1
|
Wong FMF, Leung WK. Sustainability of an Educational Program on Oral Care/Hygiene Provision by Healthcare Providers to Older Residents in Long-Term Care Institutions: A Follow-Up Study. Geriatrics (Basel) 2024; 9:84. [PMID: 38920440 PMCID: PMC11203192 DOI: 10.3390/geriatrics9030084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The importance of oral health in older adults, especially those in long-term care institutions (LTCIs), has been widely recognized. This study aimed to evaluate the sustainability of an oral health educational program (OHEP) for healthcare providers by measuring changes in their knowledge, attitudes, and practice (KAP) towards oral care provision 3 and 6 months after completing the OHEP. METHODS A pragmatic direct care nursing education trial with a control group was conducted to evaluate the sustainability of an OHEP by examining changes in KAP 3 and 6 months after the OHEP. The OHEP comprised both knowledge and skills related to oral care, whereas the control group received standard support in accordance with usual oral care practice. RESULTS The study included 20 healthcare providers in the intervention group and 20 in the control group. At 6 months post-OHEP, a significant difference in knowledge was observed between the two groups, with the intervention group maintaining a positive effect (mean 13.90). Conversely, the control group showed a significant decline in knowledge (from mean 14.25 to 12.10). Both groups showed an improvement in attitudes regarding oral health, with the intervention group exhibiting better results 3 months post-OHEP. Intervention group participants rated oral care as a higher priority. CONCLUSIONS An OHEP program for LTCI direct care staff provides enhanced knowledge and attitudes toward oral health care. Regular training in direct care and additional support may be needed to sustain optimal effects on oral care practice.
Collapse
Affiliation(s)
| | - Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
| |
Collapse
|
2
|
Howell BM, Trammell S, Livingston M, Royer R. Pilot study of the effectiveness and acceptability of an automatic toothbrush among residents in long-term care. SPECIAL CARE IN DENTISTRY 2024. [PMID: 38520685 DOI: 10.1111/scd.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/25/2024]
Abstract
AIMS Reduced mobility and/or low cognitive functioning may make it difficult for residents with special care needs in long-term care homes to brush their own teeth every day. Demands on caregiving staff in these homes may also result in skipping essential toothbrushing tasks, resulting in poor oral health. METHODS AND RESULTS This article provides the results of a 6-week pilot study that tested the effectiveness and acceptability of the Willo automatic toothbrush "robot" used among residents in long-term care compared to their regular toothbrush. Using a non-randomized delayed-start design with a convenience sample (age 38-82 years, mean = 66.9), each study participant underwent biofilm assessments at three timepoints: (1) baseline as the study began (mean = 2.33), (2) after using their regular toothbrush daily for 3 weeks (mean = 2.21), and (3) after using the Willo automatic toothbrush daily for 3 weeks (mean = 0.31). Using t-tests and repeated measures ANOVA, the Willo was significantly more effective than regular toothbrushing at reducing biofilm (p = .00004) and gingivitis (p = .002) over time. Participants also responded to brief weekly satisfaction surveys about their experiences using the two different brushes. The Willo was generally tolerated among participants, who largely reported that the brush was easy to use, not uncomfortable, and did not cause pain or bleeding. While approximately half of the study participants reported liking the Willo, the remainder did not want to replace their regular brush with the Willo, for a variety of reasons. CONCLUSION We recommend more research on the effectiveness and acceptability of automatic toothbrushes with long-term care residents, caregivers, and others who may benefit from their use.
Collapse
Affiliation(s)
- Britteny M Howell
- Division of Population Health Sciences, University of Alaska Anchorage, Anchorage, Alaska, USA
| | | | - Marin Livingston
- Division of Population Health Sciences, University of Alaska Anchorage, Anchorage, Alaska, USA
| | | |
Collapse
|
3
|
Palmers EE, De Almeida Mello J, Janssens L, De Visschere L, Declerck D, Duyck J. Implementing an oral health policy in long-term care facilities for older adults in Flanders, Belgium: The Oral Health Care Track. Gerodontology 2024; 41:149-158. [PMID: 37254273 DOI: 10.1111/ger.12693] [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] [Accepted: 05/15/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND The oral health of care-dependent older people living in residential care facilities is generally suboptimal. To facilitate adequate daily oral care and timely referral to a dental professional, studies emphasise the need for sustainable, structured oral healthcare policies in aged care organisations. The effect of such interventions is often limited or uncertain owing to a lack of understanding of how effective the integration and implementation of the policy has been within the facilities. This study reports on the development of a method to adequately implement an oral healthcare policy in long-term care organisations for older adults. MATERIALS AND METHODS An intervention mapping protocol was used to develop a theory- and practise-based methodology. This step-by-step approach combined findings from a literature review, experiences from earlier projects and behaviour change theories in a multilevel programme. RESULTS Intervention mapping yielded a systematic programme for implementing an oral healthcare policy in aged care organisations. The Oral Health Care Track or "De Mondzorglijn" comprises seven phases, each subdivided into several tasks. The programme's implementation is guided by oral healthcare coaches. CONCLUSION By using intervention mapping, it was possible to combine behaviour change theories, information derived from needs assessment and earlier experiences into a comprehensive programme to improve the oral health and quality of life of older residents in residential care facilities. Further research is needed to evaluate the use of coaches in the implementation of the Oral Health Care Track.
Collapse
Affiliation(s)
- Ellen E Palmers
- Department of Oral Health Sciences, Research Group Population Studies in Oral Health, KU Leuven, Leuven, Belgium
- LUCAS - Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Johanna De Almeida Mello
- Department of Oral Health Sciences, Research Group Population Studies in Oral Health, KU Leuven, Leuven, Belgium
- ELOHA (Equal Lifelong Oral Health for All) research group, Gerodontology, Oral Health Sciences, Ghent University, Ghent, Belgium
| | - Lynn Janssens
- Gezonde Mond, Flemish Institute for Oral Health, Flemish Agency for Care and Health, Ghent, Belgium
| | - Luc De Visschere
- LUCAS - Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
- Gezonde Mond, Flemish Institute for Oral Health, Flemish Agency for Care and Health, Ghent, Belgium
| | - Dominique Declerck
- Department of Oral Health Sciences, Research Group Population Studies in Oral Health, KU Leuven, Leuven, Belgium
- LUCAS - Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Joke Duyck
- Department of Oral Health Sciences, Research Group Population Studies in Oral Health, KU Leuven, Leuven, Belgium
- LUCAS - Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| |
Collapse
|
4
|
Wong FMF, Shie HWH, Kao E, Tsoi HM, Leung WK. Educational Programme on Knowledge, Attitudes, and Practice of Oral Care/Hygiene Provision by Healthcare Providers to Older Residents in Long-Term Care Institutions: A Case-Control Study. Geriatrics (Basel) 2024; 9:16. [PMID: 38392103 PMCID: PMC10888457 DOI: 10.3390/geriatrics9010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/30/2023] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Much attention has been paid to advocate proper oral care/hygiene provision by healthcare providers in long-term care institutions (LTCIs). This study aimed to evaluate the effects of an oral health education (OHE) programme (intervention) on knowledge, attitudes, and practice (KAP) of healthcare providers in providing oral care/hygiene to older residents in LTCIs. METHODS A case control study was conducted at two LTCIs, with one assigned as the intervention group and the other as the control group. A KAP survey was administered before and after the intervention, and oral status was assessed by standardized clinical photographs taken before and after oral hygiene provision on three older residents. RESULTS A total of 40 healthcare providers (20 in intervention and 20 in control groups) participated, with the attitudes and overall KAP significantly improved in the intervention group after the OHE programme. Interestingly, the knowledge of those in the control LTCI was significantly declined at re-evaluation (mean scores were from 17.25 to 14.30), indicating inadequate oral health and care training despite having more experience in taking care of older people. Significant differences in practice were observed between the two groups after the OHE programme (p = 0.006). The three older residents exhibited poor oral health and multiple oral problems. CONCLUSIONS This study revealed that the OHE programme effectively improved attitudes of the healthcare providers and provided a sustaining effect on attitude towards oral health and oral care. However, there were still inadequacies in oral hygiene provision by some healthcare providers, possibly due to unattended oral diseases and hygiene needs, as well as personal and environmental barriers that merit further investigation. Regular evaluation and enforcement of oral care/hygiene provision in LTCIs are necessary to maintain oral health and prevent dental and gum diseases in older residents. Immediate referral for dental treatment is recommended for older people with signs of dental/oral disease(s).
Collapse
Affiliation(s)
| | | | - Enoch Kao
- Department of Microbiology, The University of Hong Kong, Hong Kong, China
| | - Hoi Mei Tsoi
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Wai Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
5
|
Poudel P, Paudel G, Acharya R, George A, Borgnakke WS, Rawal LB. Oral health and healthy ageing: a scoping review. BMC Geriatr 2024; 24:33. [PMID: 38191307 PMCID: PMC10773108 DOI: 10.1186/s12877-023-04613-7] [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: 07/10/2023] [Accepted: 12/17/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Good oral health is an important part of healthy ageing, yet there is limited understanding regarding the status of oral health care for older people globally. This study reviewed evidence (policies, programs, and interventions) regarding oral health care for older people. METHODS A systematic search of six databases for published and grey literature in the English language by the end of April 2022 was undertaken utilising Arksey and O'Malley's scoping review framework. RESULTS The findings from oral health policy documents (n = 17) indicated a lack of priorities in national health policies regarding oral health care for older people. The most common oral health interventions reported in the published studies (n = 62) included educational sessions and practical demonstrations on oral care for older adults, nurses, and care providers. Other interventions included exercises of facial muscles and the tongue, massage of salivary glands, and application of chemical agents, such as topical fluoride. CONCLUSION There is currently a gap in information and research around effective oral health care treatments and programs in geriatric dental care. Efforts must be invested in developing guidelines to assist both dental and medical healthcare professionals in integrating good oral health as part of healthy ageing. Further research is warranted in assessing the effectiveness of interventions in improving the oral health status of the elderly and informing approaches to assist the integration of oral health into geriatric care.
Collapse
Affiliation(s)
- Prakash Poudel
- Office of Research and Education, Canberra Health Services, Australian Capital Territory (ACT) Government, Garran, ACT, 2606, Australia
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia
- Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Grish Paudel
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, NSW, 2000, Australia
- Appleton Institute, Physical Activity Research Group, Central Queensland University, QLD, Rockhampton, 4702, Australia
| | - Reecha Acharya
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia
| | - Ajesh George
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.
- Ingham Institute for Applied Medical Research, Liverpool, Australia.
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia.
- School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Wenche S Borgnakke
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
| | - Lal B Rawal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, NSW, 2000, Australia
- Appleton Institute, Physical Activity Research Group, Central Queensland University, QLD, Rockhampton, 4702, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, NSW, 2751, Australia
| |
Collapse
|
6
|
Chávez EM, Kossioni A, Fukai K. Policies Supporting Oral Health in Ageing Populations Are Needed Worldwide. Int Dent J 2022; 72:S27-S38. [PMID: 36031323 PMCID: PMC9437798 DOI: 10.1016/j.identj.2022.06.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 12/19/2022] Open
Abstract
This literature review examines the need to develop appropriate policies specific to the oral health needs of older people that are individualised, cost-effective, and sustainable. Poor oral health and impaired oral function negatively affect the health and quality of life of older adults. Developing care systems that aim to meet patients' normative needs as well as their perceived needs and expectations is one factor in successful delivery of appropriate dental care. Cost is another significant driver of utilisation, and many older adults worldwide lack adequate resources for dental care. Failure to address these issues results in poor outcomes and increased costs of dental and medical care. Disease prevention and control at early stages can preserve public and private financial resources as well as quality of life and well-being for older adults at any stage of life.
Collapse
Affiliation(s)
- Elisa M Chávez
- University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, California, USA.
| | - Anastassia Kossioni
- Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | | |
Collapse
|
7
|
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
|
8
|
Interventions to Improve the Oral Hygiene of Individuals with Alzheimer's Disease: A Systematic Review. Dent J (Basel) 2022; 10:dj10050092. [PMID: 35621545 PMCID: PMC9139279 DOI: 10.3390/dj10050092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/27/2022] [Accepted: 05/10/2022] [Indexed: 12/10/2022] Open
Abstract
This systematic review evaluates published evidence on oral hygiene interventions conducted in Alzheimer’s disease (AD) patients. PubMed, Embase, Cochrane Library, CINAHL, Dentistry & Oral Sciences Source, and Web of Science were searched for articles published up to 19 April 2021. The main outcomes of interest were the Plaque index score (PI), oral health knowledge of participants or their caregivers, and behaviors and attitudes towards oral hygiene. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies of the National Institutes of Health. The study was conducted under PROSPERO registration code CRD42021247733. Two studies met the inclusion criteria. One was a pre-post study conducted in Brazil, and the other was a prospective cohort study carried out in China. The sample sizes of these studies were 29 and 168, respectively. Both studies were carried out in institutionalized patients and presented a significant loss to follow-up. The PI and gingival index scores both improved after the application of the respective interventions, yet the differing methodologies used precluded further comparisons. The studies were deemed to be of good and regular quality, respectively. Despite the need for more comprehensive interventions to ensure a better oral health status and a higher quality of life for AD patients, an alarming lack of studies have been conducted in this population.
Collapse
|