Oral care practices of long-term care home residents and caregivers: Secondary analysis of observational video recordings

Oral health knowledge and attitude among healthcare professionals of long-term care units: A cross-sectional survey

BACKGROUND

This study aims to evaluate the knowledge and the attitude in oral health (OH) of nurses (NUR) and auxiliary health technicians (AHT) belonging to the Long-term Care Units (LTC).

METHODS

Observational cross-sectional study. A survey was applied in five MLTC in Porto (Portugal) to 145 healthcare works (HCW). Data were collected using structured questionnaires with questions about knowledge and attitude regarding oral care. Data analysis comparison was performed using non-parametric tests (α = 0.05).

RESULTS

Out of a total of 259 HCW, 145 responses were obtained (55.98% response rate). The median number of correct answers was significantly different for NUR and AHT without oral health training (OHT) (p = .035).AHT with OHT had a significantly lower number of correct answers compared to NUR with OHT (7 vs. 9, p < .001). There was no significant difference in the number of correct answers in NUR with or without OHT (p = .391) and that the AHT without OHT have a median of correct answers significantly higher than those who they have OHT (8 vs. 7, p = .020) CONCLUSIONS: Despite the positive attitude of the HCW, the knowledge is scarce. HCW recognized the urgence to update the protocols.

PRACTICAL IMPLICATIONS

Integrating dentists in the LTC team, implementation of OH protocols and providing OH training should be considered to bridge existing gaps.

Improving oral hygiene for better cognitive health: Interrelationships of oral hygiene habits, oral health status, and cognitive function in older adults

OBJECTIVES

To explore the interrelationships between oral hygiene habits, oral health status and cognitive function in older adults.

DESIGN

A cross-sectional study.

SETTING AND PARTICIPANTS

A total of 371 participants (age 76.79 [7.99] years) were enrolled from June 2020 to November 2021 in an aged care facility.

METHODS

Cognitive function was screened using the mini-mental state examination (MMSE) with adjusted cut-off points for age and education. Periodontal status (Biofilm-Gingival Interface index based on periodontal probing depth and bleeding on probing), dental status (plaque, calculus, and caries), and tooth loss were assessed through full-mouth examination. Oral hygiene habits were based on self- or informant-reporting.

RESULTS

Poor periodontal status was an associated factor for MCI (OR = 2.89, 95% CI = 1.20-6.95), while multiple tooth loss (OR = 4.90, 95% CI = 1.06 ~ 22.59), brushing teeth less than once a day (OR = 2.88, 95% CI = 1.12 ~ 7.45) and delayed dental visits (OR = 2.45, 95% CI = 1.05 ~ 5.68) were associated factors for cognitive impairment. An indirect effect of brushing teeth ≥2 daily on MMSE score through periodontal status was observed only in older adults without cognitive impairment (Bootstrap-corrected B = 0.17, 95%CI = 0.03 ~ 0.36, SE = 0.08, β = 0.08).

CONCLUSIONS AND IMPLICATIONS

Adequate toothbrushing might prevent cognitive decline indirectly by improving periodontal health only in older adults without cognitive impairment. Multiple tooth loss, infrequent toothbrushing, and delayed dental visits were associated factors for cognitive impairment. Nursing professionals and health care policymakers should advocate for the improvement of basic oral hygiene in older adults, and provide regular professional oral hygiene care for older adults with cognitive impairment.

PATIENT OR PUBLIC CONTRIBUTION

The information on oral health habits of this study was based on an interview with the participants or their caregivers during the study period.

Home care aides' attitudes to training on oral health care

This study investigated home care aides' (HCAs) oral health care experience, knowledge, and their intention to receive professional training, to explain and predict factors of their intention to receive such training. This cross-sectional study collected data through a structured questionnaire. HCAs affiliated with home care agencies in Taichung, Taiwan were recruited through purposive sampling. A total of 487 questionnaires were distributed from September to December 2015 with 280 valid responses collected (57.4%).This study predicted the factors of HCAs' intention to receive oral health care training through a decision tree analysis. The decision tree model classified the respondents with an accuracy of 77.5%. The optimal predictor variable was oral health care knowledge (χ2 = 66.662, p < 0.0001). Among the low-scoring respondents on oral health care knowledge, 76.4% were classified in the "uninterested" group, whereas 84.8% of the high scorers were classified in the "interested" group. The second best predictor variable was whether oral health care is part of the job responsibility (χ2 = 7.979, p = 0.007). Among those who answered Yes, 92.9% were in the interested group, as were 76.5% of those who answered No. It is recommended to add "disease and oral care-related content" and "safety protection, assessment, and usage of oral care tools during practical oral care process" to the oral healthcare training course content for HCAs in order to improve HCAs' oral healthcare knowledge and oral care skills. These research findings are valuable and may be taken into account in the future development of the in-service educational training of oral healthcare for HCAs.