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Schafthuizen L, Spruit-Bentvelzen L, van Dijk M, van Rosmalen J, Ista E. Implementation of a nursing oral health care protocol in a university teaching hospital: A cluster-randomized stepped-wedge design. Int J Dent Hyg 2024; 22:661-671. [PMID: 37722075 DOI: 10.1111/idh.12748] [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: 03/31/2022] [Revised: 01/24/2023] [Accepted: 07/30/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION Providing oral care is an essential part of basic nursing care but receives little priority in daily practice, with a risk of adverse events. Also, nurses report many barriers to adequate provision of oral care, such as time restraints, insufficient materials, fear of causing pain, lack of knowledge and a negative attitude towards providing oral care. METHODS We performed a cluster-randomized, stepped-wedge study to explore the effect of the the implementation of a new nursing evidence-based oral care protocol on nurses' knowledge, attitude and protocol adherence. The study population included both nursing students, graduated nurses and patients in selected wards. The implementation strategy included oral and written information, instruction videos and reminders. Nurses' knowledge and attitude towards oral care were assessed at baseline and after the implementation of the protocol with a validated 47-item questionnaire with a score range of 0-100. Secondarily, nurses' protocol adherence to teeth brushing, measured in Activities of Daily Living (ADL) dependent patients, was evaluated. The Standards for Reporting Implementation Studies (StaRI) Statement was used. RESULTS At baseline, the questionnaire was completed by 226 nurses; after implementation by 283. Knowledge had significantly improved from 68.8 to 72.3. Nurses' attitude improved not significantly. Protocol adherence was assessed in 73 ADL-dependent patients at baseline, in 51 after implementation. Adherence to teeth brushing significantly decreased in patients with permanent teeth. Also, adherence to both teeth brushing and usage of soap decreased in patients with (partial) dentures. CONCLUSION Nurses' knowledge and attitude of oral care increased somewhat after the implementation of a new nursing evidence-based protocol. After implementation, there was an unexplained decreased adherence to oral care in ADL-dependent patients.
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Affiliation(s)
- Laura Schafthuizen
- Department of Internal Medicine, Section Nursing Science, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Lotte Spruit-Bentvelzen
- Department of Internal Medicine, Section Nursing Science, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Monique van Dijk
- Department of Internal Medicine, Section Nursing Science, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Joost van Rosmalen
- Department of Biostatistics, Erasmus University Medical Centre, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Erwin Ista
- Department of Internal Medicine, Section Nursing Science, Erasmus University Medical Centre, Rotterdam, the Netherlands
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Lisiecka D, Kearns Á, Evans W, Farrell D. Aspiration pneumonia in nursing literature-a mapping review. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1393368. [PMID: 39113687 PMCID: PMC11304538 DOI: 10.3389/fresc.2024.1393368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/03/2024] [Indexed: 08/10/2024]
Abstract
Introduction Aspiration pneumonia (AP) is an infection of the lungs caused by inhalation of material. The reported incidences vary across literature and clinical populations and is associated with high morbidity and mortality. Management of AP is best carried out by a multidisciplinary team. Methods This aim of this review was to collate and describe the available evidence on AP to develop a greater understanding of the concept of AP as it is represented in the nursing literature. As a collaborative team, we undertook the six stages of a systematic mapping review. We searched for the term aspiration pneumonia in 200 peer reviewed nursing journals across 10 databases, over a ten-year period (2013-2023). Results In this review, 293 papers were coded. Dysphagia, oral health and tube feeding emerged as the most frequent risk factors for AP, and the most reported factors for preventing this condition. Mortality was the most commonly described consequence of AP, followed by hospitalisations and morbidity. Multiple management approaches were reported including dysphagia assessment, risk evaluation, oral care and texture modification of food and fluids. The role of nurses and interprofessional collaborations were described. Discussion Despite limited evidence related to the topic of AP in the nursing literature, the complexity of the causes, prevention, management and consequences of AP emerged. Certain factors, such as dysphagia, oral health, and tube feeding, were described under prevention, cause and management of AP. The importance of multidisciplinary approach in the management and prevention of AP was presented.
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Affiliation(s)
- Dominika Lisiecka
- Department of Nursing and Healthcare Sciences, Munster Technological University—Kerry Campus, Tralee, Ireland
- Kerry Speech & Language Therapy Clinic, Tralee, Ireland
| | - Áine Kearns
- Health Research Institute, School of Allied Health, University of Limerick, Limerick, Ireland
| | - William Evans
- Department of Nursing and Healthcare Sciences, Munster Technological University—Kerry Campus, Tralee, Ireland
| | - Dawn Farrell
- Department of Nursing and Healthcare Sciences, Munster Technological University—Kerry Campus, Tralee, Ireland
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Haresaku S, Miyoshi M, Muramatsu M, Monji M, Aoki H, Maeda H, Miyazono M, Obuse M, Nakashima F, Uchida S, Iino H, Akinaga K, Chishaki A, Naito T. Implementation of peer-to-peer oral care objective structured clinical examination-based learning for nursing students. Jpn J Nurs Sci 2024; 21:e12591. [PMID: 38414128 DOI: 10.1111/jjns.12591] [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: 08/16/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 02/29/2024]
Abstract
AIM Nurses' skills and confidence in providing oral care to patients play important roles in healthcare. Studies have proved that peer-to-peer learning and assessment can help improve nurses' skills and confidence. However, no study has investigated it using an objective assessment checklist. This study investigated an oral hygiene practice training program for nursing students. It focused on their oral healthcare skills, confidence, and perspectives regarding implementing an objective structured clinical examination (OSCE). METHODS A pre- and post-survey of 97 nursing students from a nursing school in Japan was conducted as a peer-to-peer oral health education training program that included an assessment and performance checklist. RESULTS Confidence in performing and assessing oral care significantly improved after attending the program. Furthermore, the changes were significantly greater in the developed program than in the training program without the checklist. The mean total assessment scores (0-25) of the first, second, third, and fourth participants in the four-student groups were 22.1, 23.4, 23.9, and 24.1, respectively. The mean scores of the second, third, and fourth participant groups were significantly higher than that of the first participant group (p < .01). Fifty-two positive and 58 negative comments were received regarding the implementation of the program with professional assessments and the checklist. The most common positive comment mentioned that the evaluation by professionals improved oral care learning and skills. CONCLUSIONS This study developed a program to improve nursing students' confidence and oral care delivery skill building in an OSCE-style delivery.
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Affiliation(s)
| | | | | | | | | | - Hitomi Maeda
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | | | - Mika Obuse
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | | | | | | | | | | | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan
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Lin PC, Wung SF, Lin PC, Lin YC, Lin CY, Huang HL. Virtual reality-based simulation learning on geriatric oral health care for nursing students: a pilot study. BMC Oral Health 2024; 24:627. [PMID: 38807116 PMCID: PMC11134768 DOI: 10.1186/s12903-024-04249-y] [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: 04/30/2023] [Accepted: 04/11/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND There is a great need for training and education in the nursing curriculum to improve nurses' knowledge and skills to provide oral health care. METHODS A pilot study was conducted to evaluate the use of a virtual reality (VR)-based Oral Health Care Learning System to train geriatric oral health care among nursing students. Fifty undergraduate nursing students were randomly assigned to experimental (n = 25) and control (n = 25) groups. The experimental group received the VR-based simulation training on geriatric oral health care and the training was implemented twice at two weeks apart from March to November 2021. The control group did not receive the training intervention. Knowledge, attitude, and self-efficacy of geriatric oral health care as well as the intention to assist oral health care for older adults were assessed at the beginning, second, and fourth weeks. Generalized estimating equations were used to analyze the effectiveness of the VR-based simulation training. RESULTS After the first round of training, students in the experimental group had significantly greater improvements in knowledge and self-efficacy of geriatric oral health care than in the control group. After the second round of training, students in the experimental group had significantly greater improvements in knowledge, attitude, and self-efficacy of geriatric oral health care as well as the intention to assist oral health care for older adult than in the control group. CONCLUSIONS The VR-based simulation training was effective to improve undergraduate nursing students' knowledge, attitudes and self-efficacy of geriatric oral health as well as the intention to assist oral health care for older adults. The VR-based simulation learning system is an effective tool to provide practice experiences to build confidence and skills and to bridge the gap of understudied geriatric oral health content in entry-level nursing curricula. TRIAL REGISTRATION ClinicalTrials.gov (NCT05248542; registration date 21/02/2022).
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Affiliation(s)
- Pei-Chao Lin
- School of Nursing, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Fen Wung
- College of Nursing, The University of Arizona, Tucson, AZ, USA
| | - Pei-Chen Lin
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Ching Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral Hygiene, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Cheng-Yu Lin
- Department of Radio, TV & Film, Shih Hsin University, Taipei, Taiwan
| | - Hsiao-Ling Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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van Noort HHJ, Harderwijk A, Everaars B, Akkermans R, van der Putten GJ, Waal GHD. The Dutch version of the Oral Health Assessment Tool: Translation and inter-rater reliability among community nurses. Int J Dent Hyg 2024; 22:140-147. [PMID: 37093920 DOI: 10.1111/idh.12678] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 02/02/2023] [Accepted: 04/02/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVES Translating the Oral Health Assessment Tool (OHAT) into Dutch and assessing the inter-rater reliability among community nurses. METHODS The original version of the OHAT was translated following the five stages of the 'Guidelines for the Process of Cross-Cultural Adaptation'. After a forward and backward translation, consensus on the pre-final version was obtained in an expert panel discussion. This version was pre-tested on its comprehensibility among 31 nurses and hereafter finalized. Then, inter-rater reliability of the OHAT-NL was determined by two trained nurses during oral assessments of 37 care-dependent community-dwelling older people. Intraclass correlation coefficient (ICC) and the Cohen's kappa statistic for individual items were estimated. RESULTS Feedback from nurses in the pre-test did lead to minor changes of the OHAT-NL. Inter-rater reliability was good (ICC 0.79; 95% CI 0.63-0.89) on the total score. Agreement on item level ranged from fair to very good, the kappa ranged from 0.36-0.89. CONCLUSIONS OHAT is now available in Dutch having good inter-rater reliability among trained community nurses. Future research can further validate the OHAT-NL and develop intervention according to total OHAT-NL scores.
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Affiliation(s)
- Harm H J van Noort
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Nutrition, Physical Activity and Sports, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Anne Harderwijk
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nursing Sciences, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Babette Everaars
- Research Group Innovations in Preventive Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Reinier Akkermans
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Gert-Jan van der Putten
- Medical Department, Orpea Dagelijks Leven, Apeldoorn, The Netherlands
- Department of Oral Function and Rehabilitation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
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Haresaku S, Kubota K, Miyoshi M, Obuse M, Aoki H, Nakashima F, Muramatsu M, Maeda H, Uchida S, Miyazono M, Iino H, Naito T. A Survey of Oral Assessment and Healthcare Education at Nursing Schools in Japan. Int Dent J 2023; 73:804-811. [PMID: 36347715 PMCID: PMC10658431 DOI: 10.1016/j.identj.2022.09.006] [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: 08/15/2022] [Revised: 09/18/2022] [Accepted: 09/27/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the performance of oral assessment and health care education at nursing schools across Japan to identify problems and the need for oral health professional support. METHODS The participants were the academic staff in charge of oral health care education in the basic, adult, gerontological, and home nursing fields of 295 schools in Japan that offered a bachelor's degree in nursing. A questionnaire was sent to 1180 heads of the nursing fields of these schools. They were requested to have oral health care educators complete the survey; data on the performance of oral assessment and health care education and human resources allocated were collected through a questionnaire. RESULTS A total of 311 (26%) questionnaires were returned, 196 (63%) of which were completed by oral health care educators. Regarding the performance of oral assessment education, the majority (71%) of them spent less than 2 hours in teaching, and only 24.5% taught the usage of oral assessment tools. Regarding the performance of oral health care education, more than 90% spent less than 2 hours in lecture-based and practical oral health care education, respectively. Less than half taught the association of periodontal diseases with diabetes and cardiovascular diseases and use of fluoride for caries prevention in the lectures, and only approximately 30% taught the usage of an interspace brush or dental floss. Moreover, less than 10% of oral health professionals taught oral health care in lectures or practical oral health care. CONCLUSIONS This study revealed problems associated with oral assessment and health care education in Japanese nursing schools. To address these, support from oral health care professionals is required. Further studies are also required to reveal problems in oral assessment and health care education in other nursing schools that do not offer a bachelor's degree programme in Japan and other countries.
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Affiliation(s)
- Satoru Haresaku
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan.
| | - Keiko Kubota
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Maki Miyoshi
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Mika Obuse
- Graduate School of Nursing Science, St. Luke's International University, Chuo-ku, Tokyo, Japan
| | - Hisae Aoki
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | | | - Masumi Muramatsu
- School of Nursing, Sapporo City University, Sapporo, Hokkaido, Japan
| | - Hitomi Maeda
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Souhei Uchida
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Mami Miyazono
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Hidechika Iino
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Sawara-ku, Fukuoka, Japan
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Oda K, Majeed S, Parsons J, Boyd M, Smith M. Putting the Mouth Into the Head-to-Toe Assessment: Nursing Oral Health Assessment Training With an Oral Health Therapist. J Nurs Educ 2023; 62:399-402. [PMID: 37413674 DOI: 10.3928/01484834-20230509-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
BACKGROUND Oral care is one of the most neglected nursing practices, lacking oral care protocols, efficient training, and awareness of the benefits for clients. In particular, there is a gap in research for nursing oral health assessment training for nursing curricula. METHOD This study explored the effects of interprofessional collaboration (IPC) training between nurses and oral health therapists (OHT) using newly developed oral health assessment tools with an aim of reducing barriers for nursing oral health assessment. The self-efficacy and confidence of nursing students in oral health assessment were evaluated using pre- and posttraining surveys, and a focus group. RESULTS Nursing students' confidence in incorporating oral health assessment into head-to-toe assessment improved after training. CONCLUSION Nursing oral health assessment training with IPC, onsite OHT support, and oral health assessment tools improved the confidence and attitudes of nursing students in oral health assessment and care provision. [J Nurs Educ. 2023;62(7):399-402.].
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Haresaku S, Miyoshi M, Kubota K, Obuse M, Aoki H, Nakashima F, Muramatsu M, Maeda H, Uchida S, Miyazono M, Iino H, Naito T. Current status and future prospects for oral care education in Bachelor of Nursing curriculums: A Japanese cross‐sectional study. Jpn J Nurs Sci 2022; 20:e12521. [PMID: 36450275 DOI: 10.1111/jjns.12521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/25/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE This study sought to investigate the current status and faculty members' perceptions of oral care education in Bachelor of Nursing curriculums in Japan. METHOD Data were gathered through a questionnaire survey of 196 participants, who were faculty members in charge of oral care education in the basic, adult, gerontological, and home nursing fields, from 295 nursing schools that offered Bachelor degrees in nursing across Japan. RESULTS The quantitative data showed that 38.5% of the participants worked for less than 5 years as oral care educators, only 15.5% taught oral care in perioperative wards, only 62.2% used an oral care training simulator, and less than 30% believed that training in the prevention of oral diseases should be enhanced. From the descriptive responses, this study identified such problems as the inability of students to perform student-on-student and patient-based oral care training owing to the risk of SARS-CoV-2 transmission, and the lack of teaching materials, time, and human resources, and cooperation with other nursing fields and health professionals. CONCLUSIONS This study revealed several problems in oral care education in the Bachelor of Nursing curriculums in Japan. To tackle these challenges, this study suggests the development of an interdisciplinary course that unifies oral care education in nursing fields, in order to promote collaborative oral care education and to improve nursing students' knowledge and skills of oral care.
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Affiliation(s)
| | - Maki Miyoshi
- Department of Nursing Fukuoka Nursing College Fukuoka Japan
| | - Keiko Kubota
- Department of Nursing Fukuoka Nursing College Fukuoka Japan
| | - Mika Obuse
- Graduate School of Nursing Science St. Luke's International University Tokyo Japan
| | - Hisae Aoki
- Department of Nursing Fukuoka Nursing College Fukuoka Japan
| | | | | | - Hitomi Maeda
- Department of Nursing, Faculty of Life Sciences Kumamoto University Kumamoto Japan
| | - Souhei Uchida
- Department of Nursing Fukuoka Nursing College Fukuoka Japan
| | - Mami Miyazono
- Department of Nursing Fukuoka Nursing College Fukuoka Japan
| | - Hidechika Iino
- Department of Nursing Fukuoka Nursing College Fukuoka Japan
| | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry Fukuoka Dental College Fukuoka Japan
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Effectiveness of Virtual Reality-Based Training on Oral Healthcare for Disabled Elderly Persons: A Randomized Controlled Trial. J Pers Med 2022; 12:jpm12020218. [PMID: 35207706 PMCID: PMC8879228 DOI: 10.3390/jpm12020218] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/16/2022] [Accepted: 02/01/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Virtual reality (VR) technology is a widely used training tool in medical education. The present study aimed to evaluate the effectiveness of VR training of oral hygiene students on providing oral healthcare to disabled elderly persons. (2) Methods: A randomized controlled trial was conducted. In 2021, oral hygiene students were randomly assigned to a VR experimental group (EG; n = 11) and a control group (CG; n = 12). The EG received two-hour, thrice-repeated VR-based training interventions at 2-week, 4-week, and 6-week follow-ups. The CG received no VR-based interventions. Data were collected using a self-administered questionnaire before and immediately after each intervention. We performed generalized estimating equations to compare the responses. (3) Results: The EG exhibited a more significant improvement in oral care-related knowledge, attitude, self-efficacy, and intention at the 6-week follow-up than the CG. The students’ intention to assist the elderly in using interdental brushes (β = 0.91), with soft tissue cleaning (β = 0.53), and with oral desensitization (β = 0.53), and to have regular dental visits (β = 0.61) improved significantly at the 6-week follow-up. (4) Conclusions: VR training positively affected students’ knowledge, attitude, self-efficacy, and intentions on providing oral healthcare to disabled elderly persons.
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Akyea M, Carter B, Colandrea M, Afshari H. Oral Health Program for VA Outpatient Clinics. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2020.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Haresaku S, Umezaki Y, Egashira R, Naito T, Kubota K, Iino H, Aoki H, Nakashima F. Comparison of attitudes, awareness, and perceptions regarding oral healthcare between dental and nursing students before and after oral healthcare education. BMC Oral Health 2021; 21:188. [PMID: 33845813 PMCID: PMC8040009 DOI: 10.1186/s12903-021-01554-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/06/2021] [Indexed: 01/29/2023] Open
Abstract
Background Oral healthcare education for health professional students is important to promote collaborative oral healthcare practice among health professionals. The purpose of this follow-up, cross-sectional study was to investigate attitudes, awareness, and perceptions regarding oral healthcare among dental and nursing students and to compare them both between baseline and the completion of the education programme and between dental and nursing students to identify problems with oral healthcare programmes in dental education. Method The subjects included 88 dental and 119 nursing students. The dental students participated in geriatric and preventive dentistry courses for oral healthcare education. The nursing students participated in independent oral healthcare courses comprising 45 h of training with case-based learning and were taught and instructed by multiple health professionals, including dentists. Questionnaires were distributed to the participants to compare attitudes, awareness, and perceptions regarding oral healthcare between baseline and the completion of the education programme and between dental and nursing students. A chi-square test, Wilcoxon signed-rank test, and Mann–Whitney U test were used to compare the data. Result and Conclusion The data of 48 (28 male and 20 female) dental students and 103 (9 male and 94 female) nursing students who completed the questionnaires both at baseline and after the education programme were used for the comparisons. After the education programme, more than 90% of the students were interested in oral healthcare practice; hoped to practise oral healthcare post-qualification; and perceived oral healthcare to be effective for preventing dental caries, periodontal diseases, and aspiration pneumonia. These attitudes and perceptions were statistically significantly improved after the education. However, the level of awareness of oral healthcare and the level of perception of the importance of collaboration with healthcare workers in oral healthcare practice after education were lower in the dental students than in the nursing students. Multi-professional oral healthcare education with case-based learning has the potential to improve awareness of oral healthcare and perceptions of the importance of collaborative oral healthcare practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01554-8.
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Affiliation(s)
- Satoru Haresaku
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan.
| | - Yojiro Umezaki
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Rui Egashira
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Keiko Kubota
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Hidechika Iino
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Hisae Aoki
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Fuyuko Nakashima
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
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Haresaku S, Kubota K, Yoshida R, Aoki H, Nakashima F, Iino H, Uchida S, Miyazono M, Naito T. Effect of multi-professional education on the perceptions and awareness of oral health care among undergraduate nursing students in a nursing school. J Dent Educ 2021; 85:786-793. [PMID: 33576016 DOI: 10.1002/jdd.12558] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/26/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study investigates the effects of a study course in oral health care on the perceptions of nursing students. The course was designed and evaluated by a multi-professional team at a Japanese nursing school. METHOD The subjects were 119 nursing students. They participated in the oral health course that comprised 45h of training in 4 years. These were designed and taught by oral health professionals, a certified speech-hearing therapist, and nurses. Questionnaires were distributed to subjects to compare their perceptions and awareness about oral health care before, in between, and after the courses. A chi-square test was used to compare the data. RESULTS After completing the courses, more than 95% of the participants were interested in the oral health care practice and expected to collaborate with oral health professionals after getting qualified. Additionally, they understood the effectiveness of oral health care for the prevention of aspiration pneumonia and perceived that oral health care should be provided to hospitalized patients and community-dwelling older adults. Their awareness of the need to learn techniques for tooth brushing support, salivary gland massage, oral management, swallowing training, removing tongue coating, and gargling, both in theory and practice, was significantly improved. CONCLUSION Multi-professional education has the potential to improve the awareness of nursing students of oral health care and promote collaborative oral health care in the future.
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Affiliation(s)
- Satoru Haresaku
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Keiko Kubota
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Rie Yoshida
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Hisae Aoki
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | | | - Hidechika Iino
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Souhei Uchida
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Mami Miyazono
- Department of Nursing, Fukuoka Nursing College, Fukuoka, Japan
| | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan
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13
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Bhagat V, Hoang H, Crocombe LA, Goldberg LR. Incorporating oral health care education in undergraduate nursing curricula - a systematic review. BMC Nurs 2020; 19:66. [PMID: 32684840 PMCID: PMC7359291 DOI: 10.1186/s12912-020-00454-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 06/28/2020] [Indexed: 01/08/2023] Open
Abstract
Background The recognised relationship between oral health and general health, the rapidly increasing older population worldwide, and changes in the type of oral health care older people require have raised concerns for policymakers and health professionals. Nurses play a leading role in holistic and interprofessional care that supports health and ageing. It is essential to understand their preparation for providing oral health care.Objective: To synthesise the evidence on nursing students' attitudes towards, and knowledge of, oral healthcare, with a view to determining whether oral health education should be incorporated in nursing education. Methods Data sources: Three electronic databases - PubMed, Scopus, and CINAHL.Study eligibility criteria, participants and interventions: Original studies addressing the research objective, written in English, published between 2008 and 2019, including students and educators in undergraduate nursing programs as participants, and conducted in Organisation of Economic Co-operation and Development countries.Study appraisal and synthesis methods: Data extracted from identified studies were thematically analysed, and quality assessment was done using the Mixed Methods Appraisal Tool. Results From a pool of 567 articles, 11 met the eligibility criteria. Findings documented five important themes: 1.) nursing students' limited oral health knowledge; 2.) their varying attitudes towards providing oral health care; 3.) the need for further oral health education in nursing curricula; 4.) available learning resources to promote oral health; and 5.) the value of an interprofessional education approach to promote oral health care in nursing programs.Limitations: The identified studies recruited small samples, used self-report questionnaires and were conducted primarily in the United States. Conclusions The adoption of an interprofessional education approach with a focus on providing effective oral health care, particularly for older people, needs to be integrated into regular nursing education, and practice. This may increase the interest and skills of nursing students in providing oral health care. However, more rigorous studies are required to confirm this. Nursing graduates skilled in providing oral health care and interprofessional practice have the potential to improve the oral and general health of older people.
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Affiliation(s)
- Vandana Bhagat
- Centre for Rural Health (CRH), E Block, Newnham Campus, University of Tasmania (UTas), Launceston, Australia
| | - Ha Hoang
- CRH, E block, Newnham Campus, UTas, Launceston, Australia
| | - Leonard A Crocombe
- CRH, ABC Building, 1 Liverpool Street, Hobart, Hobart CBD Campuses, UTas, Hobart, Australia
| | - Lynette R Goldberg
- Wicking Dementia Research & Education Centre, Room 421C (Level 4), Medical Science 1, UTas, Hobart, Australia
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14
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Patterson Norrie T, Villarosa AR, Kong AC, Clark S, Macdonald S, Srinivas R, Anlezark J, George A. Oral health in residential aged care: Perceptions of nurses and management staff. Nurs Open 2020; 7:536-546. [PMID: 32089850 PMCID: PMC7024615 DOI: 10.1002/nop2.418] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 09/27/2019] [Accepted: 10/21/2019] [Indexed: 11/13/2022] Open
Abstract
Aim This study aimed to explore the perceptions of residential aged care nursing and management staff regarding oral care, to develop strategies to improve the oral health of aged care residents. Design A qualitative approach was used. Methods Two focus groups were conducted with nursing and management staff at two residential aged care facilities and transcripts were thematically analysed. Results All staff had an awareness of the importance of oral health; however, they highlighted the significant challenges in the current system that affect implementation of oral health training and practice guidelines in the residential aged care facility. High staff turnover, time constraints, difficulties in accessing dental services and working together with residents, their families and external staff were barriers to providing oral health care. Staff highlighted the need for formalized clinical guidelines and processes and efficient dental referral pathways to create a more cohesive system of care.
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Affiliation(s)
- Tiffany Patterson Norrie
- Centre for Oral Health Outcomes & Research Translation (COHORT)Western Sydney UniversityLiverpoolNSWAustralia
- Oral Health ServicesSouth Western Sydney Local Health DistrictLiverpoolNSWAustralia
- Ingham Institute Applied Medical ResearchLiverpoolNSWAustralia
| | - Amy R. Villarosa
- Centre for Oral Health Outcomes & Research Translation (COHORT)Western Sydney UniversityLiverpoolNSWAustralia
- Oral Health ServicesSouth Western Sydney Local Health DistrictLiverpoolNSWAustralia
- Ingham Institute Applied Medical ResearchLiverpoolNSWAustralia
| | - Ariana C. Kong
- Centre for Oral Health Outcomes & Research Translation (COHORT)Western Sydney UniversityLiverpoolNSWAustralia
- Oral Health ServicesSouth Western Sydney Local Health DistrictLiverpoolNSWAustralia
- Ingham Institute Applied Medical ResearchLiverpoolNSWAustralia
| | - Sally Clark
- Oral Health ServicesSouth Western Sydney Local Health DistrictLiverpoolNSWAustralia
| | | | - Ravi Srinivas
- Centre for Oral Health Outcomes & Research Translation (COHORT)Western Sydney UniversityLiverpoolNSWAustralia
- Oral Health ServicesSouth Western Sydney Local Health DistrictLiverpoolNSWAustralia
- Ingham Institute Applied Medical ResearchLiverpoolNSWAustralia
- University of SydneySydneyNSWAustralia
| | - Jennifer Anlezark
- Oral Health ServicesSouth Western Sydney Local Health DistrictLiverpoolNSWAustralia
| | - Ajesh George
- Centre for Oral Health Outcomes & Research Translation (COHORT)Western Sydney UniversityLiverpoolNSWAustralia
- Oral Health ServicesSouth Western Sydney Local Health DistrictLiverpoolNSWAustralia
- Ingham Institute Applied Medical ResearchLiverpoolNSWAustralia
- University of SydneySydneyNSWAustralia
- Translational Health Research InstituteLiverpoolNSWAustralia
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15
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van Noort HHJ, Witteman BJM, den Hertog-Voortman R, Everaars B, Vermeulen H, Huisman-de Waal G. A context analysis on how oral care is delivered in hospitalised patients: A mixed-methods study. J Clin Nurs 2019; 29:1991-2003. [PMID: 31793109 DOI: 10.1111/jocn.15130] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 10/25/2019] [Accepted: 11/10/2019] [Indexed: 12/23/2022]
Abstract
AIMS AND OBJECTIVES To analyse oral care delivery in one hospital through exploring experiences from both nurses' and patients' perspectives and examining patients' oral health. BACKGROUND Oral health problems are associated with undernutrition and other general health outcomes. Although oral care belongs to the essentials of nursing, it is often neglected. Improving oral health may require behaviour change of both nurses and patients. Defining tailored strategies need a clear view on the context. DESIGN A context analysis in one hospital using a convergent parallel mixed-methods design was reported following the EQUATOR guidelines using two checklists: COnsolidated criteria for REporting Qualitative research (qualitative research) and STROBE (observational research). METHODS Semi-structured interviews were conducted with 19 nurses and 11 patients. The topic list was based on the Integrated Change Model. Prospective oral examination was performed among 91 surgical patients using the Oral Health Assessment Tool (OHAT). RESULTS Nurses acknowledged that they did not prioritise oral care in daily practice. Furthermore, they lacked knowledge and skills to identify and provide care for oral problems. Nurses mentioned helpful resources to perform oral care, like standardised language and instruments. However, they had no access to or were unaware of them. Patients admitted that they did not prioritise oral care due to their sickness during hospitalisation, were unaware of the importance of oral care, but felt responsible for their oral care. The most prominent oral problems identified with the OHAT were unclean mouths (n = 75, 82%), unhealthy gum and tissues (n = 55, 60%) and dry mouth (n = 42, 46%). CONCLUSIONS This context analysis identified inadequate oral care due to lack of positive attitude and knowledge in both nurses and patients, skills for nurses, and resources. RELEVANCE TO CLINICAL PRACTICE The behavioural factors indicate strategies for development of a multicomponent intervention to improve oral care in this hospital, nutritional status and general health outcomes.
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Affiliation(s)
- Harm H J van Noort
- Department of Nutrition, Physical Activity and Sports, Gelderse Vallei Hospital, Ede, The Netherlands.,Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Nursing, Christian University of Applied Sciences, Ede, The Netherlands
| | - Ben J M Witteman
- Department of Gastroenterology and Hepatology, Gelderse Vallei Hospital, Ede, The Netherlands.,Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | | | - Babette Everaars
- Research Group Innovations in Preventive Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Hester Vermeulen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands.,Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
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Can oral healthcare for older people be embedded into routine community aged care practice? A realist evaluation using normalisation process theory. Int J Nurs Stud 2018; 94:32-41. [PMID: 30933871 DOI: 10.1016/j.ijnurstu.2018.12.016] [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: 08/27/2018] [Revised: 11/08/2018] [Accepted: 12/04/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND An intervention 'Better Oral Health in Home Care' was introduced (2012-2014) to improve the oral health of older people receiving community aged care services. Implementation of the intervention was theoretically framed by the Promoting Action on Research Implementation in Health Services framework. Process outcomes demonstrated significant improvements in older people's oral health. OBJECTIVE To evaluate the extent to which the intervention has been embedded and sustained into routine community aged care practice 3 years after the initial implementation project. DESIGN A Realist Evaluation applying Normalisation Process Theory within a single case study setting. SETTING Community aged care (home care) provider in South Australia, Australia. PARTICIPANTS Purposeful sampling was undertaken. Twelve staff members were recruited from corporate, management and direct care positions. Two consumers representing high and low care recipients also participated. METHODS Qualitative methods were applied in two subcases, reflecting different contextual settings. Data were collected via semi-structured interviews and analysed deductively by applying the Normalisation Process Theory core constructs (with the recommended phases of the Realist Evaluation cycle). Retrospective and prospective analytic methods investigated how the intervention has been operationalised by comparing two timeframes: Time 1 (Implementation June 2012-December 2014) and Time 2 (Post-implementation July 2017-July 2018). RESULTS At Time 1, the initial program theory proposed that multi-level facilitation contributed to a favourable context that triggered positive mechanisms supportive of building organisational and workforce oral healthcare capacity. At Time 2, an alternative program theory of how the intervention has unfolded in practice described a changed context following the withdrawal of the project facilitation processes with the triggering of alternative mechanisms that have made it difficult for staff to embed sustainable practice. CONCLUSION Findings concur with the literature that successful implementation outcomes do not necessarily guarantee sustainability. The study has provided a deeper explanation of how contextual characteristics have contributed to the conceptualisation of oral healthcare as a low priority, basic work-ready personal care task and how this, in turn, hindered the embedding of sustainable oral healthcare into routine community aged care practice. This understanding can be used to better inform the development of strategies, such as multi-level facilitation, needed to navigate contextual barriers so that sustainable practice can be achieved.
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Improving quality of referral letters from primary to secondary care: a literature review and discussion paper. Prim Health Care Res Dev 2017; 19:211-222. [PMID: 29212565 DOI: 10.1017/s1463423617000755] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Referral letters sent from primary to secondary or tertiary care are a crucial element in the continuity of patient information transfer. Internationally, the need for improvement in this area has been recognised. This aim of this study is to review the current literature pertaining to interventions that are designed to improve referral letter quality. METHODS A search strategy designed following a Problem, Intervention, Comparator, Outcome model was used to explore the PubMed and EMBASE databases for relevant literature. Inclusion and exclusion criteria were established and bibliographies were screened for relevant resources. RESULTS A total of 18 publications were included in this study. Four types of interventions were described: electronic referrals were shown to have several advantages over paper referrals but were also found to impose new barriers; peer feedback increases letter quality and can decrease 'inappropriate referrals' by up to 50%; templates increase documentation and awareness of risk factors; mixed interventions combining different intervention types provide tangible improvements in content and appropriateness. CONCLUSION Several methodological considerations were identified in the studies reviewed but our analysis demonstrates that a combination of interventions, introduced as part of a joint package and involving peer feedback can improve.
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