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Ren Y, Liang J, Li X, Deng Y, Cheng S, Wu Q, Song W, He Y, Zhu J, Zhang X, Zhou H, Yin J. Association between oral microbial dysbiosis and poor functional outcomes in stroke-associated pneumonia patients. BMC Microbiol 2023; 23:305. [PMID: 37875813 PMCID: PMC10594709 DOI: 10.1186/s12866-023-03057-8] [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: 05/30/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Despite advances in our understanding of the critical role of the microbiota in stroke patients, the oral microbiome has rarely been reported to be associated with stroke-associated pneumonia (SAP). We sought to profile the oral microbial composition of SAP patients and to determine whether microbiome temporal instability and special taxa are associated with pneumonia progression and functional outcomes. METHODS This is a prospective, observational, single-center cohort study that examined patients with acute ischemic stroke (AIS) who were admitted within 24 h of experiencing a stroke event. The patients were divided into three groups based on the occurrence of pneumonia and the use of mechanical ventilation: nonpneumonia group, SAP group, and ventilator-associated pneumonia (VAP) group. We collected oral swabs at different time points post-admission and analyzed the microbiota using 16 S rRNA high-throughput sequencing. The microbiota was then compared among the three groups. RESULTS In total, 104 nonpneumonia, 50 SAP and 10 VAP patients were included in the analysis. We found that SAP and VAP patients exhibited significant dynamic differences in the diversity and composition of the oral microbiota and that the magnitude of this dysbiosis and instability increased during hospitalization. Then, by controlling the potential effect of all latent confounding variables, we assessed the changes associated with pneumonia after stroke and explored patients with a lower abundance of Streptococcus were more likely to suffer from SAP. The logistic regression analysis revealed that an increase in specific taxa in the phylum Actinobacteriota was linked to a higher risk of poor outcomes. A model for SAP patients based on oral microbiota could accurately predict 30-day clinical outcomes after stroke onset. CONCLUSIONS We concluded that specific oral microbiota signatures could be used to predict illness development and clinical outcomes in SAP patients. We proposed the potential of the oral microbiota as a non-invasive diagnostic biomarker in the clinical management of SAP patients. CLINICAL TRIAL REGISTRATION NCT04688138. Registered 29/12/2020, https://clinicaltrials.gov/ct2/show/NCT04688138 .
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Affiliation(s)
- Yueran Ren
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jingru Liang
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao Li
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yiting Deng
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Sanping Cheng
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiheng Wu
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Wei Song
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yan He
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiajia Zhu
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaomei Zhang
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hongwei Zhou
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Jia Yin
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
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2
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Wu C, Huang H, Xu W, Li J, Chen M, Zhao Q. Influencing factors associated with oral health among older hospitalized patients with ischemic stroke: A cross-sectional survey. Int J Nurs Sci 2023; 10:302-308. [PMID: 37545772 PMCID: PMC10401348 DOI: 10.1016/j.ijnss.2023.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 08/08/2023] Open
Abstract
Objective To investigate the oral health status of older patients with ischemic stroke and analyze the influencing factors, providing valuable insights for developing effective oral health management strategies tailored for this population. Methods A cross-sectional survey was conducted from January to June 2022, selecting 350 older patients with ischemic stroke from two tertiary hospitals in Chongqing. The Barthel Index (BI), Eating Assessment Tool (EAT-10), and Oral Health Assessment Tool (OHAT) were used to assess patients' self-care ability, swallowing function, and oral health status, respectively. A self-designed questionnaire was used to collect demographic information, disease-related information, and oral health behaviors of the patients. Binary logistic regression analysis was performed to analyze related influencing factors. Results A total of 346 older patients with ischemic stroke were included, with 199 males and 147 females. The median total score of OHAT was 5 (total score range 0-16). Dental decay (91.7%, 278/303) and poor oral hygiene (92.2%, 319/346) were the main oral health problems in this population. Binary logistic regression analysis showed that sex, hyperlipidemia, stroke severity, stroke events, oral health behaviors, and care dependency were influencing factors for the oral health of this population (P < 0.05). Conclusion The study revealed that healthcare professionals should strengthen the oral health assessment of older patients with ischemic stroke and implement individualized health education and management measures based on the characteristics of high-risk groups to promote their oral health.
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Affiliation(s)
- Chengfei Wu
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huanhuan Huang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenxin Xu
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinghong Li
- Department of Rehabilitation Medicine, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Mei Chen
- Department of Nursing, Bishan Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Klaic M, Seng E, McGrath R. Factors that influence oral hygiene care with hospitalised stroke patients: a mixed methods study. Disabil Rehabil 2022; 44:7926-7935. [PMID: 34797190 DOI: 10.1080/09638288.2021.2003450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Survivors of stroke experience poor oral health during and following hospitalisation. Health professionals consistently report that oral hygiene is complex. Interventions aiming to improve the delivery of oral hygiene care by health professionals rarely use a theoretically driven approach. This study reports the first phase in an intervention development and uses the action, actor, context, target, time (AACTT) framework and theoretical domains framework (TDF) to understand who needs to do what differently in the delivery of oral hygiene care with hospitalised stroke survivors. METHOD Mixed methods including analysis of oral health policies and clinical guidelines using the AACTT framework, focus group discussions using the TDF and audit of 60 medical records. RESULTS Policies and guidelines lack specificity regarding what oral hygiene care is and who should be responsible. Health professionals have low beliefs in their capabilities and experience numerous contextual barriers. More than 40% of patients had no documented evidence of oral hygiene care. CONCLUSION This study used a theoretically driven approach to identify barriers and enablers to health professional delivery of oral hygiene care with stroke survivors. Interventions aiming to improve clinical practice should target beliefs about capabilities, improved access to resources and detailed oral hygiene clinical guidelines.Implications for rehabilitationSurvivors of stroke experience poor oral health which can contribute to further strokes, cardiovascular disease and mortality.Health care professionals report difficulties in delivering oral hygiene care to hospitalised stroke survivors and clinical guidelines lack detail regarding oral health assessments, interventions and training.Interventions aiming to improve the delivery of oral hygiene care should target health professional beliefs about their capabilities using strategies such as behavioural practice.Resources specific to oral hygiene care for more complex patients, including suctioning toothbrushes, should be readily accessible for health professional use.Clinical guidelines and policies on oral hygiene care should include detail about training content, assessments tools and how to adapt information for patients with complex impairments.
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Affiliation(s)
- Marlena Klaic
- Allied Health Department, Royal Melbourne Hospital, Melbourne, Australia.,Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
| | - Erich Seng
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Roisin McGrath
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
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4
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Bangee M, Martinez-Garduno CM, Brady MC, Cadilhac DA, Dale S, Hurley MA, McInnes E, Middleton S, Patel T, Watkins CL, Lightbody E. Oral care practices in stroke: findings from the UK and Australia. BMC Nurs 2021; 20:169. [PMID: 34526030 PMCID: PMC8442320 DOI: 10.1186/s12912-021-00642-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/27/2021] [Indexed: 11/29/2022] Open
Abstract
Aims To examine current practice, perceptions of healthcare professionals and factors affecting provision for oral care post-stroke in the UK and Australia. Background Poor oral care has negative health consequences for people post-stroke. Little is known about oral care practice in hospital for people post-stroke and factors affecting provision in different countries. Design A cross-sectional survey. Methods Questionnaires were mailed to stroke specialist nurses in UK and Australian hospitals providing inpatient acute or rehabilitation care post-stroke. The survey was conducted between April and November 2019. Non-respondents were contacted up to five times. Results Completed questionnaires were received from 150/174 (86%) hospitals in the UK, and 120/162 (74%) in Australia. A total of 52% of UK hospitals and 30% of Australian hospitals reported having a general oral care protocol, with 53% of UK and only 13% of Australian hospitals reporting using oral care assessment tools. Of those using oral care assessment tools, 50% of UK and 38% of Australian hospitals used local hospital-specific tools. Oral care assessments were undertaken on admission in 73% of UK and 57% of Australian hospitals. Staff had received oral care training in the last year in 55% of UK and 30% of Australian hospitals. Inadequate training and education on oral care for pre-registration nurses were reported by 63% of UK and 53% of Australian respondents. Conclusion Unacceptable variability exists in oral care practices in hospital stroke care settings. Oral care could be improved by increasing training, performing individual assessments on admission, and using standardised assessment tools and protocols to guide high quality care. The study highlights the need for incorporating staff training and the use of oral care standardised assessments and protocols in stroke care in order to improve patient outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-021-00642-y.
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Affiliation(s)
- Munirah Bangee
- Faculty of Health and Care, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Cintia Mayel Martinez-Garduno
- St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Sydney, Australia
| | - Marian C Brady
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Dominique A Cadilhac
- School of Clinical Sciences at Monash Health, Monash University, VIC, Melbourne, Australia
| | - Simeon Dale
- St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Sydney, Australia
| | - Margaret A Hurley
- Faculty of Health and Care, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Elizabeth McInnes
- St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Sydney, Australia
| | - Sandy Middleton
- St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Sydney, Australia
| | - Tahera Patel
- Faculty of Health and Care, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Caroline L Watkins
- Faculty of Health and Care, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Elizabeth Lightbody
- Faculty of Health and Care, University of Central Lancashire, Preston, PR1 2HE, UK.
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Haning C, Makic MBF. Toothbrushing for Dependent Neurological Patients in the Intensive Care Unit. Crit Care Nurse 2021; 40:72-76. [PMID: 32476031 DOI: 10.4037/ccn2020445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Cailly Haning
- Cailly Haning was a critical care nurse at the Swedish Medical Center, Englewood, Colorado, at the time of this project implementation
| | - Mary Beth Flynn Makic
- Mary Beth Flynn Makic is a professor in and specialty director of the Clinical Nurse Specialist Program at the University of Colorado College of Nursing, Aurora, Colorado, and is a research scientist at Denver Health, Denver, Colorado
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Matsumoto K, Nohara Y, Wakata Y, Yamashita T, Kozuma Y, Sugeta R, Yamakawa M, Yamauchi F, Miyashita E, Takezaki T, Yamashiro S, Nishi T, Machida J, Soejima H, Kamouchi M, Nakashima N. Impact of a learning health system on acute care and medical complications after intracerebral hemorrhage. Learn Health Syst 2021; 5:e10223. [PMID: 33889732 PMCID: PMC8051343 DOI: 10.1002/lrh2.10223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/10/2020] [Accepted: 02/02/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Patients with stroke often experience pneumonia during the acute stage after stroke onset. Oral care may be effective in reducing the risk of stroke-associated pneumonia (SAP). We aimed to determine the changes in oral care, as well as the incidence of SAP, in patients with intracerebral hemorrhage, following implementation of a learning health system in our hospital. METHODS We retrospectively analyzed the data of 1716 patients with intracerebral hemorrhage who were hospitalized at a single stroke center in Japan between January 2012 and December 2018. Data were stratified on the basis of three periods of evolving oral care: period A, during which conventional, empirically driven oral care was provided (n = 725); period B, during which standardized oral care was introduced, with SAP prophylaxis based on known risk factors (n = 469); and period C, during which oral care was risk-appropriate based on learning health system data (n = 522). Logistic regression analysis was performed to evaluate associations between each of the three treatment approaches and the risk of SAP. RESULTS Among the included patients, the mean age was 71.3 ± 13.6 years; 52.6% of patients were men. During the course of each period, the frequency of oral care within 24 hours of admission increased (P < .001), as did the adherence rate to oral care ≥3 times per day (P < .001). After adjustment for confounding factors, a change in the risk of SAP was not observed in period B; however, the risk significantly decreased in period C (odds ratio 0.61; 95% confidence interval 0.43-0.87) compared with period A. These associations were maintained for SAP diagnosed using strict clinical criteria or after exclusion of 174 patients who underwent neurosurgical treatment. CONCLUSIONS Risk-appropriate care informed by the use of learning health system data could improve care and potentially reduce the risk of SAP in patients with intracerebral hemorrhage in the acute stage.
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Affiliation(s)
- Koutarou Matsumoto
- Department of Medical SupportSaiseikai Kumamoto HospitalKumamotoJapan
- Department of Health Care Administration and Management, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Yasunobu Nohara
- Medical Information CenterKyushu University HospitalFukuokaJapan
| | | | | | - Yukio Kozuma
- Department of Medical InformationSaiseikai Kumamoto HospitalKumamotoJapan
| | - Rui Sugeta
- Department of Medical InformationSaiseikai Kumamoto HospitalKumamotoJapan
| | - Miki Yamakawa
- Department of NursingSaiseikai Kumamoto HospitalKumamotoJapan
| | - Fumiko Yamauchi
- Department of NursingSaiseikai Kumamoto HospitalKumamotoJapan
| | - Eri Miyashita
- Department of NursingSaiseikai Kumamoto HospitalKumamotoJapan
| | - Tatsuya Takezaki
- Department of NeurosurgeryKumamoto University HospitalKumamotoJapan
| | - Shigeo Yamashiro
- Division of NeurosurgerySaiseikai Kumamoto HospitalKumamotoJapan
| | - Toru Nishi
- Department of NeurosurgerySakura Jyuji HospitalKumamotoJapan
| | - Jiro Machida
- Department of Medical InformationSaiseikai Kumamoto HospitalKumamotoJapan
| | - Hidehisa Soejima
- Department of InspectionSaiseikai Kumamoto HospitalKumamotoJapan
| | - Masahiro Kamouchi
- Department of Health Care Administration and Management, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
- Center for Cohort Studies, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Naoki Nakashima
- Medical Information CenterKyushu University HospitalFukuokaJapan
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Lawal IU, Ibrahim R, Ramphoma KJ. Oral hygiene in stroke survivors undergoing rehabilitation: does upper extremity motor function matters? Top Stroke Rehabil 2020; 28:531-536. [PMID: 33164693 DOI: 10.1080/10749357.2020.1845013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Traditionally, stroke rehabilitation outcomes are based on indicators of physical function, such measures may underrate the all-inclusive impact of stroke such as oral health.Objectives: To investigate the relationship between upper extremity motor function and oral hygiene status as well as the impact of stroke on Oral Health-Related Quality of Life (OHRQoL).Methods: Sixty stroke survivors were included in this cross-sectional survey. Spasticity and motor function/mobility of the affected upper extremity were assessed using the Modified Ashworth Scale and Action Research Arm Test, respectively. Oral hygiene was assessed using the Simplified Oral Hygiene Index and oral health impact was assessed using the 14-item Oral Health Impact Profile. Pearson's moment correlation coefficient was used to determine the relationship between oral hygiene and upper extremity motor function variables.Results: There were significant relationships between the oral hygiene index and Shoulder muscles spasticity (r = 0.374, p = .01), wrist muscles spasticity (r = 0.352, p = .01), as well as basic mobility (r = 0.423, p = .01). An estimated 8% (n = 5) of study participants have their QoL strongly impacted by their oral health.Conclusions: Upper extremity motor function variables such as spasticity and basic mobility matters in determining oral hygiene status after stroke. Stroke has little impact on oral health-related quality of life.
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Affiliation(s)
- I U Lawal
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, Kano, Nigeria
| | - R Ibrahim
- National Assembly Clinic Abuja, Department of Medical Services, Physiotherapy Unit, Abuja, Nigeria
| | - K J Ramphoma
- Department of Community Dentistry, School of Oral Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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Gurgel-Juarez N, Egan M, Wiseman M, Finestone H, Flowers HL. Technology for maintaining oral care after stroke: considerations for patient-centered practice. Disabil Rehabil Assist Technol 2020; 17:916-926. [PMID: 32988252 DOI: 10.1080/17483107.2020.1822450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Activities of daily living including oral care may be challenging after stroke. Some stroke survivors are not able to complete oral care independently and need assistance from healthcare professionals and care partners. Poor oral hygiene may impact stroke recovery and rehabilitation possibly incurring issues such as aspiration pneumonia, malnutrition, and social isolation. The objective of this paper is to outline practical ways to apply oral care technology in daily use for stroke survivors. MATERIALS AND METHODS We reviewed the literature on i) stroke-related impairments impacting oral care, ii) oral hygiene dental devices, and iii) technology for oral care education. RESULTS Oral care activities involve integrated skills in the areas of motivation, energy, planning, body movement and sensation, and mental acuity and health. Post-stroke impairments such as fatigue, hemiparesis, and mental impairments may impact oral care activities. Technology may help survivors and caregivers overcome some barriers. Three types of technologies are available for facilitating post-stroke oral care: i) non-powered tools and adaptations; ii) powered oral care tools, and; iii) electronic aids to guide oral care activities. Particular choices should maximise patient safety and autonomy while ensuring accessibility and comfort during oral care tasks. CONCLUSION The available device and technologies may help substantially with the accommodations needed for post-stroke oral care, improving the oral health of stroke survivors. Good oral health confers benefit to overall health and well-being and could enhance recovery and rehabilitation outcomes. Nonetheless, more research is necessary to demonstrate the feasibility and effectiveness of technology in stroke contexts.IMPLICATIONS FOR REHABILITATIONOral care may be challenging after stroke due to patient fatigue, hemiparesis, cognitive impairments, and other impaired body functions.Poor oral hygiene may impact stroke recovery and rehabilitation due to risk of aspiration pneumonia, malnutrition, and social isolation.Powered oral care tools, non-powered tools, and adaptations to non-powered tools are some of the technology available to help overcome post-stroke barriers for oral care.Computer programs and online resources for education and guidance for oral care activities may help improve recommendation uptake and compliance.
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Affiliation(s)
| | - Mary Egan
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada.,Research Institute Safest, Bruyère Research Institute, Ottawa, Canada
| | | | - Hillel Finestone
- Department of Physical Medicine and Rehabilitation, Élisabeth Bruyère Hospital, Ottawa, Canada.,Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Heather L Flowers
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada.,Research Institute Safest, Bruyère Research Institute, Ottawa, Canada.,Department of Clinical Epidemiology, The Ottawa Hospital Research Institute, Ottawa, Canada.,Canadian Partnership for Stroke Recovery, Heart and Stroke Foundation, Ottawa, Canada
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Gurgel-Juarez N, Perrier MF, Hoffmann T, Lannin N, Jolliffe L, Lee R, Brosseau L, Flowers H. Guideline Recommendations for Oral Care After Acquired Brain Injury: Protocol for a Systematic Review. JMIR Res Protoc 2020; 9:e17249. [PMID: 32609090 PMCID: PMC7367530 DOI: 10.2196/17249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/18/2020] [Accepted: 04/07/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Oral care is important to prevent buccal and systemic infections after an acquired brain injury (ABI). Despite recent advancements in the development of ABI clinical practice guidelines, recommendations for specific clinical processes and actions to attain adequate oral care often lack information. OBJECTIVE This systematic review will (1) identify relevant ABI clinical practice guidelines and (2) appraise the oral care recommendations existing in the selected guidelines. METHODS A search strategy was developed based on a recent systematic review of clinical practice guidelines for ABI. The protocol includes a search of MEDLINE, EMBASE, and DynaMed Plus databases, as well as organizational and best-practice websites and reference lists of accepted guidelines. Search terms will include medical subject headings and user-defined terms. Guideline appraisal will involve the Appraisal of Guidelines for Research and Evaluation II ratings, followed by a descriptive synopsis for oral care recommendations according to the National Health and Medical Research Council evidence levels. RESULTS This project started in April 2019, when we developed the search strategy. The preliminary search of databases and websites yielded 863 and 787 citations, respectively, for a total of 1650 citations. Data collection will start in August 2020 and we expect to begin disseminating the results in May 2021. CONCLUSIONS Nursing staff may not have detailed recommendations on how to provide oral care for neurologically impaired patients. The findings of this review will explore the evidence for oral care in existing guidelines and improve outcomes for patients with ABI. We expect to provide adequate orientations to clinicians, inform policy and guidelines for best practices, and contribute to future directions for research in the ABI realm. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/17249.
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Affiliation(s)
- Nalia Gurgel-Juarez
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Marie-France Perrier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Tammy Hoffmann
- Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Natasha Lannin
- Occupational Therapy Department, Alfred Health Hospital, Melbourne, Australia.,School of Allied Health, Faculty of Science, Health and Engineering, La Trobe University, Melbourne, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Laura Jolliffe
- Occupational Therapy Department, Alfred Health Hospital, Melbourne, Australia.,School of Allied Health, Faculty of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Rachel Lee
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Lucie Brosseau
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Heather Flowers
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.,The Ottawa Hospital Research Institute, Ottawa, ON, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada.,Institut du Savoir Montfort, Ottawa, ON, Canada.,Toronto General Hospital, University Health Network, Toronto, ON, Canada
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de Sire A, Baricich A, Ferrillo M, Migliario M, Cisari C, Invernizzi M. Buccal hemineglect: is it useful to evaluate the differences between the two halves of the oral cavity for the multidisciplinary rehabilitative management of right brain stroke survivors? A cross-sectional study. Top Stroke Rehabil 2019; 27:208-214. [DOI: 10.1080/10749357.2019.1673592] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Alessandro de Sire
- Physical and Rehabilitation Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
- Rehabilitation Unit, ‘Mons. L. Novarese’ Hospital, Moncrivello, Vercelli, Italy
| | - Alessio Baricich
- Physical and Rehabilitation Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
- Physical and Rehabilitation Medicine Unit, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Martina Ferrillo
- Department of Surgical Sciences, Specialization School of Orthodontics, Dental School, University of Turin, Turin, Italy
| | - Mario Migliario
- Dental Clinic, Department of Health Sciences, University of Eastern Piedmont ‘A. Avogadro’, Novara, Italy
| | - Carlo Cisari
- Physical and Rehabilitation Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
- Physical and Rehabilitation Medicine Unit, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Marco Invernizzi
- Physical and Rehabilitation Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, Novara, Italy
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