photographs were taken from long-term care facility residents and from patients at the Department of Dentistry of a University Hospital. The following oral health aspects were depicted: denture hygiene, oral hygiene, teeth, gums, tongue and palate/lips/cheeks. Collection continued until for each oral health aspect a pool of photographs was available that showed conditions from perfect health and hygiene to severe problems. A segmented Visual Analogue Scale was applied to assess the conditions presented in the photographs. Each photograph was assessed by each participant of this study. The benchmark was established by three dentists with academic-clinical expertise in gerodontology, special needs dentistry and periodontology. For each photograph, they provided a collective score after reaching consensus. Photographs were assessed individually by 32 general dentists and by 164 non-dental professional caregivers. Linear mixed effects models and generalized linear mixed effects models were fitted and mean squared errors were computed to quantify differences between both groups. Results For the different oral health aspects, absolute distances from the benchmark scores were 1.13 (95%CI:1.03–1.23) to 1.51 (95%CI:1.39–1.65) times higher for the caregivers than for the dentists. The odds to overestimate the condition were higher for the caregivers than the dentists for oral hygiene (OR = 0.72, 95%CI = 0.62–0.84) and teeth (OR = 0.74; 95%CI = 0.61–0.88). The odds to underestimate the condition were higher for the caregivers than the dentists for gums (OR = 1.39; 95%CI:1.22–1.59) and palate/lips/cheeks (OR = 1.22; 95%CI = 1.07–1.40). Over all assessments, the variance in caregiver scores was 1.9 (95%CI:1.62–2.23) times higher than that for the dentists. Conclusion Small but significant differences were found between dentists and non-dental professional caregivers assessing oral health-related conditions presented in photographs. When photographs are used to aid non-dental professional caregivers with the oral health assessment, these visualizations should be complemented with comments to facilitate accurate interpretation.
Collapse
Affiliation(s)
- Stefanie Krausch-Hofmann
- KU Leuven Population Studies in Oral Health - Department of Oral Health Sciences, Kapucijnenvoer 7/a - box 7001, 3000, Leuven, Belgium
| | - Trung Dung Tran
- KU Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat) - Department of Public Health and Primary Care, Kapucijnenvoer 35/d - box 7001, 3000, Leuven, Belgium
| | - Dominique Declerck
- KU Leuven Population Studies in Oral Health - Department of Oral Health Sciences, Kapucijnenvoer 7/a - box 7001, 3000, Leuven, Belgium
| | - Johanna de Almeida Mello
- KU Leuven LUCAS - Centre for Care Research and Consultancy, Minderbroedersstraat 8 - box 5310, 3000, Leuven, Belgium
| | - Anja Declercq
- KU Leuven LUCAS - Centre for Care Research and Consultancy, Minderbroedersstraat 8 - box 5310, 3000, Leuven, Belgium.,KU Leuven CESO - Center for Sociological Research, Parkstraat 45 - box 3601, 3000, Leuven, Belgium
| | - Emmanuel Lesaffre
- KU Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat) - Department of Public Health and Primary Care, Kapucijnenvoer 35/d - box 7001, 3000, Leuven, Belgium
| | - Jan De Lepeleire
- KU Leuven Academic Centre for General Practice - Department of Public Health and Primary Care, Kapucijnenvoer 33/j - box 7001, 3000, Leuven, Belgium
| | - Joke Duyck
- Biomaterials/BIOMAT - Department of Oral Health Sciences, Kapucijnenvoer 7/a - box 7001, 3000, Leuven, Belgium.
| |
Collapse
|
3
|
Ástvaldsdóttir Á, Boström AM, Davidson T, Gabre P, Gahnberg L, Sandborgh Englund G, Skott P, Ståhlnacke K, Tranaeus S, Wilhelmsson H, Wårdh I, Östlund P, Nilsson M. Oral health and dental care of older persons-A systematic map of systematic reviews. Gerodontology 2018; 35:290-304. [PMID: 30129220 DOI: 10.1111/ger.12368] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 07/01/2018] [Accepted: 07/10/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To examine the current knowledge on oral health status and dental care of older persons through a systematic mapping of systematic reviews of low or moderate risk of bias. BACKGROUND Geriatric dentistry covers all aspects of oral health and oral care of older persons. Oral health is part of general health and contributes to a person's physical, psychological and social wellbeing. METHODS A literature search was performed in three different databases (PubMed, The Cochrane Library and Cinahl) within 12 domains: Dental caries, periodontitis, Orofacial pain and temporomandibular joint (TMJ) pain, mucosal lesions, oral motor function, dry mouth, halitosis, interaction between oral status and other medical conditions, ability to interrelate and communicate, quality of life, ethics and organisation of dental care for older persons. Systematic reviews were identified and scrutinised, highlighting scientific knowledge and knowledge gaps. RESULTS We included 32 systematic reviews of which 14 were judged to be of low/moderate risk of bias. Most of the domains lack systematic reviews with low or moderate risk of bias. In two of the domains evidence was identified; in institutionalised people aged 65 or older, effective oral hygiene can prevent pneumonia. Furthermore, there is an evidence of a relationship between malnutrition (protein energy-related malnutrition, PEM) and poor appetite and edentulousness. CONCLUSIONS There is an urgent need for further research and evidence-based knowledge within most domains in geriatric dentistry and in other fields related to oral health and dental care for older persons striving for multi-disciplinary research programmes.
Collapse
Affiliation(s)
| | - Anne-Marie Boström
- Division of nursing, Department of Neurobiology, Care Sciences and Society, Karolinska institutet, Huddinge, Sweden.,Theme Aging, Karolinska University Hospital, Huddinge, Sweden.,Department of nursing, Western Norway University of Applied Sciences, Haugesund, Norway
| | - Thomas Davidson
- Division of health Care Analysis, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Pia Gabre
- Department of Preventive Dentistry, Public Dental Health, Uppsala County Council, Uppsala, Sweden.,Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Gahnberg
- Department of Preventive Dentistry, Public Dental Service, Region Västra Götaland, Sweden.,Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunilla Sandborgh Englund
- Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden.,Academic Center of Geriatric Dentistry, Karolinska institutet, Stockholm, Sweden
| | - Pia Skott
- Academic Center of Geriatric Dentistry, Karolinska institutet, Stockholm, Sweden
| | - Katri Ståhlnacke
- Public Dental Services, Region Örebro County, Sweden.,Faculty of Health and Medicine, Örebro University, Örebro, Sweden
| | - Sofia Tranaeus
- Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden.,Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
| | | | - Inger Wårdh
- Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden.,Academic Center of Geriatric Dentistry, Karolinska institutet, Stockholm, Sweden
| | - Pernilla Östlund
- Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Mikael Nilsson
- Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
| |
Collapse
|
4
|
Fjeld KG, Eide H, Mowe M, Hove LH, Willumsen T. Dental hygiene registration: development, and reliability and validity testing of an assessment scale designed for nurses in institutions. J Clin Nurs 2017; 26:1845-1853. [PMID: 27323699 DOI: 10.1111/jocn.13452] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To develop and test the dental hygiene registration, a dental hygiene assessment scale for nurses working in institutions. BACKGROUND Removal of dental plaque is a key factor in preventing oral health-related diseases. A simple, but reliable dental hygiene assessment scale that enables nurses to monitor residents' dental hygiene on a daily basis, will improve monitoring oral hygiene status and quality of dental health care. DESIGN Descriptive study on the development and evaluation of a dental hygiene registration instrument. METHODS The dental hygiene registration was developed and tested over several stages during the period of 2011-2014. Dental hygiene registration consists of a five-point plaque score scale. The score indicates whether measures are needed. A reference group comprising both medical and dental personnel designed dental hygiene registration. Dental plaque was used as a measure of dental hygiene. A pictorial series of teeth with varying amounts of plaque was used to achieve intra-examiner agreement. Dental hygiene registration assessments were scored 50 times to assess interexaminer reliability between one dental hygienist and one clinical nurse. Dental hygiene registration was validated against the plaque index score of the Simplified Oral Hygiene Index. The Regional Ethics Committee approved the study (2011/915). RESULTS Estimates for intra-examiner agreement on plaque score were good for the dental hygienist (κ = 0·7) and very good for the clinical nurse (κ = 0·8). Estimates for interexaminer reliability for dental hygiene registration between the dental hygienist and the clinical nurse were moderate (κ = 0·4). dental hygiene registration corresponded significantly with Simplified Oral Hygiene Index (Spearman's correlation coefficient = 0·8, p < 0·001) indicating good validity. CONCLUSION The developed dental hygiene registration appears to be reliable and valid. RELEVANCE TO CLINICAL PRACTICE Dental hygiene registration may contribute to the provision of daily oral care. Dental hygiene registration enables nurses to evaluate their own effort when assisting in dental hygiene and to register whether further effort is needed.
Collapse
Affiliation(s)
| | - Hilde Eide
- Faculty of Health Sciences, Buskerud and Vestfold University College, Drammen, Norway
| | - Morten Mowe
- Medical Clinic, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | | |
Collapse
|