1
|
Snogren M, Ek K, Browall M, Eriksson I, Lindmark U. Impacts on oral health attitude and knowledge after completing a digital training module among Swedish healthcare professionals working with older adults. BMC Health Serv Res 2024; 24:174. [PMID: 38326878 PMCID: PMC10851574 DOI: 10.1186/s12913-024-10639-3] [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: 06/20/2023] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Abstract
Oral health care is essential, and digital training may influence healthcare professionals' attitudes to and knowledge of oral health. The aim, therefore, was to evaluate the impact on attitudes to and knowledge of oral health after using a digital training module among Swedish healthcare professionals working within a municipality-run healthcare service for older adults. A secondary aim was to explore the healthcare professionals' experiences of using the digital module. The study comprised a survey of healthcare professionals (registered nurses (RNs), assistant nurses, and care assistants) caring for older adults in a municipality in Sweden. Pre-post-tests were conducted to evaluate the outcomes for attitudes to and knowledge of oral health and of their experiences of completing the digital training module in oral health. These were statistically explored by comparing differences between the pre-post-tests, while the open-ended questions were analysed with qualitative content analysis. The findings of this study indicate that healthcare professionals had similar perceptions of their attitudes to and knowledge of oral health both before and after the digital training module in oral health. The study also indicates that healthcare professionals experienced that it is easier to perform practical oral health care after completing the digital training. The results also show that healthcare professionals value oral health knowledge and that the digital training module was easy to use and to disseminate knowledge throughout the municipality. The findings have implications for developing, implementing, and promoting healthcare professionals' attitudes to and knowledge of oral health and in using a digital training module in combination with practical exercises in oral health in municipality health care.
Collapse
Affiliation(s)
- Maria Snogren
- School of Health Sciences, University of Skövde, Högskolevägen, 541 28, Skövde, Box 408, Sweden.
- Research School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Kristina Ek
- School of Health Sciences, University of Skövde, Högskolevägen, 541 28, Skövde, Box 408, Sweden
| | - Maria Browall
- Department of Nursing, School of Health and Welfare, Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
- Affiliated with the Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Irene Eriksson
- School of Health Sciences, University of Skövde, Högskolevägen, 541 28, Skövde, Box 408, Sweden
| | - Ulrika Lindmark
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| |
Collapse
|
2
|
Bashirian S, Khoshravesh S, Ayubi E, Karimi-Shahanjarini A, Shirahmadi S, Solaymani PF. The impact of health education interventions on oral health promotion among older people: a systematic review. BMC Geriatr 2023; 23:548. [PMID: 37697260 PMCID: PMC10494401 DOI: 10.1186/s12877-023-04259-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/27/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND One of the most common pathologic changes in older people is oral and dental problems. The oral health of older people is a public health concern. Promotion of good oral health for this cohort will have beneficial impacts on the longer-term quality of life. This study aimed to identify the types of health education interventions for the oral health of older people and to determine their effects on the oral and dental health of older people. METHODS Potential articles were retrieved from four electronic databases (PubMed/Medline, Scopus, Web of Sciences, and Embase) up to 31 September 2022 in English without limit of time. Experimental and quasi-experimental interventional studies investigating the impact of educational interventions on oral and dental health among older people over 60 years old in both sexes were considered. The quality assessment tool was the Effective Public Health Practice Project (EPHPP). RESULTS In the initial search, 1104 articles were retrieved. Finally, according to the inclusion criteria, 23 studies (seventeen randomized controlled trials (RCT) and six quasi-experimental studies) were reviewed. In this review, educational interventions for older people and their caregivers are classified. Theoretical frameworks were used in only three interventions related to older people. Outcome measures were both self-reported and objective measures. Fifteen of the included studies were of moderate quality. CONCLUSION This review provides evidence that the use of oral and dental health educational interventions was effective in improving the oral health of older people. Educational interventions were carried out both among older people and among their caregivers. Although a variety of interventions were used in the reviewed studies, more lectures were used in the interventions related to older people. In the interventions related to caregivers, in addition to lectures, practical education was also used. It is recommended to perform higher quality studies for assessing the effectiveness of interventions in this field.
Collapse
Affiliation(s)
- Saeid Bashirian
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sahar Khoshravesh
- Department of Community Health Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Erfan Ayubi
- Cancer Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Akram Karimi-Shahanjarini
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Samane Shirahmadi
- Department of Community Oral Health, School of Dentistry, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Parshang Faghih Solaymani
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Measuring Self-Efficacy and Attitudes for Providing Mouth Care in Nursing Homes. J Am Med Dir Assoc 2020; 21:1316-1321. [PMID: 32273219 DOI: 10.1016/j.jamda.2020.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/04/2020] [Accepted: 02/09/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Mouth care is increasingly recognized as an important component of care in nursing homes (NHs), yet is known to be deficient. To promote quality improvement and inform research efforts, it is necessary to have valid measures of staff self-efficacy and attitudes to provide mouth care. DESIGN A self-administered questionnaire completed by NH staff, information about the NH obtained from the administrator, and oral hygiene assessments of NH residents. SETTING AND PARTICIPANTS A total of 434 staff in 14 NHs in North Carolina who were participating in a cluster randomized pragmatic trial of Mouth Care Without a Battle (MCWB). METHODS Staff in MCWB homes completed the questionnaire at baseline; staff in control homes completed it at 2-year follow-up. The 35-item questionnaire used new items and those from previous measures, many of which were modified for the NH setting. Factorial, construct, and criterion validity were assessed. RESULTS Exploratory factor analysis identified a 3-factor 11-item self-efficacy scale (promoting oral hygiene, providing mouth care, obtaining cooperation) named "Self-Efficacy for Providing Mouth Care" (SE-PMC), and a 2-factor 11-item attitudes scale (care of residents' teeth, care of own teeth), named Attitudes for Providing Mouth Care (A-PMC). Scores varied significantly across NHs and differentiated them based on profit status, age, and, for the A-PMC, NH size. Scores also differentiated among staff based on age and, for the SE-PMC, years of experience. In NHs where staff scored more highly, residents featured better oral hygiene (P < .001). CONCLUSIONS AND IMPLICATIONS The SE-PMC and A-PMC are valid, parsimonious, and useful measures for quality improvement and research to improve mouth care in NHs that can be used jointly or individually. Preliminary evidence suggests that these scales may be associated with resident-level plaque and gingival hygiene, making them useful tools to assess promotion of mouth care.
Collapse
|
6
|
Cianetti S, Anderini P, Pagano S, Eusebi P, Orso M, Salvato R, Lombardo G. Oral Health Knowledge Level of Nursing Staff Working in Semi-Intensive Heart Failure Units. J Multidiscip Healthc 2020; 13:165-173. [PMID: 32103976 PMCID: PMC7024767 DOI: 10.2147/jmdh.s224453] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/18/2019] [Indexed: 12/27/2022] Open
Abstract
PURPOSE Critical care units, such as heart failure units, house inpatients with a compromised general health status that requires rigorous prevention of further complications. Oral health infections that gain access through the bloodstream or airway might represent such potential complications (eg, endocarditis pneumonia). Avoiding these critical occurrences requires that adequate oral health care be provided by nursing personnel. Here we assessed the knowledge of oral health care practices by nurses working in three Italian heart failure units in Umbria, Italy. DESIGN This was a cross-sectional study. METHODS Forty-four nurses were interviewed using a six-item modified Adams' questionnaire on the topic of oral health care. A multidisciplinary panel of experts established the criteria for answer correctness based on the most relevant dentistry literature evidence and judged each reply. The expected percentage of correctly replying nurses was 75%, and significant differences from this expected probability were calculated with one-sided binomial probability tests. Cronbach's α method was used to establish the questionnaire's internal consistency (reliability). RESULTS For five out of six questionnaire items, the percentage of nurses who correctly answered was significantly lower than the expected value of probability. Lack of knowledge was found for usefulness of checking the patients' mouths (p=0.003), the most relevant lesions affecting the mouth (p=0.0001), the tools/solutions for cleaning the mouth and dentures (p= 0.0416), and drugs that affect the mouth and their side effects (p<0.0001). CONCLUSION In this study, few nurses working in heart failure units showed both an adequate willingness to check inpatients and a good knowledge of oral health care (significantly lower than the expected 75%). Further studies that use validated questionnaires and include more participants should be conducted to confirm and elaborate on our preliminary data.
Collapse
Affiliation(s)
- Stefano Cianetti
- Surgical and Biomedical Sciences, Unit of Pediatric Dentistry, University of Perugia, Perugia, Italy
| | - Paola Anderini
- Surgical and Biomedical Sciences, Unit of Pediatric Dentistry, University of Perugia, Perugia, Italy
| | - Stefano Pagano
- Surgical and Biomedical Sciences, Unit of Pediatric Dentistry, University of Perugia, Perugia, Italy
| | - Paolo Eusebi
- Health Planning Service, Department of Epidemiology, Regional Health Authority of Umbria, Perugia, Italy
| | - Massimiliano Orso
- Health Planning Service, Department of Epidemiology, Regional Health Authority of Umbria, Perugia, Italy
| | - Rosario Salvato
- Department of Philosophy, Social and Human Sciences and Education, University of Perugia, Perugia, Italy
| | - Guido Lombardo
- Surgical and Biomedical Sciences, Unit of Pediatric Dentistry, University of Perugia, Perugia, Italy
| |
Collapse
|
7
|
Seleskog B, Lindqvist L, Wårdh I, Engström A, von Bültzingslöwen I. Theoretical and hands-on guidance from dental hygienists promotes good oral health in elderly people living in nursing homes, a pilot study. Int J Dent Hyg 2018; 16:476-483. [DOI: 10.1111/idh.12343] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 11/30/2022]
Affiliation(s)
- B Seleskog
- Public Dental Health Norrstrand Värmland; Karlstad Sweden
| | - L Lindqvist
- Preventive Dentistry Department; Public Dental Health Värmland; Karlstad Sweden
| | - I Wårdh
- Department of Dental Medicine; Academic Centre of Geriatric Dentistry; Karolinska Institutet; Stockholm Sweden
| | - A Engström
- Preventive Dentistry Department; Public Dental Health Värmland; Karlstad Sweden
| | - I von Bültzingslöwen
- Preventive Dentistry Department; Public Dental Health Värmland and Institute of Odontology; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| |
Collapse
|
8
|
Poudel P, Griffiths R, Wong VW, Arora A, George A. Knowledge and practices of diabetes care providers in oral health care and their potential role in oral health promotion: A scoping review. Diabetes Res Clin Pract 2017; 130:266-277. [PMID: 28662464 DOI: 10.1016/j.diabres.2017.06.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 04/21/2017] [Accepted: 06/06/2017] [Indexed: 12/17/2022]
Abstract
AIM Oral health complications are common in people with diabetes yet very little is reported about the oral health care provided in diabetes care setting. This study reviewed global evidence on the oral health care knowledge and practices of diabetes care providers and the role of non-dental health professionals in oral health promotion. METHODS A systematic search of five databases was undertaken with key search terms using a scoping review framework. Relevant studies published till October 2016 in the English language were included (n=30) and no restrictions were placed on the study design, quality or setting. RESULTS Most diabetes care providers are not addressing oral health care with the main barriers being time constraints and limited oral health knowledge. Diabetes educators (DEs) could engage in oral health promotion with few studies showing this model of care can translate into improved patient outcomes. However, no appropriate oral health training programs and assessment tools exist for DEs. With proper training, non-dental professionals like nurses have successfully incorporated oral healthcare in other settings. CONCLUSIONS DEs are well placed to promote oral health in diabetes care setting. Further research is needed to identify barriers and oral health resources to support DEs in this role.
Collapse
Affiliation(s)
- Prakash Poudel
- Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool 1871, Australia.
| | - Rhonda Griffiths
- School of Nursing & Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 1797, Australia
| | - Vincent W Wong
- Diabetes and Endocrine Service, Liverpool Hospital, Liverpool Diabetes Collaborative Research Unit, Ingham Institute Applied Medical Research, South Western Clinical School, University of New South Wales, Locked Bag 7103, Liverpool BC, NSW 1871, Australia
| | - Amit Arora
- School of Science and Health, Western Sydney University, COHORTE Research Group, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Sydney Medical School, University of Sydney, Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Building 24.2.97, Campbelltown Campus, WSU, NSW 2560, Australia
| | - Ajesh George
- COHORTE Research Group, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, University of Sydney, Locked Bag 7103, Liverpool 1871, Australia
| |
Collapse
|
9
|
Albrecht M, Kupfer R, Reissmann DR, Mühlhauser I, Köpke S. Oral health educational interventions for nursing home staff and residents. Cochrane Database Syst Rev 2016; 9:CD010535. [PMID: 27689868 PMCID: PMC6457754 DOI: 10.1002/14651858.cd010535.pub2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Associations between nursing home residents' oral health status and quality of life, respiratory tract infections, and nutritional status have been reported. Educational interventions for nurses or residents, or both, focusing on knowledge and skills related to oral health management may have the potential to improve residents' oral health. OBJECTIVES To assess the effects of oral health educational interventions for nursing home staff or residents, or both, to maintain or improve the oral health of nursing home residents. SEARCH METHODS We searched the Cochrane Oral Health Trials Register (to 18 January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2015, Issue 12), MEDLINE Ovid (1946 to 18 January 2016), Embase Ovid (1980 to 18 January 2016), CINAHL EBSCO (1937 to 18 January 2016), and Web of Science Conference Proceedings (1990 to 18 January 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 18 January 2016. In addition, we searched reference lists of identified articles and contacted experts in the field. We placed no restrictions on language or date of publication when searching the electronic databases. SELECTION CRITERIA Randomised controlled trials (RCTs) and cluster-RCTs comparing oral health educational programmes for nursing staff or residents, or both with usual care or any other oral healthcare intervention. DATA COLLECTION AND ANALYSIS Two review authors independently screened articles retrieved from the searches for relevance, extracted data from included studies, assessed risk of bias for each included study, and evaluated the overall quality of the evidence. We retrieved data about the development and evaluation processes of complex interventions on the basis of the Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare: revised guideline (CReDECI 2). We contacted authors of relevant studies for additional information. MAIN RESULTS We included nine RCTs involving 3253 nursing home residents in this review; seven of these trials used cluster randomisation. The mean resident age ranged from 78 to 86 years across studies, and most participants were women (more than 66% in all studies). The proportion of residents with dental protheses ranged from 62% to 87%, and the proportion of edentulous residents ranged from 32% to 90% across studies.Eight studies compared educational interventions with information and practical components versus (optimised) usual care, while the ninth study compared educational interventions with information only versus usual care. All interventions included educational sessions on oral health for nursing staff (five trials) or for both staff and residents (four trials), and used more than one active component. Follow-up of included studies ranged from three months to five years.No study showed overall low risk of bias. Four studies had a high risk of bias, and the other five studies were at unclear risk of bias.None of the trials assessed our predefined primary outcomes 'oral health' and 'oral health-related quality of life'. All trials assessed our third primary outcome, 'dental or denture plaque'. Meta-analyses showed no evidence of a difference between interventions and usual care for dental plaque (mean difference -0.04, 95% confidence interval (CI) -0.26 to 0.17; six trials; 437 participants; low quality evidence) or denture plaque (standardised mean difference -0.60, 95% CI -1.25 to 0.05; five trials; 816 participants; low quality evidence). None of the studies assessed adverse events of the intervention. AUTHORS' CONCLUSIONS We found insufficient evidence to draw robust conclusions about the effects of oral health educational interventions for nursing home staff and residents. We did not find evidence of meaningful effects of educational interventions on any measure of residents' oral health; however, the quality of the available evidence is low. More adequately powered and high-quality studies using relevant outcome measures are needed.
Collapse
Affiliation(s)
- Martina Albrecht
- University of HamburgMIN Faculty, Unit of Health Sciences and EducationMartin‐Luther‐King PlatzHamburgGermany20146
| | - Ramona Kupfer
- University of HamburgMIN Faculty, Unit of Health Sciences and EducationMartin‐Luther‐King PlatzHamburgGermany20146
- Institute of Social Medicine, University of LübeckNursing Research Group, Institute of Social Medicine and EpidemiologyLübeckGermany
| | - Daniel R Reissmann
- University Medical Center Hamburg‐EppendorfDepartment of Prosthetic DentistryMartinistr. 52HamburgGermany20246
| | - Ingrid Mühlhauser
- University of HamburgMIN Faculty, Unit of Health Sciences and EducationMartin‐Luther‐King PlatzHamburgGermany20146
| | - Sascha Köpke
- University of LübeckNursing Research Group, Institute of Social Medicine and EpidemiologyRatzeburger Allee 160LübeckGermanyD‐23538
| | | |
Collapse
|
10
|
Abstract
The attitude of nursing staff to the denture care of in-patients in hospital following the introduction of written guidelines on denture care was assessed together with the need for further guidelines. A survey in the form of a questionnaire was carried out on 100 nursing staff in a general hospital. The topics covered included usefulness of the guidelines and denture hygiene and general denture care procedures on the ward together with aspects of general denture care included in the nurse training programme. There was a 66% response rate. The results highlighted that the introduction of written guidelines were helpful to the nursing staff but additional training was requested. A computer-aided learning (CAL) programme on denture care aimed specifically at nursing was then developed. A total of 81 nursing staff were surveyed following the introduction of the CAL programme. The results demonstrated that the CAL programme was well received by 100% of the staff surveyed. Further work is to be undertaken on the development of an oral-health educational programme for nursing staff.
Collapse
Affiliation(s)
- Matthew Jerreat
- Division of Restorative Dentistry, Bristol Dental School, Bristol
| | | | | | - Daryll C. Jagger
- Division of Restorative Dentistry, Bristol Dental School, Bristol,
| |
Collapse
|
11
|
Goh CE, Guay MP, Lim MY, Lim SM, Loke SY, Toh HE, Nair R. Correlates of attitudes and perceived behavioural control towards oral care provision among trained and untrained nursing home caregivers in Singapore. J Clin Nurs 2016; 25:1624-33. [PMID: 27118105 DOI: 10.1111/jocn.13162] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2015] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To investigate the perspectives of nursing home caregivers towards oral care and the determinants of their attitudes and perceived behavioural control. BACKGROUND There are few studies analysing nursing home caregivers' perspectives on the provision of oral care and factors correlated with these perspectives. DESIGN Cross-sectional study. METHODS Interviewer-administered survey questionnaires were completed by caregivers from five nursing homes in Singapore (n = 94). The rating-scale questionnaire items explored caregivers' attitudes, subjective norms and perceived behavioural control, as guided by the theory of planned behaviour. Demographic characteristics, oral care training received, years of work experience, oral hygiene behaviour and dental visit frequency of the caregivers, as well as organisational characteristics such as a requirement for oral care and the number of patients under their care, were obtained. RESULTS Caregivers had very positive attitudes towards the provision of oral care. Half of the caregivers lacked confidence in providing oral care without harming the patients and this was not different by oral care training received. Multivariable linear regression analysis found that receiving oral care training and having a requirement by the nursing home to provide oral care were related to higher attitude scores but not perceived behaviour control. Having more residents under their care and on-the-job caregiver training were associated with lower perceived behavioural control. CONCLUSIONS This study found that nursing home caregivers had positive attitudes towards providing oral care, but more modest perspectives about their ability to perform that behaviour. RELEVANCE TO CLINICAL PRACTICE These findings have useful implications for the oral care training of nursing home caregivers. While attitudes towards the importance of oral care may be positive among nursing home caregivers, our study suggests that future interventions should include practical skills training for oral care management and consider organisational strategies for encouraging oral care provision.
Collapse
Affiliation(s)
- Charlene E Goh
- Faculty of Dentistry, National University of Singapore, Singapore
| | | | | | - Shy Min Lim
- National University Hospital System, University Dental Cluster, Singapore
| | | | - Hui En Toh
- National Dental Centre Singapore, Singapore
| | - Rahul Nair
- Oral Sciences, School of Dentistry, NUS, Singapore
| |
Collapse
|
12
|
Mac Giolla Phadraig C, Nunn J, Guerin S, Normand C. Should we provide oral health training for staff caring for people with intellectual disabilities in community based residential care? A cost-effectiveness analysis. EVALUATION AND PROGRAM PLANNING 2016; 55:46-54. [PMID: 26722699 DOI: 10.1016/j.evalprogplan.2015.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 12/07/2015] [Accepted: 12/10/2015] [Indexed: 06/05/2023]
Abstract
Oral health training is often introduced into community-based residential settings to improve the oral health of people with intellectual disabilities (ID). There is a lack of appropriate evaluation of such programs, leading to difficulty in deciding how best to allocate scarce resources to achieve maximum effect. This article reports an economic analysis of one such oral health program, undertaken as part of a cluster randomized controlled trial. Firstly, we report a cost-effectiveness analysis of training care-staff compared to no training, using incremental cost-effectiveness ratios (ICERs). Effectiveness was measured as change in knowledge, reported behaviors, attitude and self-efficacy, using validated scales (K&BAS). Secondly, we costed training as it was scaled up to include all staff within the service provider in question. Data were collected in Dublin, Ireland in 2009. It cost between €7000 and €10,000 more to achieve modest improvement in K&BAS scores among a subsample of 162 care-staff, in comparison to doing nothing. Considering scaled up first round training, it cost between €58,000 and €64,000 to train the whole population of staff, from a combined dental and disability service perspective. Less than €15,000-€20,000 of this was additional to the cost of doing nothing (incremental cost). From a dental perspective, a further, second training cycle including all staff would cost between €561 and €3484 (capital costs) and €5815 (operating costs) on a two yearly basis. This study indicates that the program was a cost-effective means of improving self-reported measures and possibly oral health, relative to doing nothing. This was mainly due to low cost, rather than the large effect. In this instance, the use of cost effectiveness analysis has produced evidence, which may be more useful to decision makers than that arising from traditional methods of evaluation. There is a need for CEAs of effective interventions to allow comparison between programs. Suggestions to reduce cost are presented.
Collapse
Affiliation(s)
- Caoimhin Mac Giolla Phadraig
- Department of Child and Public Dental Health, Dublin Dental University Hospital, Lincoln Place, Dublin 2, Ireland; School of Dental Science, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland.
| | - June Nunn
- Department of Child and Public Dental Health, Dublin Dental University Hospital, Lincoln Place, Dublin 2, Ireland; School of Dental Science, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland
| | - Suzanne Guerin
- Centre for Disability Studies, School of Psychology, UCD, Dublin, Ireland
| | - Charles Normand
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| |
Collapse
|
13
|
Khanagar S, Naganandini S, Tuteja JS, Naik S, Satish G, Divya KT. Improving Oral Hygiene in Institutionalised Elderly by Educating Their Caretakers in Bangalore City, India: a Randomised Control Trial. Can Geriatr J 2015; 18:136-43. [PMID: 26495047 PMCID: PMC4597813 DOI: 10.5770/cgj.18.145] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The population of older people, as well as the number of dependent older people, is steadily increasing; those unable to live independently at home are being cared for in a range of settings. Practical training for nurses and auxiliary care staff has frequently been recommended as a way of improving oral health care for functionally dependent elderly. The aim was improve oral hygiene in institutionalized elderly in Bangalore city by educating their caregivers. Methods The study is a cluster randomized intervention trial with an elderly home as unit of randomization in which 7 out of 65 elderly homes were selected. Oral health knowledge of caregivers was assessed using a pre-tested pro forma and later oral-health education was provided to the caregivers of the study group. Oral hygiene status of elderly residents was assessed by levels of debris, plaque of dentate and denture plaque, and denture stomatitis of denture wearing residents, respectively. Oral-health education to the caregivers of control group was given at the end of six months Results There was significant improvement in oral-health knowledge of caregivers from the baseline and also a significant reduction of plaque score from baseline score of 3.17 ± 0.40 to 1.57 ± 0.35 post-intervention (p < .001), debris score 2.87 ± 0.22 to 1.49 ± 0.34 (p < .001), denture plaque score 3.15 ± 0.47 to 1.21 ± 0.27 (p < .001), and denture stomatitis score 1.43 ± 0.68 to 0.29 ± 0.53 (p < .001). Conclusions The result of the present study showed that there was a significant improvement in the oral-health knowledge among the caregivers and oral-hygiene status of the elderly residents.
Collapse
Affiliation(s)
- Sanjeev Khanagar
- Department of Public Health Dentistry, K.V.G Dental College & Hospital Sullia, D.K, Karnataka
| | | | - Jaspreet Singh Tuteja
- Department of Public Health Dentistry, Rama Dental College, Hospital and Research Centre, Kanpur
| | - Sachin Naik
- Department of Public Health Dentistry, SJM Dental College & Hospital, Chitradurga, Karnataka
| | - G Satish
- Department of Conservative Dentistry and Endodontics, Darshan Dental College & Hospital, Udaipur
| | - K T Divya
- Department of Conservative Dentistry and Endodontics, Gov't. Dental College & Research Institute VIMS, Bellary, Karnataka, India
| |
Collapse
|
14
|
Wang TF, Huang CM, Chou C, Yu S. Effect of oral health education programs for caregivers on oral hygiene of the elderly: A systemic review and meta-analysis. Int J Nurs Stud 2015; 52:1090-6. [DOI: 10.1016/j.ijnurstu.2015.01.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 11/15/2022]
|
15
|
Mac Giolla Phadraig C, Guerin S, Nunn J. Should we educate care staff to improve the oral health and oral hygiene of people with intellectual disability in residential care? Real world lessons from a randomized controlled trial. SPECIAL CARE IN DENTISTRY 2015; 35:92-8. [DOI: 10.1111/scd.12102] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Caoimhin Mac Giolla Phadraig
- Department of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland
| | - Suzanne Guerin
- School of Psychology, University College Dublin, Dublin, Ireland
| | - June Nunn
- Department of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin 2, Ireland
| |
Collapse
|
16
|
Janssens B, De Visschere L, van der Putten GJ, de Lugt-Lustig K, Schols JM, Vanobbergen J. Effect of an oral healthcare protocol in nursing homes on care staffs' knowledge and attitude towards oral health care: a cluster-randomised controlled trial. Gerodontology 2014; 33:275-86. [DOI: 10.1111/ger.12164] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Barbara Janssens
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Ghent Belgium
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Nijmegen The Netherlands
- Community Dentistry and Oral Public Health; Dental School; Ghent University; Ghent Belgium
| | - Luc De Visschere
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Ghent Belgium
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Nijmegen The Netherlands
- Community Dentistry and Oral Public Health; Dental School; Ghent University; Ghent Belgium
| | - Gert-Jan van der Putten
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Ghent Belgium
- Birkhoven Zorggoed; Amersfoort The Netherlands
- University of Applied Sciences; Utrecht The Netherlands
- Department of Oral Function and Prosthetic Dentistry; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - Kersti de Lugt-Lustig
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Ghent Belgium
- Department of Oral Function and Prosthetic Dentistry; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
- Naarderheem; Vivium Zorggroep; Huizen The Netherlands
| | - Jos M.G.A. Schols
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Ghent Belgium
- Caphri; Departments of Family Medicine and Health Services Research; Maastricht University; Maastricht The Netherlands
| | - Jacques Vanobbergen
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Ghent Belgium
- BENECOMO; Flemish-Netherlands Geriatric Oral Research Group; Nijmegen The Netherlands
- Community Dentistry and Oral Public Health; Dental School; Ghent University; Ghent Belgium
| |
Collapse
|
17
|
Zimmerman S, Sloane PD, Cohen LW, Barrick AL. Changing the culture of mouth care: mouth care without a battle. THE GERONTOLOGIST 2014; 54 Suppl 1:S25-34. [PMID: 24443603 DOI: 10.1093/geront/gnt145] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE OF THE STUDY Culture change aims to fundamentally improve care provision in a manner consistent with individual preferences. However, few studies of culture change have focused on the quality of daily care, despite the fact that system-wide efforts are important to assure the effectiveness, adoption, and sustainability of person-centered care to meet daily needs. This paper describes a new culture change practice, Mouth Care Without a Battle. The focus on mouth care is predicated on the important association between person-centered support for oral hygiene and quality of life. DESIGN AND METHODS Mouth Care Without a Battle is a person-centered approach to quality mouth care for persons with cognitive and physical impairment. It was developed by an interdisciplinary team of clinician researchers based on literature review, consultation with experts, environmental scan of existing programs, and testing in nursing homes. Building from the success of Bathing Without a Battle, Mouth Care Without a Battle was evaluated in terms of changed care practices and outcomes, developed into a training program, and packaged for dissemination as a digital video disk (DVD) and website. RESULTS The development and evaluation of Mouth Care Without a Battle demonstrate attention to the areas necessary to establish the evidence-base for culture change, to ultimately empower and support staff to provide care to achieve quality outcomes. IMPLICATIONS As illustrated in this paper, it is beneficial to build the evidence base for culture change by attending to care processes and outcomes benefiting all residents, ability to implement culture change, and costs of implementation.
Collapse
Affiliation(s)
- Sheryl Zimmerman
- *Address correspondence to Sheryl Zimmerman, School of Social Work and the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Boulevard, Campus Box 7590, Chapel Hill, NC 27599-7590. E-mail:
| | | | | | | |
Collapse
|
18
|
Khanagar S, Kumar A, Rajanna V, Badiyani BK, Jathanna VR, Kini PV. Oral health care education and its effect on caregivers' knowledge, attitudes, and practices: A randomized controlled trial. J Int Soc Prev Community Dent 2014; 4:122-8. [PMID: 25254198 PMCID: PMC4170545 DOI: 10.4103/2231-0762.139843] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The population of older people as well as the number of dependent older people is steadily increasing. Those unable to live independently at home are being cared for in a range of settings. Practical training for nurses and auxiliary care staff has frequently been recommended as a way of improving oral health care for functionally dependent elderly. AIM To evaluate an oral health education program for the caretakers of institutionalized elderly. MATERIALS AND METHODS The study was a cluster randomized intervention trial with an elderly home as the unit of randomization. Seven out of 65 elderly homes accommodating a total of 78 caretakers and 462 elderly residents were selected in Bangalore city, India, out of which 3 elderly homes were assigned to the intervention group and 4 to the control group. Oral health knowledge of caretakers was assessed using a pre-tested proforma; later, oral health education was provided to the caretakers of the intervention group. Oral health education was given at the end of 6 months to the caretakers of the control group. Chi-square test, Fisher exact test, and paired proportion test were used for statistical analysis. RESULTS There was significant improvement in the oral health knowledge of the caretakers from baseline in the interventional group. CONCLUSION The results of the present study showed that there was a significant improvement in the oral health knowledge among the caretakers. Educating the caretakers for assisting or enabling residents for maintaining oral hygiene is essential.
Collapse
Affiliation(s)
- Sanjeev Khanagar
- Department of Public Health Dentistry, Kurunji Venkatramana Gowda, Dental College and Hospital, Sullia, Dakshina Kannada, Karnataka, India
| | - Amit Kumar
- Department of Public Health Dentistry, Sarjug Dental College and Hospital, Laheriasarai, Darbhanga, Bihar, India
| | - Vasuda Rajanna
- Department of Public Health Dentistry, The Oxford Dental College, Bangalore, Karnataka, India
| | - Bhumika Kamal Badiyani
- Department of Public Health Dentistry, Sarjug Dental College and Hospital, Laheriasarai, Darbhanga, Bihar, India
| | - Vinod Rakesh Jathanna
- Department of Conservative Dentistry and Endodontics, Shrinivasa Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Prajna V Kini
- Department of Oral Medicine and Radiology, Shrinivasa Institute of Dental Sciences, Mangalore, Karnataka, India
| |
Collapse
|
19
|
de Lugt-Lustig KH, Vanobbergen JN, van der Putten GJ, De Visschere LM, Schols JM, de Baat C. Effect of oral healthcare education on knowledge, attitude and skills of care home nurses: a systematic literature review. Community Dent Oral Epidemiol 2013; 42:88-96. [DOI: 10.1111/cdoe.12063] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 06/29/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Kersti H.M.E. de Lugt-Lustig
- BENECOMO Flemish-Netherlands Geriatric Oral Research Group Ghent; Belgium/Nijmegen The Netherlands
- Department of Oral Function and Prosthetic Dentistry; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
- Naarderheem; Vivium Zorggroep; Huizen The Netherlands
| | - Jacques N.O. Vanobbergen
- BENECOMO Flemish-Netherlands Geriatric Oral Research Group Ghent; Belgium/Nijmegen The Netherlands
- Department of Community Dentistry and Oral Public Health; Ghent University; Ghent Belgium
| | - Gert-Jan van der Putten
- BENECOMO Flemish-Netherlands Geriatric Oral Research Group Ghent; Belgium/Nijmegen The Netherlands
- Birkhoven Zorggoed Amersfoort; Amersfoort The Netherlands
| | - Luc M.J. De Visschere
- BENECOMO Flemish-Netherlands Geriatric Oral Research Group Ghent; Belgium/Nijmegen The Netherlands
- Department of Community Dentistry and Oral Public Health; Ghent University; Ghent Belgium
| | - Jos M.G.A. Schols
- BENECOMO Flemish-Netherlands Geriatric Oral Research Group Ghent; Belgium/Nijmegen The Netherlands
- CAPHRI/Department of General Practice and Department of Health Services Research; Maastricht University; Maastricht The Netherlands
| | - Cees de Baat
- BENECOMO Flemish-Netherlands Geriatric Oral Research Group Ghent; Belgium/Nijmegen The Netherlands
- Department of Oral Function and Prosthetic Dentistry; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| |
Collapse
|
20
|
Weening-Verbree L, Huisman-de Waal G, van Dusseldorp L, van Achterberg T, Schoonhoven L. Oral health care in older people in long term care facilities: a systematic review of implementation strategies. Int J Nurs Stud 2013; 50:569-82. [PMID: 23290098 DOI: 10.1016/j.ijnurstu.2012.12.004] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Revised: 12/04/2012] [Accepted: 12/06/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Oral hygiene is necessary to maintain oral health and quality of life. However, the oral hygiene and the oral health care of older people in long term care facilities are poor. This indicates that care is not in compliance with the available guidelines and protocols, and stresses the importance of a clear evidence-based implementation strategy to improve oral health care. The aim of this study is to review implementation strategies used to promote or improve oral health care for older people in long term care facilities from the perspective of behaviour change, to code strategy content at the level of determinants, and to explore their effectiveness. DESIGN Systematic review of literature. DATA SOURCES The digital databases of the Cochrane Library, PubMed and Cinahl have been searched up to September 2011 for relevant articles. REVIEW METHODS After a systematic selection process, included studies were quality assessed by three researchers. We extracted the study characteristics using the EPOC Data Collection Checklist and Data Abstraction Form. Strategy content was extracted and coded by using the Coding Manual for Behavioural Change Techniques. This manual groups the behaviour change techniques under relevant behavioural determinants. RESULTS Twenty studies were included in this review. Implementation strategies were delivered by dental hygienists or dentists. Oral health care was performed by nurses and nurse assistants in all studies. All studies addressed knowledge, mostly operationalized as one educational session. Knowledge was most often combined with interventions addressing self efficacy. Implementation strategies aimed at knowledge (providing general information), self-efficacy (modelling) or facilitation of behaviour (providing materials to facilitate behaviour) were most often identified as successful in improving oral health. CONCLUSIONS Knowledge, self-efficacy and facilitation of behaviour are determinants that are often addressed in implementation strategies for successful improvement of oral health care in older patients. Strategies addressing increasing memory, feedback of clinical outcomes, and mobilizing social norm are promising and should be studied in the future. However, as the quality and heterogeneity of studies is a reason for concern, it is not possible to unequivocally recommend strategies or combinations of strategies for improving oral health care in the older population. When choosing strategies to improve oral health care, care professionals should thoroughly examine the setting and target group, identify barriers to change and tailor their implementation strategies to these barriers for oral health care.
Collapse
Affiliation(s)
- L Weening-Verbree
- University Medical Center Groningen, Centre for Dentistry and Oral Hygiene Groningen (CTM), Groningen, The Netherlands
| | | | | | | | | |
Collapse
|
21
|
Le P, Dempster L, Limeback H, Locker D. Improving residents’ oral health through staff education in nursing homes. SPECIAL CARE IN DENTISTRY 2012; 32:242-50. [DOI: 10.1111/j.1754-4505.2012.00279.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
22
|
Mac Giolla Phadraig C, Guerin S, Nunn J. Train the trainer? A randomized controlled trial of a multi-tiered oral health education programme in community-based residential services for adults with intellectual disability. Community Dent Oral Epidemiol 2012; 41:182-92. [DOI: 10.1111/cdoe.12006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 08/18/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Caoimhin Mac Giolla Phadraig
- Department of Child and Public Dental Health; Dublin Dental University Hospital; Trinity College Dublin; Dublin; Ireland
| | - Suzanne Guerin
- School of Psychology; University College Dublin; Dublin; Ireland
| | - June Nunn
- Department of Child and Public Dental Health; Dublin Dental University Hospital; Trinity College Dublin; Dublin; Ireland
| |
Collapse
|
23
|
Factors affecting caregivers' perceptions of residents' oral health in long-term care facilities in Taiwan. Geriatr Nurs 2012; 33:350-7. [PMID: 22495002 DOI: 10.1016/j.gerinurse.2012.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 03/08/2012] [Accepted: 03/08/2012] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to investigate the differences between resident oral care policies provided by 2 types of long-term care (LTC) institutions. The study also investigated factors affecting LTC institutional caregivers' perceptions of the residents' oral health. Overall, 103 completed questionnaires were returned. Of these, 44 were from senior citizen welfare institutions, and 59 were from nursing homes. The variables affecting these perceptions included institution type and whether the residents attended hospital dental clinics or consulted a hospital doctor regarding oral health problems. The research results showed that institution type and whether an oral care-related professional was available in an institution were correlated with an increase in institutional caregivers' perceptions of oral care.
Collapse
|
24
|
Park MS, Choi-Kwon S. [The effects of oral care education on caregivers' knowledge, attitude, & behavior toward oral hygiene for elderly residents in a nursing home]. J Korean Acad Nurs 2012; 41:684-93. [PMID: 22143217 DOI: 10.4040/jkan.2011.41.5.684] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE To investigate the effects of oral care education on knowledge, attitudes & behavior of caregivers in oral care and oral hygiene for residents in nursing homes. METHODS In this quasi-experimental study, the intervention group (n=27) of residents received oral care from intervention group caregivers (n=28) who had received 6 weeks of oral care education. The control group (n=27) of residents received usual oral care from control group caregivers (n=26). Data on knowledge, attitude, and behavioral change in oral health care by the caregivers and plaque index & halitosis of the residents were collected. Data were analyzed using SPSS WIN 16.0. RESULTS 1) Scores on caregivers' knowledge (p<.001) and behavior (p<.001) for oral care were higher in the intervention group 6 and 12 weeks. The caregivers' attitude (p<.001) score for oral care was higher in the intervention group 12 weeks. 2) The plaque index (p=.004) and halitosis (p=.002) of the nursing home residents were lower in the intervention group than the control group at 6 and 12 weeks. CONCLUSION Oral care education programs for caregivers are effective in improving the oral hygiene of elderly residents in nursing homes through enhancement of caregivers' knowledge, attitude, and behavioral change.
Collapse
Affiliation(s)
- Myung Sook Park
- Department of Nursing Science, Sun Moon University, Asan, Korea
| | | |
Collapse
|
25
|
Willumsen T, Karlsen L, Naess R, Bjørntvedt S. Are the barriers to good oral hygiene in nursing homes within the nurses or the patients? Gerodontology 2011; 29:e748-55. [PMID: 22023222 DOI: 10.1111/j.1741-2358.2011.00554.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To explore nursing home patients' oral hygiene and their nurses' assessments of barriers to improvement. BACKGROUND In nursing homes, nurses are responsible for patients' oral hygiene. MATERIALS AND METHODS This study assessed the oral hygiene of 358 patients in 11 Norwegian nursing homes. 494 nurses in the same nursing homes participated in a questionnaire study. RESULTS More than 40% of patients had unacceptable oral hygiene. 'More than 10 teeth' gave OR = 2, 1 (p = 0.013) and 'resist being helped' OR = 2.5 (p = 0.018) for unacceptable oral hygiene. Eighty percent of the nurses believed knowledge of oral health was important, and 9.1% often considered taking care of patients' teeth unpleasant. Half of the nurses reported lack of time to give regular oral care, and 97% experienced resistant behaviour in patients. Resistant behaviour often left oral care undone. Twenty-one percent of the nurses had considered making legal decisions about use of force or restraints to overcome resistance to teeth cleaning. CONCLUSION Oral hygiene in the nursing homes needed to be improved. Resistant behaviour is a major barrier. To overcome this barrier nurses' education, organisational strategies to provide more time for oral care, and coping with resistant behaviour in patients are important factors.
Collapse
|
26
|
Sonde L, Emami A, Kiljunen H, Nordenram G. Care providers’ perceptions of the importance of oral care and its performance within everyday caregiving for nursing home residents with dementia. Scand J Caring Sci 2011; 25:92-9. [DOI: 10.1111/j.1471-6712.2010.00795.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
27
|
Wårdh I, Paulsson G, Fridlund B. Nursing staff's understanding of oral health care for patients with cancer diagnoses: an intervention study. J Clin Nurs 2008; 18:799-806. [PMID: 18298505 DOI: 10.1111/j.1365-2702.2007.02051.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to evaluate long-lasting changes in the nursing staff's understanding of oral health care for cancer patients after an oral health care intervention. The study also assessed whether there were changes between registered nurses and auxiliary nurses. BACKGROUND The maintenance of good oral health care in cancer patients is essential for nutrition, recovery and wellbeing and requires the involvement of nursing staff. However, several studies reveal that the need to prioritize oral health care has not been made sufficiently clear. METHODS The nursing staff (registered nurses, n = 133 and auxiliary nurses, n = 109) on five wards at different hospitals providing cancer care took part in a four-hour oral healthcare training session, including the use of an oral assessment guide and answered a questionnaire initially and after this intervention. The data were statistically analyzed. RESULTS Several aspects of implementation opportunities improved, but they did not include attitudes to oral health care. Knowledge of oral diseases decreased, more for auxiliary nurses than for registered nurses. CONCLUSIONS A four-hour oral health training session and subsequent activities improve the nursing staff's understanding of oral health care for patients with cancer diagnoses in some respects but not in terms of attitudes to oral health care or specific oral knowledge. RELEVANCE TO CLINICAL PRACTICE Oral healthcare education and training activities for nursing staff can produce some improvements in the understanding of oral health care for cancer patients but not in attitudes and specific oral knowledge. These areas must be covered during the basic education period or/and by a routine oral healthcare programme for nursing staff, probably including an oral healthcare standard.
Collapse
Affiliation(s)
- Inger Wårdh
- Department of Gerodontology, Karolinska Institutet, Huddinge, Sweden.
| | | | | |
Collapse
|
28
|
Tewogbade A, FitzGerald K, Prachyl D, Zurn D, Wilson C. Attitudes and practices of nurses on a pediatric cancer and stem cell transplant ward: adaptation of an oral care protocol. SPECIAL CARE IN DENTISTRY 2008; 28:12-8. [PMID: 18271769 DOI: 10.1111/j.1754-4505.2008.00004.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study evaluated nurses' current practices and understanding of oral health for hematology and oncology patients. A written questionnaire administered to 33 nurses on the pediatric cancer and blood disorders unit of Children's Medical Center of Dallas included questions on oral evaluation, oral hygiene, and case-based questions. Information gathered was used to develop an oral care protocol. The study found that nurses were proficient in diagnosing obvious conditions including mucositis and pseudomembranous candidiasis, but they were less than proficient when diagnosing less easily recognizable conditions such as xerostomia. The nurses were found to have inadequate knowledge of the treatment and oral hygiene protocols for conditions that they could and could not diagnose. The protocol based on the questionnaire results included information gathering, oral hygiene protocol, evaluation of viral infection, evaluation of fungal infection, oral assessment guide, and treatment protocol. Through information gathering, an oral health care policy may be developed and implemented to aid in the treatment of children undergoing care for malignancies.
Collapse
|
29
|
MacEntee MI, Wyatt CCL, Beattie BL, Paterson B, Levy-Milne R, McCandless L, Kazanjian A. Provision of mouth-care in long-term care facilities: an educational trial. Community Dent Oral Epidemiol 2007; 35:25-34. [PMID: 17244135 DOI: 10.1111/j.1600-0528.2007.00318.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This randomized clinical trial aimed to assess the effectiveness of a pyramid-based education for improving the oral health of elders in long-term care (LTC) facilities. METHODS Fourteen facilities matched for size were assigned randomly to an active or control group. At baseline in each facility, care-aides in the active group participated with a full-time nurse educator in a seminar about oral health care, and had unlimited access to the educator for oral health-related advice throughout the 3-month trial. Care-aides in the control group participated in a similar seminar with a dental hygienist but they received no additional advice. The residents in the facilities at baseline and after 3 months were examined clinically to measure their oral hygiene, gingival health, masticatory potential, Body Mass Index and Malnutrition Indicator Score, and asked to report on chewing difficulties. RESULTS Clinical measures after 3 months were not significantly different from baseline in either group, indicating that education neither influenced the oral health nor the dental hygiene of the residents. CONCLUSIONS A pyramid-based educational scheme with nurses and care-aides did not improve the oral health of frail elders in this urban sample of LTC facilities.
Collapse
Affiliation(s)
- M I MacEntee
- Division of Prosthodontics and Dental Geriatrics, Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada.
| | | | | | | | | | | | | |
Collapse
|
30
|
Chalmers JM, King PL, Spencer AJ, Wright FAC, Carter KD. The oral health assessment tool--validity and reliability. Aust Dent J 2005; 50:191-9. [PMID: 16238218 DOI: 10.1111/j.1834-7819.2005.tb00360.x] [Citation(s) in RCA: 254] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Oral Health Assessment Tool (OHAT) was a component of the Best Practice Oral Health Model for Australian Residential Care study. The OHAT provided institutional carers with a simple, eight category screening tool to assess residents' oral health, including those with dementia. This analysis presents OHAT reliability and validity results. METHODS A convenience sample of 21 residential care facilities (RCFs) in urban and rural Victoria, NSW and South Australia used the OHAT at baseline, three-months and six-months to assess intra- and inter-carer reliability and concurrent validity. RESULTS Four hundred and fifty five residents completed all study phases. Intra-carer reliability for OHAT categories: percent agreement ranged from 74.4 per cent for oral cleanliness, to 93.9 per cent for dental pain; Kappa statistics were in moderate range (0.51-0.60) for lips, saliva, oral cleanliness, and for all other categories in range of 0.61-0.80 (substantial agreement) (p < 0.05). Inter-carer reliability for OHAT categories: percent agreement ranged from 72.6 per cent for oral cleanliness to 92.6 per cent for dental pain; Kappa statistics were in moderate range (0.48-0.60) for lips, tongue, gums, saliva, oral cleanliness, and for all other categories in range of 0.61-0.80 (substantial agreement) (p < 0.05). Intraclass correlation coefficients for OHAT total scores were 0.78 for intra-carer and 0.74 for inter-carer reliability. Validity analyses of the OHAT categories and examination findings showed complete agreement for the lips category, with the natural teeth, dentures, and tongue categories having high significant correlations and percent agreements. The gums category had significant moderate correlation and percent agreement. Non-significant and low correlations and percent agreements were evident for the saliva, oral cleanliness and dental pain categories. CONCLUSION The Oral Health Assessment Tool was evaluated as being a reliable and valid screening assessment tool for use in residential care facilities, including those with cognitively impaired residents.
Collapse
Affiliation(s)
- J M Chalmers
- The University of Iowa, College of Dentistry, Iowa City 52242, USA.
| | | | | | | | | |
Collapse
|
31
|
Pearson A, Chalmers J. Oral hygiene care for adults with dementia in residential aged care facilities. ACTA ACUST UNITED AC 2004. [DOI: 10.1111/j.1479-6988.2004.00009.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
32
|
|
33
|
Pearson A, Chalmers J. Oral hygiene care for adults with dementia in residential aged care facilities. ACTA ACUST UNITED AC 2004. [DOI: 10.11124/jbisrir-2004-378] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
34
|
Pearson A, Chalmers J. Oral hygiene care for adults with dementia in residential aged care facilities. ACTA ACUST UNITED AC 2004; 2:1-89. [PMID: 27820001 DOI: 10.11124/01938924-200402030-00001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this systematic review was to report on the best available evidence relating to oral hygiene for adults with dementia in residential aged care facilities, including: INCLUSION CRITERIA: This review considered any randomised or non-randomised controlled studies, cohort studies, case-control studies, multiple time series studies, uncontrolled studies, descriptive studies and opinions of respected authorities (including theses and other publications) related to residents with dementia living in residential aged care facilities in Australia and overseas; community-dwelling adults with dementia; and special needs adult populations (for preventive oral hygiene care strategies and interventions).The review considered studies and publications designed to:1 quantify the oral health status of older adults living in residential aged care facilities;2 quantify the oral health status of adults with dementia living in the community and in residential aged care facilities;3 evaluate tools used to assess the oral health of residents by staff and carers working in residential aged care facilities;4 evaluate preventive oral hygiene care strategies and interventions used in special needs adult populations (including adults with dementia); and5 evaluate oral health care training and oral hygiene care provision, staff and carers working in residential aged care facilities.Dental outcome measures of interest were those relating to the prevalence, incidence, experiences and increments of oral diseases and conditions including: denture problems, coronal and root caries, periodontal diseases (plaque accumulation, gingivitis, loss-of-attachment), oral mucosal conditions, xerostomia and salivary gland hypofunction, tooth loss, difficulty chewing, behavioural problems and pain/discomfort. Related characteristics and outcomes of interest included: medical conditions, medications, cognitive status, functional status, nutritional status and sociodemographics. SEARCH STRATEGY The aim of the search was to locate relevant English-language studies and publications appearing between 1980 and 2002. The search utilised a two-step approach, involving an initial search of electronic databases using combinations of key words followed by a second extensive search carried out using the identified key words. This was supplemented with a secondary search of the references cited in the identified studies. Electronic database searched were: Cinahl, Embase, Psycinfo, Medline and Current Contents. METHODOLOGICAL QUALITY All selected studies were critically appraised by two reviewers prior to inclusion in the review. RESULTS In regards to relevance, incidence, experiences, and increments of oral diseases and conditions, possible risk factors identified included: saliva dysfunction, polypharmacy, comorbid medical conditions, swallowing and dietary problems, increased functional dependence, need for assistance with oral hygiene care, and poor access and utilisation of dental care.Evidence on the use of assessment tools by carers to evaluate residents' oral health showed that successful assessment of residents with and without dementia by nursing staff requires appropriate staff training by a dental professional. Coupled with appropriate training, an oral assessment screening tool designed for residents with dementia has been successfully used by nursing and care staff to identify residents requiring further review by dental professionals. Expert opinion in the field indicates that oral assessment screenings by a staff member and then by a dentist would ideally be undertaken upon admission to a facility, and regularly thereafter by staff and/or dentists as required.Clinicians and researchers suggested that oral hygiene care strategies to prevent oral diseases and conditions were found to be effective in preventing oral diseases, and thus are relevant for use in the resident with dementia.In regards to the provision of dental treatment and ongoing management of oral diseases and conditions, the use of adjunctive and preventive aids were found to be effective when introduced in conjunction with a staff training program:Expert opinion suggests that behaviour management techniques will increase the potential of performing oral hygiene care interventions. CONCLUSIONS This review suggests that the training of staff in the form of a comprehensive practically oriented program addressing areas such as oral diseases, oral screening assessment, and hands-on demonstration of oral hygiene techniques and products is likely to have a positive impact on the management of oral hygiene care within residential aged care facilities. The review also identified that regular brushing with fluoride toothpaste, use of therapeutic fluoride products and application of therapeutic chlorhexidine gluconate products are validated by research as effective for the general population and some populations with special needs.
Collapse
Affiliation(s)
- Alan Pearson
- 1The Joanna Briggs Institute, Adelaide, South Australia, Professor of Nursing, La Trobe University, Melbourne, Victoria, and Adjunct Professor, The University of Adelaide, Adelaide, South Australia, Australia 2Preventive and Community Dentistry, The University of Iowa, Iowa City, Iowa, USA Associate Professor Jane Chalmers, Preventive and Community Dentistry, College of Dentistry, The University of Iowa, Iowa City, IA 52242-1010, USA
| | | |
Collapse
|
35
|
Wårdh I, Hallberg LRM, Berggren U, Andersson L, Sörensen S. Oral health education for nursing personnel; experiences among specially trained oral care aides: one-year follow-up interviews with oral care aides at a nursing facility. Scand J Caring Sci 2003; 17:250-6. [PMID: 12919459 DOI: 10.1046/j.1471-6712.2003.00214.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The improved dental health in most industrialized countries is not apparent among elderly and long-term care patients. Oral healthcare has been found to have low priority in nursing care. To create lasting positive effects in oral healthcare education, a new educational model was tested in an oral healthcare project. After approval from ethical committee, nursing assistant and nurses' aides took part in a dental auscultation period at a dental clinic to serve as oral care aides additional to traditional oral healthcare education. Following this period, the aides were given responsibility for the oral healthcare at their ward. After serving as oral care aides for 1 year, interviews were made and analysed based on the Grounded Theory methodology. The aim was to investigate how the oral care aides had experienced their new duties regarding oral healthcare. The results indicated that, despite several environmental changes, reluctant residents and occasional lack of commitment from colleagues, the oral care aides felt responsible for the oral healthcare provision. The oral care aides expressed courage, the capacity to cope with reality, confirmation and empathy, characteristics that propelled them from novices to oral care aides with an expert competence.
Collapse
Affiliation(s)
- Inger Wårdh
- Department of Oral and Maxillofacial Surgery, Central Hospital, Västerås, Sweden.
| | | | | | | | | |
Collapse
|
36
|
Ohrn KEO, Sjöden PO. Experiences of oral care in patients with haematological malignancies or head and neck cancer. Eur J Cancer Care (Engl) 2003; 12:274-82. [PMID: 12919307 DOI: 10.1046/j.1365-2354.2003.00417.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of the present study was to investigate cancer patients' experiences of oral hygiene information, oral care and self-care, information on oral complications, examination of the oral cavity, and ability to eat and drink during cancer treatment, and to explore patient attitudes to oral examination and oral hygiene. The sample consisted of 41 consecutive patients treated with radiotherapy for head and neck cancer (n = 18) or with chemotherapy for haematological malignancies (n = 23). Patients were interviewed at the end of radiotherapy or the second/third chemotherapy cycle. Compared with patients receiving chemotherapy, those who received radiotherapy had significantly more often visited hospital dentistry, been informed about oral complications and oral hygiene, received instructions in oral hygiene procedures, and been examined by hospital staff. More of the radiotherapy patients experienced oral symptoms and difficulties to eat and drink during treatment. There were no significant differences between the groups with regard to patient experiences of the oral hygiene procedures. Only one patient objected to having hospital staff discuss oral hygiene procedures, and three did not want hospital staff to examine their oral cavity. Patients undergoing radiotherapy or chemotherapy need to be monitored during treatment with regard to their oral status and oral symptoms and complications. There are no acceptable reasons for allowing patients to suffer from oral symptoms that can be reduced.
Collapse
Affiliation(s)
- K E O Ohrn
- Högskolan Dalarna, Health and Caring Sciences, S-791 88 Falun, Sweden.
| | | |
Collapse
|
37
|
Paulsson G, Söderfeldt B, Nederfors T, Fridlund B. The effect of an oral health education program after three years. SPECIAL CARE IN DENTISTRY 2003; 23:63-9. [PMID: 14620765 DOI: 10.1111/j.1754-4505.2003.tb00292.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Three years after providing an oral health education program (OHEP) to nursing personnel, the authors analyzed the effect of the program on knowledge of the importance of oral health and on perception among the nurses of the possibility to implement oral care in patient care. The study was based on a cross-sectional survey of all nursing personnel (N = 2,901) in five municipalities in the Southwestern Sweden, of whom 950 had attended four one-hour lessons during an OHEP in 1996. The response rate to the survey questionnaire was 67% (1,930 subjects). Statistical analysis was performed by means of descriptive and analytical statistics. The program was shown to have an independent effect on the dependent variables "knowledge of oral health" and "assessment of implementation possibilities," This study has given further evidence of the feasibility of an educational program to improve both knowledge and implementation of oral health care.
Collapse
Affiliation(s)
- Gun Paulsson
- School of Social and Health Sciences, Halmstad University, Box 823, S-30118 Halmstad, Sweden.
| | | | | | | |
Collapse
|
38
|
|
39
|
Paulsson G, Söderfeldt B, Fridlund B, Nederfors T. Recall of an oral health education programme by nursing personnel in special housing facilities for the elderly. Gerodontology 2001; 18:7-14. [PMID: 11813391 DOI: 10.1111/j.1741-2358.2001.00007.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the recall of oral health knowledge and confidence by nursing personnel in special housing facilities for the elderly, three years after an education programme. DESIGN A cross sectional design using a questionnaire. SAMPLE All nursing personnel, a total of 2,901 subjects, in five municipalities in south-western Sweden; of whom 950 had attended the programme. The response rate was 67% (1930 subjects). INTERVENTION An oral health education programme consisting of four one-hour lessons. RESULTS The oral health education programme still had an effect on the participants' attitudes towards oral health three years later. When comparing the trained group (OHEP+) which attended the programme with those who did not have training (OHEP-), the perceived ability, opportunity and the knowledge of oral health were significantly better in the former group, p < 0.01 Further, within the OHEP- group who did not attend the programme there was a significant difference in the perceived ability, opportunity and the knowledge of oral health between those with a higher level of health care education, p < 0.01. CONCLUSIONS The effect of an oral health education programme on the participants' attitudes towards oral health persists at least for three years. The data indicate that trainees with a low level of health care education benefit most.
Collapse
Affiliation(s)
- G Paulsson
- Centre for Health Promotion Research, Halmstad University, Halmstad, Sweden.
| | | | | | | |
Collapse
|
40
|
Isaksson R, Paulsson G, Fridlund B, Nederfors T. Evaluation of an oral health education program for nursing personnel in special housing facilities for the elderly. Part II: Clinical aspects. SPECIAL CARE IN DENTISTRY 2000; 20:109-13. [PMID: 11203883 DOI: 10.1111/j.1754-4505.2000.tb00012.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In Sweden, efforts are being made to create strategies for evaluating realistic dental treatment needs among the elderly, who are retaining more natural teeth. These strategies focus on the importance of maintaining adequate oral hygiene. Elderly in long-term-care facilities often depend on nursing personnel for carrying out daily oral hygiene procedures. Therefore, the nursing personnel's knowledge about and attitudes toward oral health make oral health education for health care professionals an important concern. The purpose of this study was to evaluate the clinical oral health outcome in residents after their caregivers had undergone a one-session, four-hour oral health education program. The study consisted of an intervention with a pre- and a post-test and was carried out in three municipalities in the southwestern part of Sweden. A newly developed oral health screening protocol was carried out for 170 subjects living in long-term-care facilities both before and 3-4 months after nursing personnel had attended an oral health education program. Following the intervention, a statistically significant improvement was recorded for changes in oral mucosal color, a modified plaque index which measured oral hygiene status, and a mucosal index which recorded mucosal inflammation. This study indicated that a limited, one-session, four-hour oral health education, offered to caregivers within long-term-care facilities, had a positive impact on the oral health status of residents.
Collapse
|
41
|
Simons D, Baker P, Jones B, Kidd EA, Beighton D. An evaluation of an oral health training programme for carers of the elderly in residential homes. Br Dent J 2000; 188:206-10. [PMID: 10740904 DOI: 10.1038/sj.bdj.4800432] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The objectives of this study were: to evaluate carers' knowledge of oral health; to provide a high quality, consistent, oral health training programme for carers in residential homes; to evaluate the quality of this programme by examining both carers' changes in knowledge and any changes in carers' behaviour as reported by residents and to assess any changes in the oral health of the elderly residents after one year. DESIGN A cross-sectional, multi-centre study using a carer training programme, evaluated by both a questionnaire conducted with carers and residents and oral examination of residents. SETTING In August 1996, 20 (20%) of the residential/nursing homes, in West Hertfordshire were chosen at random and all managers contacted and offered an oral examination for all their residents. Ten (10%) of the homes were also offered an oral health training programme for their carers. Eighteen homes accepted the oral examination for all consenting residents and 7 of the 10 homes offered accepted the carer training. SUBJECTS Thirty-nine carers from 7 of the residential homes attended an oral health training course and 213 elderly residents in the 18 homes were examined both at baseline and after 12 months. RESULTS Carers' baseline knowledge about oral health was poor; the oral health training programme was enjoyed and their knowledge gain after one week was high. However, the elderly residents perceived no change in the oral care given by carers either after one week or after one year and there was no measurable improvement in the oral health of residents after carer training, except for an increase in filled coronal surfaces. Few of the carers originally trained were still working in the same residential homes after one year. CONCLUSION Although the carer training programme was well received, no changes in oral health practice resulted. Barriers to practice of oral care by carers remained and training, even when including practical skills, evaluation by peers and a high knowledge gain, failed to reduce these barriers.
Collapse
Affiliation(s)
- D Simons
- West Herts Community Dental Services, Principal Health Centre, Civic Close, St Albans
| | | | | | | | | |
Collapse
|
42
|
Paulsson G, Nederfors T, Fridlund B. Conceptions of oral health among nurse managers. A qualitative analysis. J Nurs Manag 1999; 7:299-306. [PMID: 10786549 DOI: 10.1046/j.1365-2834.1999.00136.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM The aim of this study was to describe how nurse managers perceive oral health in general and the oral health of the care-receiver in particular. BACKGROUND Oral health and general health are independent and influence each other through biological, psychological, emotional and developmental factors. To most adults, oral health is a natural daily routine of hygiene, whereas to people who are dependent on other people's assistance, it is a procedure carried out by nursing personnel. METHODS Data were collected through interviews and analysed according to the phenomenographical method. FINDINGS Five categories emerged describing how nurse managers perceive oral health: maintaining patients' well-being, having knowledge about oral health, behaviour towards the patient, feeling of being insufficient and creating the necessary conditions. CONCLUSION The nurses considered oral health an important and obvious, but neglected, part of nursing. They expressed the wish to be updated in the knowledge area concerned, both for themselves and for their personnel. A majority called for standards for oral care, including documentation, which was considered necessary for the successful implementation. IMPLICATIONS A suggestion for further research is to study whether the creation of national standards may increase its status and quality.
Collapse
Affiliation(s)
- G Paulsson
- Oral and Dental Health Centre, Central Hospital, Halmstad, Sweden
| | | | | |
Collapse
|