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Dumbuya J, Marwaha RS, Shah PK, Challa S. To assess the knowledge, attitudes, and confidence of caregivers and administrators towards the oral health of nursing home residents in San Antonio, Texas. BMC Geriatr 2024; 24:511. [PMID: 38867158 PMCID: PMC11167851 DOI: 10.1186/s12877-024-04784-x] [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] [Received: 03/20/2023] [Accepted: 02/05/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVE The primary objective of this research was to use qualitative methods to assess the knowledge, attitudes, and confidence of caregivers in their ability to provide oral hygiene assistance to residents. The secondary objective was to assess the knowledge and attitude of administrators on the provision of oral hygiene assistance for residents, and their confidence in caregivers' ability to provide oral hygiene assistance to nursing home residents in San Antonio, Texas. METHODS A semi-structured interview guide was used to conduct face-to-face interviews with seven caregivers and twelve administrative staff from ten nursing homes in San Antonio, Texas. Employees in nursing homes who are caring for residents are referred to as caregivers and those whom they care for are referred to as nursing home residents. One survey instrument was developed for the caregiver's knowledge, attitude, and confidence toward providing oral health care, and another to assess the administrator's knowledge, attitude, and confidence in caregivers providing oral care for nursing home residents. The interviews were recorded, transcribed, and coded for thematic content. RESULTS The findings revealed that caregivers and administrators had adequate knowledge of the connection between oral and systemic health. The administrators were confident that caregivers were adequately trained to provide oral hygiene care for residents. Caregivers had a positive attitude toward the importance of good oral health. They regularly assessed the residents' oral health, but due to time constraints, staffing shortages, and other competing tasks providing oral health care to the residents was challenging. Most caregivers were confident in their skills in providing oral care for the residents since 85.6% agreed. On the contrary, almost half of the administrators were confident that caregivers have the necessary skills to provide oral care for residents, while 41.7% were unsure. CONCLUSIONS The study gave a broader insight into the provision of oral care in nursing home residents from the perspectives of caregivers and administrative staff. Administrators must provide caregivers with adequate training and time so they can provide adequate oral health care for the residents.
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Affiliation(s)
- Joseph Dumbuya
- The University of Texas Health Science Center at San Antonio School of Dentistry, 7703 Floyd Curl Drive, 78229, San Antonio, TX, USA.
| | - Rochisha S Marwaha
- The University of Texas Health Science Center at San Antonio School of Dentistry, 7703 Floyd Curl Drive, 78229, San Antonio, TX, USA
| | - Pankil K Shah
- The University of Texas Health Science Center at San Antonio Joe R. & Teresa Lozano Long School of Medicine, 7703 Floyd Curl Drive, 78229, San Antonio, TX, USA
| | - Suman Challa
- The University of Texas Health Science Center at San Antonio School of Dentistry, 7703 Floyd Curl Drive, 78229, San Antonio, TX, USA
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Allenspach P, Srinivasan M. Oral health status of institutionalized older adults receiving domiciliary dental care: A cross-sectional retrospective study. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38745373 DOI: 10.1111/scd.13013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/10/2024] [Accepted: 04/19/2024] [Indexed: 05/16/2024]
Abstract
AIM This study aimed to evaluate the oral health of care-dependent institutionalized older adults receiving domiciliary dental care. METHODS AND RESULTS Dental health records of institutionalized adults receiving regular domiciliary dental care were examined (observation period: 5 years). Relevant demographic and oral health information were extracted. Statistical analyses included descriptive and non-parametric tests (α = .05). Records of 398 nursing home residents (mean-age: 84.9 ± 6.4 years) were included. Average time spent by the residents in the institution was 2.8 ± 1.5 years. The mean number of teeth present and the overall DMF-T score was 14.7 ± 9.1 and 27.4 ± 6.2, respectively. The DMF-T score increased until the 3-year recall, with a significant increase in the number of decayed teeth (2-year: p = .013; 3-year: p = .010). An improvement in the residents' periodontal health was seen during the observation period but was not statistically significant. CONCLUSION The findings of this cross-sectional study confirmed that regular domiciliary dental care provision to institutionalized older adults helps maintain gingival and periodontal health. However, the incidence of dental caries might still be a problem that needs to be addressed with effective measures that improve the daily oral care provision to these older adults.
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Affiliation(s)
- Philipp Allenspach
- Clinic of General-, Special Care- and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Murali Srinivasan
- Clinic of General-, Special Care- and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
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Chen M, Weng Y, Zhang J, Gu L, Chen W, Qiao M, Wang M, Huang X, Chen L, Zhang L. Factors associated with nurses' attitudes for providing oral care in geriatric care facilities: a cross-sectional study. BMC Oral Health 2023; 23:801. [PMID: 37884891 PMCID: PMC10605944 DOI: 10.1186/s12903-023-03517-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND The world's population is getting older. This issue is accompanied by a rise in the number of older people suffering from dementia and disability, for whom oral hygiene care is challenging. Nurses' attitudes toward providing oral care (POC) are critical for the elderly, while few studies have investigated the determinant factors of nurses' attitudes by identifying the current work pressure, resilience and self-efficacy in geriatric care facilities (GCFs). It is of great significance to explore the nurses' attitudes toward POC and associated influencing factors related to psychological aspects including resilience, self-efficacy, and stress from the workplace. METHODS Attitudes for Providing Mouth Care (A-PMC) in Chinese version were used in this cross-sectional study with 160 nurses in 2 GCFs. Data were collected using online questionnaires and analyzed by multiple linear regression analysis. Statistically significant values were considered at p < 0.05. RESULTS A total of 160 nurses participated in this study, with an average age of 32.86 ± 7.43. The mean score for the A-PMC was 2.81 ± 0.47. The score of A-PMC was negatively correlated with work pressure (r=-0.332, p < 0.01), and positively correlated with resilience (r = 0.735, p < 0.01) and self-efficacy (r = 0.425, p < 0.01) respectively. Multiple linear regression analyses identified that the potential influencing factors of A-PMC were education background, work hours every shift, self-efficacy, work pressure and resilience. CONCLUSIONS The study results indicate nurses' attitudes regarding PMC were at a low level, which is influenced by many factors. To improve nurses' attitudes toward PMC and the oral hygiene (OH) of the elderly in GCFs, it is necessary to increase nurses' education and training, establish a reasonable and effective incentive mechanism to improve nurses' work motivation and other intervention measures to reduce work pressure.
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Affiliation(s)
- Mengxia Chen
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yanqiu Weng
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China
- Shanghai Quality Control Center of Geriatric Care, Shanghai, China
| | - Jingwen Zhang
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Liyan Gu
- Department of Neurology, No. 905 Hospital of PLA Navy, Shanghai, China
| | - Wenyao Chen
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China
- Shanghai Quality Control Center of Geriatric Care, Shanghai, China
| | - Mengting Qiao
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Mengdi Wang
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xiaorong Huang
- Department of Nursing, Huzhou University, Huzhou, Zhejiang, China
| | - Lan Chen
- Department of Nursing, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Lingjuan Zhang
- Education and Scientific Research Department of Clinical Nursing, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
- Shanghai Quality Control Center of Geriatric Care, Shanghai, China.
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Melbye EL, Bull VH, Hidle KS. Assessment of the SmartJournal Intervention for Improved Oral Care in Nursing Homes: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e46926. [PMID: 37801358 PMCID: PMC10589829 DOI: 10.2196/46926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Poor oral health is common in nursing home residents, and health care professionals report numerous barriers when it comes to the provision of oral care for care-dependent older adults, such as a lack of oral health knowledge and skills, care-resistant behaviors in residents, lack of adequate oral care routines, insufficient systems for documentation of issues related to oral health, a high workload, and unclear responsibilities. An intervention, SmartJournal, has been developed to assist health personnel in preserving older patients' oral health. SmartJournal is a digital tool with three components: (1) documentation of oral hygiene routines; (2) monthly oral health assessment; and (3) education on geriatric oral care. An updated framework for research on complex interventions has been used to guide the various phases in the development of this intervention. This study focuses on the evaluation phase. OBJECTIVE We aim to assess (1) the effectiveness of SmartJournal use in enhancing nursing home caregivers' capability, opportunity, motivation, and routines related to oral care; and (2) whether SmartJournal use results in improved oral health for nursing home residents. METHODS We will use a cluster randomized controlled trial to assess impacts of SmartJournal use as specified under study objectives. Nursing homes located in Rogaland, Norway, will be recruited and randomly assigned to an intervention and a control group. The intervention group will be provided with tablets containing SmartJournal and support from research staff, while the control group will continue with existing oral care routines. Both groups will receive oral hygiene packages. The intervention will last for 12 weeks. Measurements will be performed in both groups at baseline, 3 months, and 9 months and include (1) a survey assessing caregivers' capability, opportunity, motivation, and routines related to oral care; and (2) assessment of oral health status in residents using mucosal-plaque score as a primary outcome measure. Analyses will include descriptive statistics and statistical techniques to look for changes and differences in the study variables within and between the intervention and control groups throughout the study period. Associations between study variables will also be investigated. RESULTS Recruitment of nursing homes for the intervention and control groups was completed in February 2023. Recruitment of individual participants (ie, nursing home residents and caregivers) is ongoing, and baseline measurements are being performed consecutively. Results are expected to be ready for analyses in fall 2024. CONCLUSIONS We aim to assess the effects of SmartJournal use on oral care and oral health in nursing homes. Results from this work may inform further development and implementation of SmartJournal and similar digital tools aiming to enhance health care services offered to care-dependent people. Finally, SmartJournal may have potential as a learning tool in educational programs for nurses and other health care professionals. TRIAL REGISTRATION ClinicalTrials.gov NCT05724043; https://clinicaltrials.gov/study/NCT05724043. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46926.
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Affiliation(s)
| | - Vibeke Hervik Bull
- Research Department, Oral Health Centre of Expertise Rogaland, Stavanger, Norway
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Chang AK, Kim BK, Kim AY. The impact of aromatherapy-based oral care on oral conditions, salivary pH, and halitosis in older adults with dementia: Pilot study. Geriatr Nurs 2023; 53:109-115. [PMID: 37536001 DOI: 10.1016/j.gerinurse.2023.07.010] [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] [Received: 04/17/2023] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 08/05/2023]
Abstract
Inadequate oral care and poor oral health in older adults are known to increase the risk of dementia. Dementia patients residing in long-term care facilities are especially vulnerable to oral diseases due to their care-resistant behavior. This study aimed to investigate the effects of a 7-day oral care program based on an aroma solution in 58 dementia patients (29 each in the experimental and control groups) admitted to a long-term care hospital in South Korea. The experimental group received oral care with a solution containing peppermint, tea tree, and lemon essential oils, and the control group with a saline solution. The effectiveness of oral care was assessed by the participants' oral condition, salivary pH, and halitosis. The experimental group showed significant improvements (P<.001) in all three outcomes, indicating that oral care with an aroma solution can improve the oral health of older dementia patients residing in long-term care facilities.
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Affiliation(s)
- Ae Kyung Chang
- Professor, College of Nursing Science, Kyung Hee University, Seoul, South Korea
| | - Bo Kyoung Kim
- College of Nursing Science, Kyung Hee University, Seoul, South Korea
| | - Ah Young Kim
- College of Nursing Science, Kyung Hee University, Seoul, South Korea..
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Tsui PK, Chau PH, Wong JYH, Wang MP, Gao X, Lam OLT, Leung KCM, Lo ECM, Tiwari A. Oral care knowledge, attitude and practice among nursing staff in acute hospital settings in Hong Kong. PLoS One 2023; 18:e0289953. [PMID: 37582111 PMCID: PMC10427009 DOI: 10.1371/journal.pone.0289953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 07/17/2023] [Indexed: 08/17/2023] Open
Abstract
Investigating the oral care delivered by nursing staff in acute hospital setting is having a remarkable shortage within the current literature. This was provoked due to lack of previous performed investigation in the acute hospital setting besides inconsistent existence of a standardized and comprehensive oral care knowledge, attitude and practice (KAP) instrumentation. Therefore, the purpose of this study is to assess the oral care KAP level for inpatients among nursing staff; to identify possible barriers to the provision of oral care; and to identify training preferences to improve the oral care of inpatients, in acute hospital settings in Hong Kong; and to provide standardized comprehensive KAP based assessment tool that would benefit and guide other future studies. In this study, a cross-sectional survey was conducted after a 55-item self-administered structured questionnaire was developed. A modified KAP tool was developed. The tool includes 4 domains: oral care knowledge, attitude, practice, and experience. Nursing staff was recruited from July 2018 to April 2019 via convenience sampling. Either online or printed questionnaires were completed. Proportions of nursing staff with good KAP, as defined by having 60% of the total score in the respective domain, were estimated with 95% confidence intervals (CI). Analysis of covariance was used to compare the mean scores of KAP among different independent variables and identify the factors associated with good KAP. 404 nursing staff were recruited. Approximately 29.5%, 33.7% and 14.9% of the respondents had good oral care knowledge, attitude and practice, respectively, and 53.2% of the respondents had unpleasant oral care experience. Better oral care practice was associated with higher levels of oral care knowledge (β = 0.1) and oral care attitude (β = 0.3). To conclude: nursing staff in acute hospital settings reported low levels of oral care KAP with variations between the RN, EN and HCA. This study adds to the literature the association between oral care unpleasant experiences and the oral care practice, as well as oral care knowledge and attitude which also in turns associated with practice. The developed standardised tool could be applied for future studies. Recommendations on the future research, training and practices were made.
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Affiliation(s)
- Pui Ki Tsui
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- Department of Childcare, Elderly and Community Services, Hong Kong Institute of Vocational Education (Sha Tin), Hong Kong Special Administrative Region, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Janet Yuen Ha Wong
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- School of Nursing & Health Studies, Hong Kong Metropolitan University, Hong Kong Special Administrative Region, Hong Kong, China
| | - Man Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Xiaoli Gao
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Otto Lok Tao Lam
- George & Fay Yee Centre for Healthcare Innovation, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Katherine Chiu Man Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Agnes Tiwari
- School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- School of Nursing, Hong Kong Sanatorium & Hospital Limited, Hong Kong Special Administrative Region, Hong Kong, China
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Janssens L, Petrauskiene E, Tsakos G, Janssens B. Clinical and Subjective Oral Health Status of Care Home Residents in Europe: A Systematic Review. J Am Med Dir Assoc 2023; 24:1013-1019.e40. [PMID: 37105236 DOI: 10.1016/j.jamda.2023.03.021] [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] [Received: 12/21/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Several studies demonstrated the poor oral health of care home residents in Europe but there is no systematic overview of the relevant literature. The objective of this study was to systematically review the evidence on the clinical and subjective oral health outcomes of care home residents in Europe. DESIGN The study design is a systematic review. METHODS AND PARTICIPANTS All included publications presented data on clinical and/or subjective oral health outcomes in care home residents in Europe with no restrictions for language or study design. MEDLINE, Embase, and CINAHL were searched, including publications from January 2010 onward. Data extraction and quality assessment (Qualsyst tool) was performed by 2 researchers independently. Findings were synthesized narratively, lack in data homogeneity restricted the relevance of a meta-analysis. RESULTS Eighty-three papers from 18 countries were included in the systematic review, with a sample size ranging from 39 to 92,827 participants. Their mean age was older than 80 years. The residents had few natural teeth, with fewer than a third a functional natural dentition. Removable dentures were present in half to 80% of residents. A high prevalence of dental caries was reported. Oral hygiene was insufficient, for both natural teeth and removable dentures. Few residents had a healthy periodontium. Clinical treatment needs were found in most residents. Perceived treatment needs were high with at least one-third of care home residents reporting a need for care due to poor oral health. A fifth to half of the residents reported negative impacts of their oral condition on their everyday lives. CONCLUSION AND IMPLICATIONS This systematic review clearly highlights the poor oral health and high burden of oral conditions among care home residents across Europe, irrespective of country or health care system. There is need for substantial policy actions to improve oral health in care homes.
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Affiliation(s)
- Lynn Janssens
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Gerodontology, Oral Health Sciences, Ghent University, Ghent, Belgium.
| | - Egle Petrauskiene
- UCL Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Georgios Tsakos
- UCL Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Barbara Janssens
- ELOHA (Equal Lifelong Oral Health for All) Research Group, Gerodontology, Oral Health Sciences, Ghent University, Ghent, Belgium
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Shirobe M, Edahiro A, Motokawa K, Morishita S, Ohara Y, Motohashi Y, Iwasaki M, Watanabe Y, Hirano H. Association between Dementia Severity and Oral Hygiene Management Issues in Older Adults with Alzheimer's Disease: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3841. [PMID: 36900852 PMCID: PMC10001667 DOI: 10.3390/ijerph20053841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Oral hygiene management issues vary across types and clinical stages of dementia. We aimed to clarify the issues related to oral hygiene management in older adults with Alzheimer's disease (AD) according to stages defined by the Functional Assessment Staging of Alzheimer's Disease (FAST). In all, 397 records (45 men and 352 women; average age, 86.8 years; age range, 65-106) from older adults with AD were used for the cross-sectional study. We used data from a cohort of older adults (≥65 years old) who required long-term care and lived in the Omorimachi area of Yokote City, Akita Prefecture, Japan. Multilevel logistic regression analysis was conducted to examine the associations of the FAST stage, set as the exposure variable, with oral hygiene management parameters set as outcome variables. Compared to the reference category (combined FAST stage 1-3), FAST stages 6 and 7 had significantly higher odds ratios for refusal of oral health care, dependence in performing oral health care, and rinsing and gargling disability. FAST stages 4 and 7 were associated with dental plaque accumulation. Oral health care for older adults with AD should be planned appropriately according to dementia severity.
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Affiliation(s)
- Maki Shirobe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Ayako Edahiro
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Shiho Morishita
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
- School of Health Sciences, Meikai University, 1 Meikai, Urayasu-shi, Chiba 279-8550, Japan
| | - Yuki Ohara
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Yoshiko Motohashi
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Masanori Iwasaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Yutaka Watanabe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
- Gerodontology, Department of Oral Health Science, Hokkaido University, Kita 13-jo Nishi 7-chome, Kita-ku, Sapporo-shi, Hokkaido 060-8586, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
- Dentistry and Oral Surgery, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
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Balwanth S, Singh S. Caregivers’ knowledge, attitudes, and oral health practices at long-term care facilities in KwaZulu-Natal. Health SA 2023; 28:2147. [PMID: 37064651 PMCID: PMC10091066 DOI: 10.4102/hsag.v28i0.2147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/15/2022] [Indexed: 02/05/2023] Open
Abstract
Background Vulnerable individuals residing at long-term care facilities require special oral health consideration. Examining concepts of oral health and hygiene practices of caregivers becomes essential for understanding the quality of oral health services provided to residents. Aim This study explored the oral health-related knowledge, attitudes and practices (KAP) of caregivers. Setting Long-term care facilities in the eThekwini District, KwaZulu-Natal. Methods A cross-sectional study was conducted at seven long-term care facilities among 188 caregivers who completed a self-administered questionnaire. Data were collated and analysed using the Statistical Package for the Social Sciences (SPSS) version 24. Inferential techniques included an analysis of variance (ANOVA) test. A p-value ≤ 0.05 was considered to be statistically significant. Results Participants reported that dentures do not to be cleaned (n = 139; 73.9%). Participants (n = 70; 37.2%) reported that some medications have oral side effects. Most participants (n = 173; 92%) were optimistic about improving their oral health knowledge and skills. Participants (n = 108; 57.4%) only reported flossing when they had food trapped between their teeth. Few participants (n = 30; 16%) reported visiting the dentist every 6 months. Conclusion Participants had a positive attitude to improve their oral health-related knowledge and practices. However, the study showed that there is a need to scale-up oral health education and training activities for caregivers. Contribution It is envisaged that findings of this study will demonstrate the importance of oral health-related knowledge among caregivers in providing better oral health care through improved attitudes and practices.
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Affiliation(s)
- Sonam Balwanth
- Discipline of Dentistry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Shenuka Singh
- Discipline of Dentistry, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Jonker M, Engelsma C, Manton DJ, Visser A. Decision-Making concerning Involuntary Oral Care for Older Individuals with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16655. [PMID: 36554537 PMCID: PMC9779801 DOI: 10.3390/ijerph192416655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
Many older individuals with dementia (OIWD) show care-resistant behavior for oral care. Providing care despite resistance is considered to be involuntary care. Although involuntary care should be minimized, in some OIWD it may be necessary to avoid health risks. This study aims to assess the attitudes of healthcare providers with regard to involuntary oral care provision for OIWD who show care-resistant behavior. An online questionnaire consisting of general questions and case specific questions was administered via social media and networking to individuals involved in the oral care of OIWD. A total of 309 participants were included in this study. The outcomes of the questionnaires were categorized per case. In all cases, a discrepancy was seen between the assessment of oral health problems as potentially harmful (range: 73.1-93.5%) and the willingness to provide involuntary care (range: 31.1-63.4%). Hence, many healthcare providers are aware of the subsequent potential health risks related to not providing care, but are still reluctant to provide involuntary oral care. Therefore, many OIWD who show care-resistant behavior potentially do not receive the necessary oral care they require.
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Affiliation(s)
- Maud Jonker
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
| | - Coos Engelsma
- Medical Ethics and Decision Making, Department of Ethics, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
| | - David J. Manton
- Department of Cariology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam and University of Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Anita Visser
- Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
- Department of Gerodontology, Faculty for Dentistry, Radboud University Medical Center, Radboud University Nijmegen, 6525 EX Nijmegen, The Netherlands
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Kang B, Pan W, Karel MJ, Corazzini KN, McConnell ES. Care rejection and aggression among veterans with dementia with and without posttraumatic stress disorder: A multi-group analysis. Int J Nurs Stud 2022; 135:104330. [DOI: 10.1016/j.ijnurstu.2022.104330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 06/16/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022]
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Snogren M, Pakpour AH, Eriksson I, Stensson M, Ek K, Browall M. Psychometric evaluation of a short-form version of the Swedish "Attitudes to and Knowledge of Oral Health" questionnaire. BMC Geriatr 2022; 22:513. [PMID: 35733123 PMCID: PMC9219230 DOI: 10.1186/s12877-022-03215-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 06/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare professionals' attitudes to and knowledge of oral health are fundamental to providing good oral health care to older adults. One instrument that assesses healthcare professionals' attitudes to and knowledge of oral health in a Swedish context is the "Attitudes to and Knowledge of Oral health" (AKO) questionnaire. Two of the three item-groups of the AKO have previously been validated in a Swedish context. However, it is crucial that all three item-groups are validated, and beneficial to design a shorter, easy-to-use questionnaire for healthcare professionals while maintaining adequate integrity of its reliability and validity. Therefore, the present study aims to develop a short-form version of AKO and to secure its psychometric properties. METHODS Psychometric evaluation with Classical Test Theory and Item Response Theory to validate and shorten AKO with 611 healthcare professionals from a population of 1159 working in a municipality in an urban area in western Sweden. RESULTS Of the original 16 items in the AKO, 13 were shown to warrant retention in the abbreviated/shortened form. These showed acceptable validity and reliability for assessing healthcare professionals' attitudes to and knowledge of oral health. CONCLUSION This validated short-form version of AKO shows acceptable validity and reliability after being reduced to 13 items, structured in a 3-part scale. The items are consistent with the total scale, indicating that the internal consistency is acceptable. Future studies should be performed to evaluate AKO in other groups of healthcare professionals, across cultures, languages, and so on, to investigate its use and strengthen its validity and reliability.
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Affiliation(s)
- Maria Snogren
- School of Health Sciences, University of Skövde, Skövde, Sweden. .,Research School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Amir H Pakpour
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Nursing, School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Irene Eriksson
- School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Malin Stensson
- Centre of Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Kristina Ek
- School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Maria Browall
- Department of Nursing, School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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13
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Jørgensen L, Pedersen B, Lerbæk B, Haslund-Thomsen H, Thorup CB, Albrechtsen MT, Jacobsen S, Nielsen MG, Kusk KH, Laugesen B, Voldbjerg SL, Grønkjær M, Bundgaard K. Nursing care during COVID-19 at non-COVID-19 hospital units: A qualitative study. NORDIC JOURNAL OF NURSING RESEARCH 2022; 42:101-108. [PMID: 35729941 PMCID: PMC9204132 DOI: 10.1177/20571585211047429] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 11/15/2022]
Abstract
The maintenance of physical distance, the absence of relatives and the relocation of registered nurses to COVID-19 units presumably affects nursing care at non-COVID-19 units. Using a qualitative design, this study explored registered nurses’ experiences of how COVID-19 influenced nursing care in non-COVID-19 units at a Danish university hospital during the first wave of the virus. The study is reported using the COREQ checklist. The analysis offered two findings: (1) the challenge of an increased workload for registered nurses remaining in non-COVID-19 units and (2) the difficulty of navigating the contradictory needs for both closeness to and distance from patients. The study concluded that several factors challenged nursing care in non-COVID-19 units during the COVID-19 pandemic. These may have decreased the amount of contact between patients and registered nurses, which may have contributed to a task-oriented approach to nursing care, leading to missed nursing care.
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Affiliation(s)
- Lone Jørgensen
- Clinic for Surgery and Cancer Treatment, Aalborg University Hospital, Aalborg, Denmark.,Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Birgith Pedersen
- Clinic for Surgery and Cancer Treatment, Aalborg University Hospital, Aalborg, Denmark.,Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Birgitte Lerbæk
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Clinic for Internal and Emergency Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Helle Haslund-Thomsen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinic for Anesthesiology, Children, Circulation and Women, Aalborg University Hospital, Aalborg, Denmark
| | - Charlotte Brun Thorup
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | | | - Sara Jacobsen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Marie Germund Nielsen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | | | - Britt Laugesen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Center for Clinical Guidelines, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Siri Lygum Voldbjerg
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Nursing Education, University College North Denmark, Aalborg, Denmark
| | - Mette Grønkjær
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Karin Bundgaard
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinic for Neuro-, Head and Orthopaedic Diseases, Aalborg University Hospital, Aalborg, Denmark
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14
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Edman K, Wårdh I. Oral health care beliefs among care personnel working with older people - follow up of oral care education provided by dental hygienists. Int J Dent Hyg 2022; 20:241-248. [PMID: 35090198 PMCID: PMC9303192 DOI: 10.1111/idh.12588] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/28/2021] [Accepted: 01/23/2022] [Indexed: 11/26/2022]
Abstract
Objectives The proportion of older people in the population is increasing rapidly. Along with this comes an increase in the number of people requiring assistance in daily living, including oral care. Swedish law stipulates that care personnel who work with older people should be offered oral health education every year. The aim of this study was to investigate oral health care beliefs among such personnel. Methods A questionnaire study was conducted among 2167 personnel providing care to older people at special accommodation sites and in home care. Data were collected using the Nursing Dental Coping Beliefs Scale. Descriptive statistics were calculated and logistic regression analysis was performed. Results Personnel working in home care had lower odds of having an internal locus of control than those working in special accommodation, and personnel with less than 10 years of working experience had lower odds than their more experienced counterparts. Men had higher odds of having an external locus of control than women. Conclusions It seems important to ensure that home care personnel and less experienced personnel attend oral care educational sessions, and to encourage male staff to focus on oral care work.
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Affiliation(s)
- Kristina Edman
- Oral and Maxillofacial Surgery, Department of Surgical Sciences, Medical Faculty, Uppsala University, Uppsala, Sweden; Center for Public Dental Services, Region Dalarna, Falun, Sweden; Center for Clinical Research, Uppsala University/Region Dalarna, Falun, Sweden
| | - Inger Wårdh
- Department of Dental Medicine and Academic Center for Geriatric Dentistry, Karolinska Institute, Stockholm, Sweden; Department of Health Sciences, Karlstad University, Karlstad, Sweden
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15
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Assessment of Knowledge, Attitude, and Practice of Iranian Nurses towards Toothbrush Maintenance and Use. Nurs Res Pract 2021; 2021:3694141. [PMID: 34950516 PMCID: PMC8692049 DOI: 10.1155/2021/3694141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/03/2021] [Indexed: 11/17/2022] Open
Abstract
Background Since nurses are considered a role model in society, they should have sufficient knowledge, attitude, and practice in the field of oral hygiene. This study was aimed to assess the nurses' knowledge, practice, and attitude towards toothbrush maintenance and use. Methods In this cross-sectional study, 325 nurses working in hospitals affiliated to Kermanshah University of Medical Sciences were randomly recruited. Data collection tools included a demographic information form and a researcher-made questionnaire on knowledge, attitude, and practice regarding toothbrush maintenance and use. Data were analyzed by SPSS software using descriptive and inferential statistics (Mann–Whitney U and Kruskal–Wallis H). Results The mean scores of nurses' knowledge, attitude, and practice were 59.2 ± 16.4, 64.2 ± 20.6, and 51.4 ± 17.0 out of 100, respectively. There was no statistically significant relation between nurses' knowledge, attitude, and practice and their gender, age, level of education, and work experience. Conclusions Nurses had moderate knowledge, attitude, and practice regarding toothbrush maintenance and use, which is not very desirable given their role model. Therefore, training courses are recommended to be held to increase the nurses' knowledge, attitude, and practice regarding toothbrush maintenance and use.
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16
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Oral Assessment and Preventive Actions within the Swedish Quality Register Senior Alert: Impact on Frail Older Adults' Oral Health in a Longitudinal Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413075. [PMID: 34948684 PMCID: PMC8701784 DOI: 10.3390/ijerph182413075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 12/24/2022]
Abstract
Poor oral health is common among older people in nursing homes. To identify and prevent oral health problems among the residents, ROAG-J (Revised Oral Assessment Guide–Jönköping), a risk-assessment instrument, is used by nursing staff routinely, and the outcome is registered in the web-based Swedish quality register Senior Alert. This study aims to investigate the preventive actions registered when oral health problems are identified and the effect of these actions longitudinally. ROAG-J data registered at nursing homes in Sweden during 2011–2016 were obtained from the Senior Alert database. Out of 52,740 residents (≥65 years), 41% had oral health problems, of whom 62% had preventive actions registered. The most common action was “Assistance with cleaning teeth”. Longitudinally, during the five-year observation period, a slight increase in oral health problems assessed with ROAG-J was found. Registered preventive actions, however, led to significant improvement in the subsequent assessment for the ROAG items lips, tongue, and dentures. Standardised risk assessments like ROAG-J provide an opportunity to detect problems early and establish preventive actions. The study, however, indicates a further need for structured education and a continuous follow-up in ROAG-J. Moreover, increased collaboration between nursing and dental care to improve oral health for older residents at nursing homes is needed.
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17
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Sigurdardottir AS, Geirsdottir OG, Ramel A, Arnadottir IB. Cross-sectional study of oral health care service, oral health beliefs and oral health care education of caregivers in nursing homes. Geriatr Nurs 2021; 43:138-145. [PMID: 34890954 DOI: 10.1016/j.gerinurse.2021.11.010] [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: 08/04/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess oral care beliefs and oral hygiene procedures among nursing home personnel to identify strengths and weaknesses in managing oral care. METHODS A cross-sectional study in two nursing homes using an oral health care questionnaire including the Nursing Dental Coping Belief Scale. RESULTS A total of 109 health personnel participated. Oral care was seldomly achieved twice a day and dental supplies were not guaranteed. Registered nurses found the oral health of residents more acceptable than did allied health personnel with less oral care education, who mostly delivered daily care. Conversely, nursing staff with oral care education had lower dental coping beliefs, suggesting a lack of self-reliance in controlling oral health outcomes. CONCLUSION Dental supplies should be part of nursing care equipment. Educational programs could increase positive oral health beliefs and enhance the quality of care in these settings, particularly among those who are accountable for oral care.
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Affiliation(s)
| | - Olof Gudny Geirsdottir
- Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Aragata 14, 101 Reykjavik, Iceland
| | - Alfons Ramel
- Faculty of Food Science and Nutrition, School of Health Sciences, University of Iceland, Aragata 14, 101 Reykjavik, Iceland
| | - Inga Bergmann Arnadottir
- Faculty of Odontology, School of Health Sciences, University of Iceland, Vatnsmyravegur 16, 101 Reykjavík, Iceland
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18
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Campagna S, Basso I, Vercelli E, Ranfone M, Dal Molin A, Dimonte V, Di Giulio P. Missed Nursing Care in a Sample of High-Dependency Italian Nursing Home Residents: Description of Nursing Care in Action. J Patient Saf 2021; 17:e1840-e1845. [PMID: 32168274 DOI: 10.1097/pts.0000000000000643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to describe omitted or delayed nursing care (i.e., missed nursing care [MNC]) in a sample of Italian nursing homes (NHs). METHODS Nurses from 50 NHs located in Northern Italy selected the 20 most dependent residents in their care and reported instances of MNC for three to five consecutive shifts. They described the type of MNC, its cause(s), management, recurrence, and severity of possible consequences for the resident. Information on the residents and the NH was also collected. The instances of MNC were classified as potentially avoidable/preventable or not. RESULTS Overall, 266 (85.3%) of 312 nurses participated and 1000 residents were observed during 381 shifts (164 mornings, 164 afternoons, and 53 nights); 101 (38%) nurses reported 223 instances of MNC among 175 residents (17.5%). Ninety-seven omissions and 109 delays occurred during the day shift (56 omissions were delegated to the next shift). The most frequent MNC was drug administration (n = 71, 34.5%). In 24 (44.4%) of 54 instances of delayed drug administration, the delay was less than 30 minutes. Nurses rated approximately 20% of MNC (n = 41) as highly severe because of the discomfort caused to the resident, the clinical impact, or the repetitiveness of the situation. Nurses ascribed almost half of MNC (n = 100, 48.5%) to inadequate staffing, and they categorized 26 (11.6%) instances of MNC as unavoidable. CONCLUSIONS The number of nurse-reported instances of MNC we reported was much lower than that previously collected with available instruments. Most MNC did not impact the comfort and safety of residents. A certain proportion of MNC was unavoidable.
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Affiliation(s)
- Sara Campagna
- From the Department of Public Health and Pediatrics, University of Torino, Torino
| | - Ines Basso
- From the Department of Public Health and Pediatrics, University of Torino, Torino
| | - Elisa Vercelli
- From the Department of Public Health and Pediatrics, University of Torino, Torino
| | - Marco Ranfone
- From the Department of Public Health and Pediatrics, University of Torino, Torino
| | - Alberto Dal Molin
- Department of Translational Medicine, University of Piemonte Orientale, Novara
| | | | - Paola Di Giulio
- From the Department of Public Health and Pediatrics, University of Torino, Torino
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19
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Oral hygiene and health-related quality of life in institutionalized older people. Eur Geriatr Med 2021; 13:213-220. [PMID: 34313976 PMCID: PMC8860786 DOI: 10.1007/s41999-021-00547-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/16/2021] [Indexed: 11/18/2022]
Abstract
Aim We evaluated oral hygiene level and its association with oral health and general health-related quality of life (HRQoL) among older residents in long-term care facilities. Findings Only one-fifth of residents had good oral hygiene. Poor oral hygiene was associated with poor oral health and diminished HRQoL. Message Oral hygiene, oral health, and HRQoL may be improved with oral care education of caregivers, professional cooperation, and regular oral healthcare of older residents in long-term care facilities. Purpose We evaluated the level of oral hygiene and its association with oral health status and need for oral treatment among older residents in long-term care facilities. In addition, the association between oral hygiene level and health-related quality of life (HRQoL) was explored. Methods This cross-sectional study assessed 231 dentate residents in long-term care facilities (71% female, mean age 81 years, 70% had dementia). Nurses assessed residents and completed questionnaires on participants’ background information, diagnoses, oral healthcare habits, and HRQoL with the 15D instrument. Two qualified dentists performed clinical oral examinations (number of teeth, plaque index, periodontal condition, open caries lesions, and dry mouth). We used a modified plaque index (PI) to measure the level of oral hygiene (good, moderate, and poor) and calculated the clinical Asymptotic Dental Score (ADS) to determine the oral inflammation burden. Results Of the residents, 21% had good, 35% moderate, and 44% poor oral hygiene according to PI. Poor oral hygiene was associated with poorer cognitive status (P = 0.010) and higher oral inflammation burden (P < 0.001). Moreover, poor oral hygiene was associated with poorer HRQoL in a correlation analysis adjusted for age and gender. Conclusions Oral hygiene of older individuals in long-term care is insufficient. Poor oral hygiene is a marker for poor HRQoL. Residents also have a high burden of oral inflammatory diseases and a need for dental care. Older residents’ oral hygiene and HRQoL may be improved with oral care education of caregivers and regular dental check-ups.
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20
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Kim B, Lee KH, Cho E, Kim H. Behaviors of care providers and resistiveness to oral care of persons living with dementia. Geriatr Nurs 2021; 42:915-918. [PMID: 34098445 DOI: 10.1016/j.gerinurse.2021.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
Abstract
Since care providers' behavior could be related to resistiveness to care (RTC) among persons living with dementia, developing care providers' behavioral strategies to reduce or prevent RTC is required. This study examined whether care providers' person-centered or task-centered behaviors were related to RTC. A secondary data analysis was conducted using 70 videos of 23 persons living with dementia who received routine oral care in long-term care settings. Data were analyzed using linear mixed models. Among task-centered behaviors, "physically controlling" significantly increased RTC. For person-centered behaviors, "cooperatively negotiating" increased RTC, while "assessing comfort" decreased RTC. Care providers need to consider the comfort or needs of persons living with dementia rather than physically controlling them in oral care situations. These findings may offer insight into the context of RTC occurrences to provide more comfortable oral care for persons living with dementia.
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Affiliation(s)
- Bora Kim
- Yonsei University College of Nursing, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea; Brain Korea 21 FOUR Project, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea
| | - Kyung Hee Lee
- Yonsei University College of Nursing, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea; Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea.
| | - Eunhee Cho
- Yonsei University College of Nursing, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea; Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea
| | - Heejung Kim
- Yonsei University College of Nursing, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea; Mo-Im Kim Nursing Research Institute, Yonsei University, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul 03722, Korea
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21
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Weening-Verbree LF, Schuller DAA, Cheung SL, Zuidema PDSU, Schans PDCPVD, Hobbelen DJSM. Barriers and facilitators of oral health care experienced by nursing home staff. Geriatr Nurs 2021; 42:799-805. [PMID: 34090223 DOI: 10.1016/j.gerinurse.2021.04.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/18/2022]
Abstract
Objectives to explore attitudes, perceptions, and perceived barriers to and the perceived facilitators of daily oral health care and the actual daily oral health care performances among nursing home staff. Methods A mixed methods study in 21 nursing homes was completed; a) questionnaires for nursing staff and managers; b) focus group interviews with nursing staff. Results 409 (21%) questionnaires were completed by nursing staff and 14 focus group interviews organized. Conclusions attitude was not a barrier in this study, while oral care was not performed according to guidelines. Nursing staff reported a lack of products, while toothbrushes are available. The most frequently mentioned barriers were lack of support of dental staff, oral care for clients with cognitive impairment, and a lack of education. Increasing facilitators could be; more (practical) education combined with tailored advice from internal dental staff. Where and on whom will the research have an impact? Nursing home staff, nursing home organizations/ managers and dental professionals working in nursing homes.
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Affiliation(s)
- Lina Francina Weening-Verbree
- Hanze University of Applied Sciences Groningen, Research group Healthy Ageing, Allied Health Care and Nursing, Groningen, Netherlands; Center for Dentistry and Oral Hygiene, University Medical Center Groningen, Netherlands; University of Groningen, Groningen, Netherlands.
| | - Dr Annemarie Adriana Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, Netherlands; University of Groningen, Groningen, Leiden, TNO, Netherlands
| | - Sie-Long Cheung
- Hanze University of Applied Sciences Groningen, Research group Healthy Ageing, Allied Health Care and Nursing, Groningen, Netherlands; Department of Health Psychology, University Medical Center Groningen, University of Groningen, Netherlands; Hanze University of Applied Sciences, Petrus Driessenstraat 3, Groningen 9714 CA, Netherlands
| | - Prof Dr Sytse Ulbe Zuidema
- University of Groningen, Groningen, Netherlands; Department of General Practice and Elderly Care Medicine, University Medical Center Groningen (UMCG), Groningen, Netherlands
| | - Prof Dr Cornelis P Van Der Schans
- Hanze University of Applied Sciences Groningen, Research group Healthy Ageing, Allied Health Care and Nursing, Groningen, Netherlands; Department of Health Psychology, University Medical Center Groningen, University of Groningen, Netherlands; Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Netherlands; Hanze University of Applied Sciences, Petrus Driessenstraat 3, Groningen 9714 CA, Netherlands
| | - Dr Johannes Simon Maria Hobbelen
- Hanze University of Applied Sciences Groningen, Research group Healthy Ageing, Allied Health Care and Nursing, Groningen, Netherlands; University of Groningen, Groningen, Netherlands; Hanze University of Applied Sciences, Petrus Driessenstraat 3, Groningen 9714 CA, Netherlands
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22
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Kang B, Pan W, Karel MJ, McConnell ES. Rejection of Care and Aggression among Older Veterans with Dementia: The Influence of Background Factors and Interpersonal Triggers. J Am Med Dir Assoc 2021; 22:1435-1441.e1. [PMID: 33939963 DOI: 10.1016/j.jamda.2021.03.032] [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: 03/04/2021] [Accepted: 03/27/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To test relationships among background factors, interpersonal triggers, rejection of care, and aggression among veterans living with dementia in residential long-term care settings, based on the need-driven dementia-compromised behavior model. DESIGN A mixed methods secondary analysis of program evaluation data from the Staff Training in Assisted Living Residences-Veterans Health Administration intervention implemented by the US Department of Veterans Affairs healthcare system. SETTING AND PARTICIPANTS In total, 315 older veterans who participated in the 2013‒2016 Staff Training in Assisted Living Residences-Veterans Health Administration program at 76 Community Living Centers (Veterans Affairs-operated nursing homes). METHODS Text data that captured the interdisciplinary team observations of distressed behaviors of concern and their circumstances were coded into categorical variables and then combined with existing quantitative data to test hypothesized relationships using structural equation modeling. RESULTS Rejection of care was directly affected by interpersonal triggers (β = 0.32, P < .005) and background factors such as depression (β = 0.29, P < .018), anxiety (β = -0.18, P < .023), and cognitive status (β = 0.10, P < .049). Depression also had an indirect effect on rejection of care through interpersonal triggers (α × β = 0.13 × 0.32 = 0.04, P < .012). Aggression was directly affected by both interpersonal triggers (β = 0.19, P < .009) and functional status (β = 0.17, P < .011). Both function (α × β = 0.12 × 0.19 = 0.02, P < .035) and depression (α × β = 0.13 × 0.19 = 0.03, P < .005) had indirect effects on aggression through interpersonal triggers. CONCLUSIONS AND IMPLICATIONS Interpersonal triggers influenced rejection of care and aggression in veterans with dementia. Background factors such as depression and severity of functional impairment increased the likelihood of these symptoms. Study findings emphasize the importance of developing and implementing interventions that improve interpersonal relationships and developing targeted interventions for those with depressive symptoms.
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Affiliation(s)
- Bada Kang
- Duke University School of Nursing, Durham, NC, USA; Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea.
| | - Wei Pan
- Duke University School of Nursing, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Michele J Karel
- Office of Mental Health and Suicide Prevention, Department of Veterans Affairs, Washington, DC, USA
| | - Eleanor S McConnell
- Duke University School of Nursing, Durham, NC, USA; Geriatric Research, Education and Clinical Center, Durham Department of Veterans Affairs Medical Center, Durham, NC, USA
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23
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Thapa R, Chimoriya R, Arora A. The development and psychometric properties of oral health assessment instruments used by non-dental professionals for nursing home residents: a systematic review. BMC Geriatr 2021; 21:35. [PMID: 33422009 PMCID: PMC7797120 DOI: 10.1186/s12877-020-01989-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 12/25/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Globally, oral health status of the geriatric population residing in nursing homes is poor. The integration of non-dental professionals is vital to monitor oral health, early identification and triaging of oral health problems, and timely referral to dental professionals. The aims of this systematic review were to provide a summary on the development and characteristics of oral health assessment instruments currently used by non-dental professionals for nursing home residents, and to perform a critical appraisal of their psychometric properties. METHODS This review was conducted as per the PRISMA guidelines. CINHAL (EBSCO), Medline (Ovid), and EMBASE (Ovid) were searched systematically. Two reviewers independently screened the title, abstract, and full text of the studies as per the eligibility criteria. Studies describing oral health assessment instruments used to assess oral health of nursing home residents by non-dental professionals were included. Using a methodological framework, each instrument was evaluated for purpose, content, and psychometric properties related to validity, reliability, feasibility, generalisability, and responsiveness. Additionally, the reporting quality assessment of each included study was performed according to the SURGE guidelines. RESULTS Out of the 819 screened articles, 10 studies were included in this review. The 10 identified instruments integrated 2 to 12 categories to assess oral health, which was scored on a 2 to 5-point scale. However, the measurement content varied widely, and none were able to comprehensively measure all aspects of oral health. Three measurement approaches were identified: performance- based assessment, direct inspection of the oral health status, and interview measures. Only eight instruments provided quality assessment on the basis of validity, reliability, feasibility and generalisability, whereas three instruments- Brief Oral Health Status Examination, Dental Hygiene Registration, and Oral Health Assessment Tool reported good methodological quality on at least one assessment criteria. CONCLUSIONS None of the instruments identified in this review provided a comprehensive assessment of oral health, while three instruments appeared to be valid and reliable. Nonetheless, continuous development of instruments is essential to embrace the complete spectrum of oral health and address the psychometric gaps.
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Affiliation(s)
- Rojina Thapa
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Ritesh Chimoriya
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
- School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, 2010, Australia.
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia.
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Konstantopoulou K, Kossioni A, Karkazis H, Polyzois G. Implementation and evaluation of an oral health education programme for caregivers in nursing homes. SPECIAL CARE IN DENTISTRY 2021; 41:154-163. [PMID: 33382125 DOI: 10.1111/scd.12558] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 11/30/2022]
Abstract
AIM The aim was the design, implementation, and evaluation of an oral health education program for nursing home caregivers. METHODS AND RESULTS Fifty-five formal caregivers working in the three units of a nursing home were allocated to either a control (n = 27) or an intervention group (n = 28). A knowledge and attitudes questionnaire about oral health was developed and completed by the caregivers. Then, an education program about oral heath in older people was applied to the intervention group, and the completion of the questionnaire was repeated by both the intervention and control groups. Two months after the intervention, the questionnaire was completed again by the intervention group. Within groups analyses revealed a statistically significant increase in knowledge and attitudes only in the intervention group after the implementation of the education program (P < .001). Between-group analyses showed that the total knowledge and attitudes score in the intervention group were statistically significantly higher than in the control group (P < .001 and P = .02, respectively). In the intervention group, knowledge and attitudes were maintained in the measurement recorded 2 months later (P = .11 and P = .21, respectively). CONCLUSION The education program was effective in improving the caregivers' knowledge and attitudes toward nursing home residents' oral health and maintaining them 2 months after implementation.
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Affiliation(s)
- Kalliopi Konstantopoulou
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastassia Kossioni
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Hercules Karkazis
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Gregory Polyzois
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Shirobe M, Hidaka R, Hirano H, Ohara Y, Endo K, Watanabe Y, Hakuta C. The effectiveness of a desensitization technique for mitigating oral and facial tactile hypersensitivity in institutionalized older persons: A randomized controlled trial. J Dent Sci 2020; 16:987-993. [PMID: 34141114 PMCID: PMC8189835 DOI: 10.1016/j.jds.2020.09.014] [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: 09/06/2020] [Revised: 09/23/2020] [Indexed: 11/17/2022] Open
Abstract
Background/purpose Oral health care provision in long-term care settings is often limited by specific behaviors exhibited by residents, which may be interpreted as a refusal of care. Such behaviors can be attributed to oral tactile hypersensitivity (TH), which is characterized by aberrations in the perception of oral stimuli. TH is also associated with a decline in ingestion and swallowing function. The purpose of this study was to examine the effectiveness of a technique for mitigating TH (TMH) among institutionalized older persons. Materials and methods In this study, 18 institutionalized older persons (Mean age, 90.6 ± 4.5 years; 92.9% females) with TH were randomized to a control group or an intervention group. Pre- and post-intervention assessments were conducted for seven participants in each group. Routine oral care was provided by the facility's staff in both groups. TMH in the intervention group was performed by a dental hygienist over a 3-month period. Results In the intervention group, the number of areas with TH was significantly reduced (P = 0.027). No significant change was observed in the control group. Conclusion The results of this study suggest that TMH can effectively mitigate TH. Our findings provide clinicians with an additional treatment option for hypersensitivity in older patients. Additional long-term studies with larger sample sizes are required to confirm the effectiveness of this technique.
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Affiliation(s)
- Maki Shirobe
- The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Rena Hidaka
- Department of Oral Health Sciences for Community Welfare, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Dentistry and Oral Surgery, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Yuki Ohara
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Keiko Endo
- Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yutaka Watanabe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
- Corresponding author. Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Kita 13, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8586, Japan. Fax: +81 11 706 4582.
| | - Chiyoko Hakuta
- Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
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Aagaard K, Meléndez‐Torres GJ, Overgaard C. Improving oral health in nursing home residents: A process evaluation of a shared oral care intervention. J Clin Nurs 2020; 29:3392-3402. [DOI: 10.1111/jocn.15373] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/25/2020] [Accepted: 05/24/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Karin Aagaard
- Department of Health Science and Technology, Public Health and Epidemiology Group Aalborg University Aalborg Øst Denmark
| | - G. J. Meléndez‐Torres
- Peninsula Technology Assessment Group College of Medicine and Health University of Exeter Exeter England
| | - Charlotte Overgaard
- Department of Health Science and Technology, Public Health and Epidemiology Group Aalborg University Aalborg Øst Denmark
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Chen R, Irving M, Clive Wright FA, Cunich M. An evaluation of health workforce models addressing oral health in residential aged care facilities: A systematic review of the literature. Gerodontology 2020; 37:222-232. [PMID: 32478960 DOI: 10.1111/ger.12475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 03/20/2020] [Accepted: 05/03/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND In Australia and globally, there is an increasing problem of unmet oral health needs of older people above 65 residing in aged care facilities. Various workforce models have been trialled to implement oral health care programmes in aged care facilities, but the evidence behind these programmes and their underlying workforce models is not known. OBJECTIVE To systematically review the literature on the effectiveness, and economic feasibility of the current workforce models addressing oral care in aged care facilities. METHODS CINAHL, Cochrane CENTRAL, MEDLINE, EMBASE, EMB Reviews, NHS Economic Evaluation Database and grey literature were searched. Studies were included if they described an oral health workforce model with a clinical intervention and defined oral health outcome measures. Analysis was conducted using the NHMRC guidelines for scientific and economic evaluations. RESULTS Twenty-eight studies were included. Four distinct workforce models of care were identified. 60% of the studies demonstrated short-term effectiveness in clinical measures. Workforce models were similar in their effectiveness, with varying levels of quality within each model. Although three studies considered individual components of economic feasibility, only one provided a comprehensive economic analysis of both the costs and health outcomes. CONCLUSIONS IMPLICATIONS OF FINDINGS All workforce models of care had some positive impact on oral health for residents of aged care. Oral health should be included as a health focus in age care facilities. Future studies should include longer-term health outcomes with rigorous economic analysis to ensure sustainably delivered workforce models of care for oral health management within aged care.
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Affiliation(s)
- Rebecca Chen
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Irving
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - F A Clive Wright
- Centre for Education and Research on Ageing, Concord Clinical School, University of Sydney, Aged Care and Rehabilitation, Concord Repatriation General Hospital, Sydney Local Health District, Concord, NSW, Australia
| | - Michelle Cunich
- Boden Collaboration for Obesity, Nutrition, Exercise & Eating Disorders, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Sydney Health Economics Collaborative, Sydney Local Health District, Camperdown, NSW, Australia
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Akifusa S, Liu HY, Huang MS, Funahara M, Izumi M, Harada K, Shono Y. Comparison of attitudes towards persons with dementia, knowledge of dementia and ageism amongst students in Taiwan and Japan: A cross-sectional study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:301-309. [PMID: 31967693 DOI: 10.1111/eje.12498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 06/10/2023]
Abstract
INTRODUCTION This study aimed to compare the attitudes towards people with dementia, knowledge of dementia and ageism amongst Taiwanese and Japanese dental hygiene students. MATERIAL AND METHODS A total of 328 students participated in this cross-sectional study. Attitudes, knowledge and ageism were assessed using self-reports. Participants' association with older adults or persons with dementia was also assessed. Primary outcomes included attitude, knowledge and ageism amongst students. Secondary outcomes were the factors related to their desire to work with persons with dementia. RESULTS Data of 175 Taiwanese and 91 Japanese students were analysed. There were significantly more Japanese (69.2%) than Taiwanese (33.2%) students without experience of cohabitation with older adults. More Taiwanese (45.1%) than Japanese students (30.8%) gave a neutral answer regarding their desire to work with persons with dementia. Japanese students scored significantly higher on the attitude and ageism scales than did Taiwanese students; however, the scores of knowledge assessment were approximately the same. Attitude or ageism did not correlate with knowledge amongst students from either country. Logistic regression analysis revealed that the desire to work with persons having dementia was related to ageism and the relationship with these people, irrespective of country. CONCLUSION Although the students had comparable levels of knowledge, there existed significant difference in the attitudes and the degree of ageism between students from Taiwan vs Japan. This finding may prompt improvement of education on dementia, where differences in nationality and lifestyle, including the rate of ageing and family structure, are taken into consideration.
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Affiliation(s)
- Sumio Akifusa
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Fukuoka, Japan
| | - Hsiu-Yueh Liu
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Kaohsiung, Taiwan
| | - Mao-Suan Huang
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Madoka Funahara
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Fukuoka, Japan
| | - Maya Izumi
- School of Oral Health Sciences, Faculty of Dentistry, Kyushu Dental University, Fukuoka, Japan
| | - Kazuaki Harada
- Faculty of Dentistry, Kyushu Dental University, Fukuoka, Japan
| | - Yasuo Shono
- Faculty of Dentistry, Kyushu Dental University, Fukuoka, Japan
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Botngård A, Eide AH, Mosqueda L, Malmedal W. Elder abuse in Norwegian nursing homes: a cross-sectional exploratory study. BMC Health Serv Res 2020; 20:9. [PMID: 31900138 PMCID: PMC6942332 DOI: 10.1186/s12913-019-4861-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/22/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Elder abuse is a global public health and human rights problem that is predicted to increase as many countries experience a rapid growth in their population of older adults. Elder abuse undermines an older person's well-being and is associated with a range of serious health consequences. In institutional care settings, older residents are particularly vulnerable and hence at higher risk of being abused, but few countries have explored the extent and nature of this phenomenon in national studies. The aim of this study is to estimate the prevalence of observed and perpetrated staff-to-resident abuse in Norwegian nursing homes. METHODS We conducted a cross-sectional exploratory study of nursing staff in 100 randomly drawn Norwegian nursing homes. Nursing staff completed a pen and paper survey measuring how often during the past year they had observed staff commit acts of neglect and psychological, physical, financial/material, and sexual abuse towards residents. They also reported how often they had perpetrated acts of abuse themselves, and these rates were disaggregated by nursing staff's gender, age and education. RESULTS Of 3693 nursing staff (response rate 60.1%), 76% had observed one or more incidents of elder abuse during the past year, and 60.3% reported they had perpetrated one or more incidents of abuse in the same period. Psychological abuse and neglect were most commonly reported. Male staff reported more acts of physical abuse, while female staff reported more acts of neglect. Higher education of staff was associated with higher rates of self-reported psychological abuse, physical abuse and neglect. CONCLUSIONS This first national survey of staff in Norwegian nursing homes is one of the largest studies globally estimating the prevalence of elder abuse in institutional settings. Overall, we found staff-to-resident abuse to be relatively common, and our findings propose a need for preventive strategies to improve the quality of life and safety of residents in Norwegian nursing homes.
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Affiliation(s)
- Anja Botngård
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Arne Henning Eide
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Health Research, SINTEF Digital, Oslo, Norway
| | - Laura Mosqueda
- Keck School of Medicine of University of Southern California, Los Angeles, USA
| | - Wenche Malmedal
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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Hoben M, Yoon MN, Lu L, Estabrooks CA. If we cannot measure it, we cannot improve it: Understanding measurement problems in routine oral/dental assessments in Canadian nursing homes-Part I. Gerodontology 2019; 37:153-163. [PMID: 31774205 DOI: 10.1111/ger.12449] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/26/2019] [Accepted: 10/26/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare Resident Assessment Instrument-Minimum Data Set 2.0 (RAI) oral/dental items collected by nursing home (NH) care staff to (a) assessments collected by trained research assistants (RAs) and (b) "gold standard" clinical assessments by dental hygienists (DHs). BACKGROUND Routine collection of RAI oral/dental items is mandatory in most Canadian NHs. However, the performance of these items is less than optimal and oral/dental problems are severely under-reported. Accurate assessment is a prerequisite for preventing, detecting and treating oral health problems. Not knowing the reasons for performance problems is a barrier to improving performance of the RAI oral/dental items. MATERIALS AND METHODS We included 103 NH residents from 4 NHs in Edmonton, Alberta, Canada. Using Kappa statistics, we compared the agreement of residents' last (no older than 90 days) RAI assessment with RAI assessments completed by trained RAs and "gold standard" clinical assessments by DHs. We also assessed the inter-rater reliability (IRR) of RA and DH assessments. RESULTS Care staff assessments had poor agreement with RA and DH assessments (Kappa < 0.2 for most items). RAs and DHs identified more oral/dental problems than care staff. However, IRR of RA assessments was low (Kappa < 0.7 for 7/9 items). IRR of DH assessments was acceptable (Kappa > 0.7) for most items. CONCLUSIONS The quality of RAI oral/dental assessments can be improved by better training care staff and ensuring appropriate time to do the assessments. However, remaining problems-even with trained RAs-suggest that rewording some of the items or supplementing them by more robust tools may be required.
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Affiliation(s)
- Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Minn N Yoon
- School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Lily Lu
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Oral Health Status and Need for Oral Care in an Aging Population: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224558. [PMID: 31752149 PMCID: PMC6888624 DOI: 10.3390/ijerph16224558] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 11/05/2019] [Accepted: 11/10/2019] [Indexed: 12/15/2022]
Abstract
Background. The world population is aging. This phenomenon is accompanied by an increase in the number of elderly with dementia, whose oral hygiene care is a challenge. Objective. This paper presents a literature review of oral health status and the need for oral care in people with dementia, as compared to people without dementia and also of the relationship between periodontal disease and cognitive impairment. Methods. A systematic review was conducted in PubMed, CINAHL, and the Cochrane Library. Fifty-six articles met the inclusion criteria and were consequently included for quality assessment and data extraction. Results. No significant differences were found between both groups with regard to the number of present teeth, DMFT Index, edentulousness/use of denture, and orofacial pain. Coronal/root caries and retained roots were more common in people with dementia than in those without dementia. Most of the participants with dementia presented gingival bleeding or inflammation and they suffered from the periodontal disease more than people without dementia. Conclusions. Poor oral health is a common condition among the elderly with dementia. The education process of caregivers might improve the oral health status of people with dementia. Finally, periodontal disease might contribute to the onset or progression of dementia.
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Johansson I, Torgé CJ, Lindmark U. Is an oral health coaching programme a way to sustain oral health for elderly people in nursing homes? A feasibility study. Int J Dent Hyg 2019; 18:107-115. [PMID: 31618518 DOI: 10.1111/idh.12421] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 07/30/2019] [Accepted: 10/12/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVES This study examines the feasibility of an oral health coaching programme involving practical support on individual level to staff in a nursing home in Sweden, aiming to improve oral health care-related beliefs of nursing staff and the oral health of residents. METHODS This intervention study consisted of three wards from one nursing home, and both staff (n = 48) and residents (n = 58) were invited. In the control ward, 9 staff and 16 residents participated; in test ward 1, 10 staff and 13 residents participated; and at test ward 2, 14 staff and 17 residents participated. An oral health coaching programme was performed 4 h/wk for 3 months. The staff completed the nursing Dental Coping Beliefs Scale at baseline and after 9 months. Oral health of the residents was assessed using the Revised Oral Assessment Guide and mucosal-plaque score at baseline and after 3, 6 and 9 months. RESULTS At baseline, 33 staff participated and 22 at 9 months follow-up. For the residents, the figures were 48 and 32, respectively. After the intervention, the nursing DCBS revealed changes related to usage of fluoride, oral health support, gum disease and approximal cleaning. The most frequently reported oral health problems among the residents pertained to teeth and gums. The residents' relatively high level of oral health was stable during the study period. CONCLUSIONS Despite limitations in the programme, an oral health coaching programme can support nursing staff in maintaining a high level of oral health in residents. The programme was shown feasible, although design improvements are needed.
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Affiliation(s)
- Isabelle Johansson
- The Research School of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Aging Research Network, Jönköping, Sweden
| | - Cristina Joy Torgé
- Aging Research Network, Jönköping, Sweden.,Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Ulrika Lindmark
- Aging Research Network, Jönköping, Sweden.,Department of Natural Science and Biomedicine, Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Aging and Oral Care: An Observational Study of Characteristics and Prevalence of Oral Diseases in an Italian Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193763. [PMID: 31591317 PMCID: PMC6801690 DOI: 10.3390/ijerph16193763] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 12/17/2022]
Abstract
Background: Poor oral health is a common condition in patients suffering from dementia. Several aspects of this systemic pathology contribute to causing oral problems: cognitive impairment, behavior disorders, communication and, motor skills deterioration, low levels of cooperation and medical-nursing staff incompetency in the dental field. Objectives: The objectives of this study were to evaluate the prevalence and the characteristics of oral pathology in a demented elderly population, as well as to check the association between the different degree of dementia and the oral health condition of each patient. Materials and Methods: In this observational study (with cross-sectional design) two groups of elderly patients suffering from dementia, living in two different residential care institutions were recruited. The diagnosis of dementia of each included patient was performed using the Clinical Dementia Rating Scale. In order to evaluate the oral health condition of the included subjects, each patient underwent a physical examination of the oral cavity, during which different clinical parameters were analyzed (number of remaining teeth, oral mucosa, periodontal tissues, bone crests). To each parameter, a score was assigned. Spearman’s Rho test was used. Results: Regarding the prevalence of oral pathology in elderly suffering from dementia, it emerged that 20.58% of the included patients had mucosal lesions and/or new mucosal formations (in most cases undiagnosed and therefore untreated). The prevalence of periodontal disease was equal to 82.35% and a marked clinically detectable reabsorption of bone crests was found in almost all patients (88.23%). 24.13% of patients, who underwent the oral examination, had totally edentulous maxillae and/or with retained roots, without prosthetic rehabilitations. The correlation index r showed the presence of a linear correlation (inverse relationship) between the degree of dementia and the state of health of the oral cavity of each patient. Conclusions: Several factors contribute to poor oral health in the elderly suffering from dementia: cognitive functions deterioration, behavioral disorders and inadequate medical-staff nursing training on oral hygiene. This study also demonstrated that the lower the dementia degree is, the lower tends to be the oral health status. In order to guarantee a complete assistance to these patients, residential care institutions should include in their healthcare program specific dental protocols.
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Abstract
AIM To explore the enablers and barriers perceived by community nurses in the promotion of oral health in an adult community trust directorate. BACKGROUND Oral health care promotion in community care settings is being neglected. England and Wales have witnessed marked improvements in periodontal disease; however, no improvements have been seen in older people. METHOD A qualitative methodology was employed, where eight nurses from Band 5 to 7 were interviewed using a semi-structured approach. The data was analysed thematically. FINDINGS Data analysis was organised into four themes: professional self-concept and the development of knowledge, skills and attitudes necessary in the promotion of oral health; the impact an organisation has on the promotion of oral health and an exploration of the enablers and barriers identified by the community nurses while delivering care; the relationships between the nurse and patient and the potential impact on oral health promotion; the concept of self-regard in relation to the promotion of oral health and its overall impact. A commitment to improving oral health and requests for additional educational input were apparent. Organisational enablers and barriers were identified, alongside the crucial role a positive self-regard for oral health care may play in the promotion of oral health. CONCLUSION Nurses need relevant education, organisational support, adequate resources and support from a multidisciplinary team to deliver optimal oral health promotion.
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Affiliation(s)
- Brendan Garry
- Clinical Teacher, Florence Nightingale Faculty of Nursing and Midwifery, King's College London
| | - Sue Boran
- Senior Fellow, Higher Education Academy, Course Director District Nursing, School of Health and Social Care, Department of Primary and Social Care, London South Bank University
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Barriers and facilitators for provision of oral health care in dependent older people: a systematic review. Clin Oral Investig 2019; 23:979-993. [PMID: 30707299 DOI: 10.1007/s00784-019-02812-4] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 01/11/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Provision of oral health care (OHC), including oral hygiene (OH) or oral/dental treatment, to dependent older people (DOP) is frequently insufficient. We aimed to assess barriers and facilitators perceived by different healthcare professionals towards providing OHC to DOP. MATERIALS AND METHODS A systematic review was performed. Studies reporting on knowledge, attitudes, and beliefs acting as barriers and facilitators for provision of OHC were included. One database (PubMed) was searched and data extraction independently performed by two reviewers. Thematic analysis was used and identified themes translated to the domains and constructs of the theoretical domains framework (TDF) and aligned with the domains of the behavior change wheel (BCW). Analyses were stratified for the two target behaviors (providing oral hygiene and providing oral/dental treatment) and according to different stakeholders' perspective. For quantitative analysis, frequency effect sizes (FES) were calculated. RESULTS In total, 1621 articles were identified and 41 (32 quantitative, 7 qualitative, 2 mixed method) studies included. Within these 41 studies, there were 7333 participants (4367 formal caregivers, 67 informal caregivers, 1100 managers of care, 1322 dentists, 340 DOP). Main barriers for providing OH were "lack of knowledge" (FES 65%, COM-B domain: capability, TDF domain: knowledge) and "patients refusing care" (62%, opportunity, environmental context and resources). Main facilitators were "OHC training/education" (41%, capability, skills) and "presence of a dental professional" (21%, opportunity, environmental context and resources). Main barriers for provision of dental treatment were "lack of suitable facilities for treatment/transportation of patients" (76%) and "patients refusing care" (53%) (both: opportunity, environmental context and resources). Main facilitators were "regular visiting dentist" (35%) and "routine assessment/increased awareness by staff" (35%) (both: opportunity, environmental context and resources). CONCLUSIONS A number of barriers and facilitators for providing different aspects of OHC were identified for different stakeholders. CLINICAL RELEVANCE Our findings help provide the evidence to develop implementation strategies for providing high-quality systematic OHC to DOP. REGISTRATION This review was registered at Prospero (CRD42017056078).
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Srinivasan M, Delavy J, Schimmel M, Duong S, Zekry D, Trombert V, Gold G, Müller F. Prevalence of oral hygiene tools amongst hospitalised elders: A cross‐sectional survey. Gerodontology 2019; 36:125-133. [DOI: 10.1111/ger.12388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 12/10/2018] [Accepted: 12/13/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
| | - Joris Delavy
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
- Division of Gerodontology University of Bern Bern Switzerland
| | - Stephan Duong
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
| | - Dina Zekry
- Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics Geneva University Hospitals Thônex Switzerland
| | - Veronique Trombert
- Department of Internal Medicine and Rehabilitation (Trois‐Chêne) Geneva University Hospitals Geneva Switzerland
| | - Gabriel Gold
- Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics Geneva University Hospitals Thônex Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine, University of Geneva Geneva Switzerland
- Service of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics Geneva University Hospitals Thônex Switzerland
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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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Rantzow V, Andersson P, Lindmark U. Occurrence of oral health problems and planned measures in dependent older people in nursing care. J Clin Nurs 2018; 27:4381-4389. [PMID: 29943858 DOI: 10.1111/jocn.14584] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 06/10/2018] [Accepted: 06/16/2018] [Indexed: 01/10/2023]
Abstract
AIMS AND OBJECTIVE To describe oral health problems and planned measures in older people receiving nursing care. BACKGROUND Poor oral health conditions have a negative impact on the quality of life of older people. Therefore, oral care is an important task in daily nursing activities. METHODS Data were obtained from the web-based Swedish national quality register Senior Alert. Data regarding oral health status and planned measures in individuals ≥65 years from one county in Sweden between July 2014-June 2015 were included. The Revised Oral Assessment Guide-the Jönköping (ROAG-J) was used routinely by nursing staff in nursing care facilities to measure oral health status. RESULTS Oral assessments were made on 2,567 individuals (65.7% women). The most common oral health problem was related to "Teeth" (43.0%), which indicates deficient oral hygiene and/or broken teeth. At least one measure was planned in all the participants. The most common planned measures were "Moistening of the mouth" (16.6%), followed by "Brushing - assistance or complete help" (13.5%). CONCLUSION Oral health problems were common, and planned measures did not seem to be sufficient to address the identified problems. The results indicate that greater priority should be given to the oral health care of older people in nursing care. RELEVANCE TO CLINICAL PRACTICE The study highlights the importance of not only identifying oral health problems but also having knowledge and strategies for oral health care. Collaboration is needed to support nurses in caring for the oral health care of older people in nursing homes.
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Affiliation(s)
| | - Pia Andersson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Ulrika Lindmark
- Department of Natural Science and Biomedicine, Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Aging Research Network - Jönköping (ARN-J), Jönköping, Sweden
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39
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Jablonski RA, Kolanowski AM, Azuero A, Winstead V, Jones-Townsend C, Geisinger ML. Randomised clinical trial: Efficacy of strategies to provide oral hygiene activities to nursing home residents with dementia who resist mouth care. Gerodontology 2018; 35:365-375. [PMID: 30004139 DOI: 10.1111/ger.12357] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The purpose of this study was to test the efficacy of MOUTh (Managing Oral Hygiene Using Threat Reduction), a nonpharmacologic, relationship-based intervention vs. control on 2 primary outcomes for nursing home (NH) residents with dementia who resisted mouth care: (i) reduction in the occurrence and intensity of care-resistant behaviours (CRBs) and (ii) improvement in oral health. Two secondary outcomes were also examined: (i) the duration of mouth care and (ii) the completion of oral hygiene activities. BACKGROUND Persons with dementia who exhibit CRBs are at risk for inadequate mouth care and subsequent systemic illnesses. MATERIALS AND METHODS The study used a randomised repeated measures design. Recruitment occurred in 9 nursing homes that varied in size, ownership, reimbursement patterns and location. One hundred and one nursing home residents with dementia were randomised at the individual level to experimental (n = 55) or control groups (n = 46). One hundred participants provided data for the analyses. RESULTS Compared to the control group, persons in the experimental group had twice the odds of allowing mouth care and completing oral hygiene activities; they also allowed longer duration of mouth care (d = 0.56), but showed only small reductions in the intensity of CRBs (d = 0.16) and small differential improvements in oral health (d = 0.18). CONCLUSION The data suggest that this intervention facilitates mouth care among persons with dementia. The management of refusal behaviour may be a clinically more realistic approach than reducing or eradicating refusals.
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Affiliation(s)
- Rita A Jablonski
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.,Memory Disorders Clinic, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ann M Kolanowski
- College of Nursing, The Pennsylvania State University, University Park, PA, USA
| | - Andres Azuero
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Vicki Winstead
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Maria L Geisinger
- School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA
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40
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Yoon MN, Ickert C, Slaughter SE, Lengyel C, Carrier N, Keller H. Oral health status of long-term care residents in Canada: Results of a national cross-sectional study. Gerodontology 2018; 35:359-364. [PMID: 29993140 DOI: 10.1111/ger.12356] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the oral health and oral prosthetic status of long-term care residents in four Canadian provinces. BACKGROUND Oral health can have significant impact on the health and quality of life of older adults. Seniors in long-term care are highly dependent on care staff for basic activities of daily living and are at risk for poor oral health. MATERIALS AND METHODS Five hundred and fifty-nine randomly selected residents were examined from thirty-two long-term care homes in Alberta, Manitoba, Ontario and New Brunswick, Canada. Four experienced registered dental hygienists, one in each province, completed a standardised oral health examination with each participant, examining lip health, breath odour, saliva appearance, natural teeth count, gingival inflammation, tooth and jaw pain, denture status, mucosal status and oral health abnormalities. RESULTS Of the examined residents, 57.6% were dentate, with an average of 16.4 (SD = 8.0) teeth. Most dentate residents had moderate or severe inflammation on at least one tooth (79.6%). Sixty per cent of residents wore dentures, and 43.2% of edentulous residents had poor hygiene of their dentures. Nine per cent of residents required urgent dental treatment for oral health problems such as broken teeth, infection, severe decay and ulcers. CONCLUSION This study provides an estimate of the prevalence of oral health problems in residents living in long-term care homes across Canada and indicates that improvement in oral health care is needed. Future work on development strategies aimed at optimising oral health for long-term care residents is required.
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Affiliation(s)
- Minn N Yoon
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Carla Ickert
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Susan E Slaughter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Christina Lengyel
- Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Natalie Carrier
- École des Sciences des Aliments, de Nutrition et d'études Familiales, Faculté des Sciences de la Santé et des Services Communautaires, Université de Moncton, Moncton, New Brunswick, Canada
| | - Heather Keller
- Research Institute for Aging, Schlegel-University of Waterloo, Waterloo, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
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Lyons M, Smith C, Boaden E, Brady MC, Brocklehurst P, Dickinson H, Hamdy S, Higham S, Langhorne P, Lightbody C, McCracken G, Medina-Lara A, Sproson L, Walls A, Watkins DC. Oral care after stroke: Where are we now? Eur Stroke J 2018; 3:347-354. [PMID: 31236482 DOI: 10.1177/2396987318775206] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 04/12/2018] [Indexed: 01/25/2023] Open
Abstract
Purpose There appears to be an association between poor oral hygiene and increased risk of aspiration pneumonia - a leading cause of mortality post-stroke. We aim to synthesise what is known about oral care after stroke, identify knowledge gaps and outline priorities for research that will provide evidence to inform best practice. Methods A narrative review from a multidisciplinary perspective, drawing on evidence from systematic reviews, literature, expert and lay opinion to scrutinise current practice in oral care after a stroke and seek consensus on research priorities.Findings: Oral care tends to be of poor quality and delegated to the least qualified members of the caring team. Nursing staff often work in a pressured environment where other aspects of clinical care take priority. Guidelines that exist are based on weak evidence and lack detail about how best to provide oral care. Discussion Oral health after a stroke is important from a social as well as physical health perspective, yet tends to be neglected. Multidisciplinary research is needed to improve understanding of the complexities associated with delivering good oral care for stroke patients. Also to provide the evidence for practice that will improve wellbeing and may reduce risk of aspiration pneumonia and other serious sequelae. Conclusion Although there is evidence of an association, there is only weak evidence about whether improving oral care reduces risk of pneumonia or mortality after a stroke. Clinically relevant, feasible, cost-effective, evidence-based oral care interventions to improve patient outcomes in stroke care are urgently needed.
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Affiliation(s)
- Mary Lyons
- Faculty of Health and Wellbeing, University of Central Lancashire, UK.,Department of International Public Health, Liverpool School of Tropical Medicine, UK
| | - Craig Smith
- Division of Cardiovascular Sciences, Manchester Academic Health Science Centre, University of Manchester, UK.,Department of Neurosciences, Salford Royal NHS Foundation Trust, UK
| | - Elizabeth Boaden
- Faculty of Health and Wellbeing, University of Central Lancashire, UK
| | - Marian C Brady
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, UK
| | - Paul Brocklehurst
- North Wales Organisation for Randomised Trials in Health, Bangor Institute of Health and Medical Research and Salford Royal NHS Foundation Trust, UK
| | - Hazel Dickinson
- Faculty of Health and Wellbeing, University of Central Lancashire, UK
| | - Shaheen Hamdy
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Susan Higham
- Institute of Psychology, Health and Society, University of Liverpool, UK
| | - Peter Langhorne
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, UK
| | | | - Giles McCracken
- Centre for Oral Health Research, School of Dental Sciences, Newcastle University, UK
| | | | - Lise Sproson
- National Institute for Health Research Devices for Dignity Healthcare Technology Cooperative, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - Angus Walls
- Edinburgh Dental Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, UK
| | - Dame Caroline Watkins
- Faculty of Health and Wellbeing, University of Central Lancashire, UK.,Faculty of Health Sciences, Australian Catholic University, Australia
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Fjeld KG, Eide H, Mowe M, Sandvik L, Willumsen T. A 1-year follow-up of a randomized clinical trial with focus on manual and electric toothbrushes' effect on dental hygiene in nursing homes. Acta Odontol Scand 2018; 76:257-261. [PMID: 29239260 DOI: 10.1080/00016357.2017.1416166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE A 2-month randomized clinical trial (RCT) study comparing electric and manual toothbrushes used by residents in nursing homes showed significant reduction in plaque score for both groups. The aim of this follow up study was to study if the effect sustained in a longer perspective when toothbrushes were used according to resident's own preference. MATERIALS AND METHODS One year after baseline of the RCT-study, 100 participants were re-examined. The simplified oral hygiene index (OHI-S) was used as outcome measure on dental plaque. RESULTS The mean age was 86.6, 78.1% had three or more medical diagnoses and 52.2% had moderate to severe cognitive impairment. The mean number of natural teeth was 18.8. After 1 year, mean plaque scores was significantly reduced within the population, from 1.2 to 0.7 (p < .001). A total of 46 participants preferred to use an electric toothbrush and 54 preferred manual. No significant difference in plaque score was found between electric and manual toothbrushes. CONCLUSION After 1 year, the improvement in dental hygiene from the RCT study sustained for users of both electric and manual toothbrush. Focus upon tooth brushing seems to be efficient and both manual and electric toothbrushes should be available in nursing homes.
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Affiliation(s)
- Katrine Gahre Fjeld
- Department of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Hilde Eide
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University College of Southeast-Norway, Drammen, Norway
| | - Morten Mowe
- Medical Clinic, Oslo University Hospital and Inst. Clinical Medicine, University of Oslo, Oslo, Norway
| | - Leiv Sandvik
- Department of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Tiril Willumsen
- Department of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
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McAnulla A, Reid B, Zieba M. Developing an integrated resource to promote oral health in nursing homes. Nurs Older People 2018; 30:25-28. [PMID: 29480656 DOI: 10.7748/nop.2018.e1019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2018] [Indexed: 11/09/2022]
Abstract
Public health is the responsibility of every nurse and nursing practice should adopt a life course approach to the promotion of health and well-being. This approach requires a renewed focus on health promotion interventions aimed at older people, including those resident in nursing homes. The oral health status of older people in nursing homes has been reported as suboptimal, predisposing them to poorer health-related quality of life. Interventions focusing on knowledge and behaviours related to oral health management for nurses, other caregivers and older people have the potential to improve the provision of oral care. This article discusses a project undertaken by a team of preregistration nursing students to plan and develop an integrated oral health promotion resource for older people in nursing homes. Healthy Smile, Healthy Me comprises a poster called five steps for oral hygiene and an oral health box. Initial feedback from a pilot of the resource in a nursing home is encouraging and research is planned to explore the feasibility, acceptability and efficacy of the resource.
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Affiliation(s)
| | - Bernie Reid
- School of Nursing, Ulster University, Northern Ireland
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Widström E, Tillberg A, Byrkjeflot LI, Stein L, Skudutyte-Rysstad R. Community-based preventive activities in the Public Dental Service in Norway. Int J Dent Hyg 2017; 16:e112-e119. [PMID: 29235237 DOI: 10.1111/idh.12326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of this study was to describe community-based preventive interventions undertaken by the dental team outside the dental clinics in Norway, from the dental hygienists' and the dentists' perspective, with the main focus on target groups and existing guidelines and routines for these activities. A secondary aim was to identify the personnel responsible for developing the local guidelines and the knowledge sources for the guidelines. METHODS With the assistance of the Chief Dental Officers in 15 Public Dental Service (PDS) regions, questionnaires were emailed to the local clinics (n = 421). In each, the most experienced dental hygienist and dentist were asked to respond; 215 dentists and 166 and dental hygienists responded (60%). RESULTS Almost 40% of the respondents reported that their clinic had guidelines on community-based activities conducted outside the clinics. Dental hygienists and local chief dentists were responsible for planning them. The main target groups were young children and the dependent elderly; the majority of the activities were carried out at child welfare centres and for personnel at nursing homes or for home care nurses. CONCLUSION At the regional and local level, a more strategic and coordinated approach to the provision of community-based activities is needed, including assessment of oral health needs among population groups. Continuous documentation and evaluation of results are necessary for optimal use of available resources and to facilitate an evidence-based approach.
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Affiliation(s)
- E Widström
- Department of Clinical Dentistry, UiT The Arctic University of Norway, Tromsø, Norway.,National Institute for Health and Welfare (THL), Helsinki, Finland
| | - A Tillberg
- Department of Clinical Dentistry, UiT The Arctic University of Norway, Tromsø, Norway.,The Public Dental Health Service Competence Centre for Northern Norway, Tromsø, Norway
| | - L I Byrkjeflot
- Department of Clinical Dentistry, UiT The Arctic University of Norway, Tromsø, Norway
| | - L Stein
- Department of Clinical Dentistry, UiT The Arctic University of Norway, Tromsø, Norway
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45
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Choi JS, Yi YJ, Donnelly LR. Oral health of older residents in care and community dwellers: nursing implications. Int Nurs Rev 2017; 64:602-609. [PMID: 29034970 DOI: 10.1111/inr.12417] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Poor oral health is associated with a reduced quality of life and serious illnesses. Consequently, nurses need to be more aware of oral health to improve the general health of residents in care. AIM To evaluate and compare oral health behaviours and levels of salivary haemoglobin and dental biofilm acidogenicity, which can be used to evaluate oral disease activity, between residents and community dwellers in South Korea. METHODS This cross-sectional study included 133 participants: 64 residents and 69 community dwellers. All participants completed a questionnaire and tests to measure their salivary haemoglobin and dental biofilm acidogenicity. RESULTS A higher percentage of community dwellers than of residents brushed their teeth three times a day, cleaned their tongue, used interdental cleaning devices and had visited a dental clinic within 1 year. The levels of salivary haemoglobin and dental biofilm acidogenicity tended to be higher in residents than in community dwellers. CONCLUSION Residents showed poorer oral health behaviours and higher levels of gingival bleeding and acid production by oral bacteria than did community dwellers. IMPLICATIONS FOR NURSING PRACTICE Nursing staff should enhance their monitoring of oral hygiene status and provide quality oral care to residents through cooperation with dental professionals. IMPLICATIONS FOR NURSING AND HEALTH POLICY Policymakers should be aware that oral health is an essential component of improving general health and well-being and therefore strive to develop policies to promote oral care services provided to residents. Nursing policies, such as mandating oral care and hands-on training in oral care for nursing staff, are important. We also suggest that factors related to oral care be added to the establishment or accreditation standards of care facilities.
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Affiliation(s)
- J S Choi
- College of Health Science, Gachon University, Incheon, Korea
| | - Y J Yi
- College of Nursing, Gachon University, Incheon, Korea
| | - L R Donnelly
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
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Deutsch A, Siegel E, Cations M, Wright C, Naganathan V, Brodaty H. A pilot study on the feasibility of training nurses to formulate multicomponent oral health interventions in a residential aged care facility. Gerodontology 2017; 34:469-478. [PMID: 28836301 DOI: 10.1111/ger.12295] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVES This 10 weeks feasibility study investigated whether residential care nurses with 12 hours advanced oral health training in assessments and saliva testing could formulate, implement and monitor individualised oral care plans of early dementia residents. METHOD Four trained lead advocate nurses using SXI-D, OHIP14, oral health assessment tool (OHAT) assessments and a modified saliva test formulated nurse scheduled comprehensive oral care plans (NSCOCPs) by selecting and scheduling preventive products and procedures multiple times throughout the day to alkalise the mouth of 8 residents as an adjunct to assisted brushing and high-fluoride toothpaste. RESULTS Nurse assessments, saliva tests and care plans were validated against oral health therapist (OHT) findings. Care plan agreement between Nurse and OHT intervention selection and scheduling was high (75%-88%). Untrained nurse compliance was very high, 86%-99% for the 4930 scheduled interventions. Untrained nurses delivered multiple scheduled interventions by following NSCOCPs despite initially not understanding the reason for each of 9 interventions categories. NSCOCPs could track and monitor whether a recommended intervention had been completed by general nursing staff over 3 nursing shifts. CONCLUSION The role of nurses may have to be expanded beyond traditional roles to meet the growth and changes in oral health needs in residential facilities. Intensive training of a few lead advocate nurses to assess risk and formulate individualised NSCOCPs provides a method to transfer knowledge to untrained staff and deliver multicomponent preventive interventions soon after entry into residential care where timely visits by dental professionals to examine residents and prescribe preventive interventions are infrequent or unlikely.
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Affiliation(s)
- Alan Deutsch
- Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia
| | - Emma Siegel
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Monica Cations
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Clive Wright
- Centre for Education and Research on Ageing, Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, University of Sydney, Concord, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia
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Oral Health Status of Older Adults in Sweden Receiving Elder Care: Findings From Nursing Assessments. Nurs Res 2017; 65:215-23. [PMID: 27124257 DOI: 10.1097/nnr.0000000000000158] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Frail elderly people often have poor oral hygiene, contributing to oral health problems that can detract significantly from quality of life. OBJECTIVE The aim of this study was to describe oral health status of frail elderly individuals using the Revised Oral Assessment Guide-Jönköping (ROAG-J), a mouth assessment instrument that can be used in daily nursing care. METHODS Data were obtained from the Swedish Senior Alert quality registry in one Swedish municipality. ROAG-J assessments on admission to elder care and one subsequent occasion were used. ROAG-J measurements documented oral health in nine areas: voice, lips, oral mucosa, tongue, gums, teeth, saliva, swallowing, and presence of any prostheses or implants. Assessments were made by nursing staff during the course of daily nursing care. RESULTS Individuals 65 years of age or older and receiving elder care services (N = 667) were involved; 1,904 assessments made between November 2011 and March 2014 were used for the analysis. On the basis of both assessments, less than one third of participants had oral health problems. No significant difference in any of the oral health variables was found between first and subsequent assessments. At first assessment, men and women differed in tongue health (p < .01); at the subsequent assessment, gender differences in voice (p < .05), mucous membranes (p < .003), tongue (p < .01), and saliva (p < .006) were observed. DISCUSSION Most participants had good oral health. Assessments made by nursing staff using the ROAG-J demonstrate that this tool can be used in daily nursing care, where different, important oral conditions may be encountered. However, knowledge about oral health conditions and the ROAG-J instrument is important to ensure high validity. The ROAG-J enables nursing staff to detect problems in the mouth and to guide decisions related to oral health interventions.
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Hoben M, Clarke A, Huynh KT, Kobagi N, Kent A, Hu H, Pereira RAC, Xiong T, Yu K, Xiang H, Yoon MN. Barriers and facilitators in providing oral care to nursing home residents, from the perspective of care aides: A systematic review and meta-analysis. Int J Nurs Stud 2017; 73:34-51. [PMID: 28531550 DOI: 10.1016/j.ijnurstu.2017.05.003] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 04/30/2017] [Accepted: 05/08/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Oral health of nursing home residents is generally poor, with severe consequences for residents' general health and quality of life and for the health care system. Care aides in nursing homes provide up to 80% of direct care (including oral care) to residents, but providing oral care is often challenging. Interventions to improve oral care must tailor to identified barriers and facilitators to be effective. This review identifies and synthesizes the evidence on barriers and facilitators care aides perceive in providing oral care to nursing home residents. METHODS We systematically searched the databases MEDLINE, Embase, Evidence Based Reviews-Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. We also searched by hand the contents of key journals, publications of key authors, and reference lists of all studies included. We included qualitative and quantitative research studies that assess barriers and facilitators, as perceived by care aides, to providing oral care to nursing home residents. We conducted a thematic analysis of barriers and facilitators, extracted prevalence of care aides reporting certain barriers and facilitators from studies reporting quantitative data, and conducted random-effects meta-analyses of prevalence. RESULTS We included 45 references that represent 41 unique studies: 15 cross-sectional studies, 13 qualitative studies, 7 mixed methods studies, 3 one-group pre-post studies, and 3 randomized controlled trials. Methodological quality was generally weak. We identified barriers and facilitators related to residents, their family members, care providers, organization of care services, and social interactions. Pooled estimates (95% confidence intervals) of barriers were: residents resisting care=45% (15%-77%); care providers' lack of knowledge, education or training in providing oral care=24% (7%-47%); general difficulties in providing oral care=26% (19%-33%); lack of time=31% (17%-47%); general dislike of oral care=19% (8%-33%); and lack of staff=22% (13%-31%). CONCLUSIONS We found a lack of robust evidence on barriers and facilitators that care aides perceive in providing oral care to nursing home residents, suggesting a need for robust research studies in this area. Effective strategies to overcome barriers and to increase facilitators in providing oral care are one of the most critical research gaps in the area of improving oral care for nursing home residents. Strategies to prevent or manage residents' responsive behaviors and to improve care aides' oral care knowledge are especially needed.
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Affiliation(s)
- Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - Alix Clarke
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| | - Kha Tu Huynh
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - Nadia Kobagi
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
| | - Angelle Kent
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
| | - Huimin Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | | | - Tianyuan Xiong
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Kexin Yu
- Department of Psychology and Behavioral Sciences, Zhejiang University, Hangzhou, Zhejiang, China.
| | - Hongjin Xiang
- Ultrasound Department, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
| | - Minn N Yoon
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
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Effect of an oral healthcare programme on care staff knowledge and attitude regarding oral health: a non-randomised intervention trial. Clin Oral Investig 2017; 22:281-292. [DOI: 10.1007/s00784-017-2110-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 03/20/2017] [Indexed: 10/19/2022]
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50
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Jablonski-Jaudon RA, Kolanowski AM, Winstead V, Jones-Townsend C, Azuero A. Maturation of the MOUTh Intervention: From Reducing Threat to Relationship-Centered Care. J Gerontol Nurs 2017; 42:15-23; quiz 24-5. [PMID: 26934969 DOI: 10.3928/00989134-20160212-05] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/14/2016] [Indexed: 11/20/2022]
Abstract
The purpose of the current article is to describe a personalized practice originally conceived as a way to prevent and minimize care-resistant behavior to provide mouth care to older adults with dementia. The original intervention, Managing Oral Hygiene Using Threat Reduction Strategies (MOUTh), matured during the clinical trial study into a relationship-centered intervention, with emphasis on developing strategies that support residents' behavioral health and staff involved in care. Relationships that were initially pragmatic (i.e., focused on the task of completing mouth care) developed into more personal and responsive relationships that involved deeper engagement between mouth care providers and nursing home (NH) residents. Mouth care was accomplished and completed in a manner enjoyable to NH residents and mouth care providers. The MOUTh intervention may also concurrently affirm the dignity and personhood of the care recipient because of its emphasis on connecting with older adults.
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