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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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Eggersdorfer M, Akobundu U, Bailey RL, Shlisky J, Beaudreault AR, Bergeron G, Blancato RB, Blumberg JB, Bourassa MW, Gomes F, Jensen G, Johnson MA, Mackay D, Marshall K, Meydani SN, Tucker KL. Hidden Hunger: Solutions for America's Aging Populations. Nutrients 2018; 10:E1210. [PMID: 30200492 PMCID: PMC6165209 DOI: 10.3390/nu10091210] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 08/24/2018] [Accepted: 08/30/2018] [Indexed: 02/07/2023] Open
Abstract
The global population, including the United States, is experiencing a demographic shift with the proportion of older adults (aged ≥ 65 years) growing faster than any other age group. This demographic group is at higher risk for developing nutrition-related chronic conditions such as heart disease and diabetes as well as infections such as influenza and pneumonia. As a result, an emphasis on nutrition is instrumental for disease risk reduction. Unfortunately, inadequate nutrient status or deficiency, often termed hidden hunger, disproportionately affects older adults because of systematic healthcare, environmental, and biological challenges. This report summarizes the unique nutrition challenges facing the aging population and identifies strategies, interventions, and policies to address hidden hunger among the older adults, discussed at the scientific symposium "Hidden Hunger: Solutions for America's Aging Population", on March 23, 2018.
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Affiliation(s)
- Manfred Eggersdorfer
- DSM Nutritional Products AG, Human Nutrition and Health, 4002 Basel, Switzerland.
- Department of Healthy Ageing, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands.
| | | | - Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA.
| | - Julie Shlisky
- The Sackler Institute for Nutrition Science, The New York Academy of Sciences, New York, NY 10007, USA.
| | | | - Gilles Bergeron
- The Sackler Institute for Nutrition Science, The New York Academy of Sciences, New York, NY 10007, USA.
| | - Robert B Blancato
- National Coordinator, Defeat Malnutrition Today, Washington, DC 20006, USA.
| | - Jeffrey B Blumberg
- Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
| | - Megan W Bourassa
- The Sackler Institute for Nutrition Science, The New York Academy of Sciences, New York, NY 10007, USA.
| | - Filomena Gomes
- The Sackler Institute for Nutrition Science, The New York Academy of Sciences, New York, NY 10007, USA.
| | - Gordon Jensen
- Larner College of Medicine, University of Vermont, Burlington, VT 05405, USA.
| | - Mary Ann Johnson
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE 68583, USA.
| | - Douglas Mackay
- Council for Responsible Nutrition, Washington, DC 20036, USA.
| | | | - Simin Nikbin Meydani
- Jean Mayer USDA Human Nutrition Research Center on Aging and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
| | - Katherine L Tucker
- Biomedical & Nutritional Sciences Department, University of Massachusetts Lowell, Lowell, MA 01854, USA.
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Bonwell PB, Parsons PL, Best AM, Hise S. An interprofessional educational approach to oral health care in the geriatric population. GERONTOLOGY & GERIATRICS EDUCATION 2013; 35:182-199. [PMID: 24131421 DOI: 10.1080/02701960.2013.827572] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
An interprofessional educational approach was used to provide five in-service training sessions for all direct health care providers in a long-term care facility, and one half-day seminar/live webinar for community-licensed health care professionals. Content included presentations by five disciplines: (a) periodontist: oral-systemic relationship, (b) oral pathologist: oral pathology, (c) pharmacist: oral health-pharmacological link, (d) dietitian: oral health-dietary link, and (e) occupational therapist: providing and practicing proper oral hygiene. Significant improvement in posttest scores for the five in-service training sessions and the half-day seminar/live webinar was revealed in t-test results, representing an increase in knowledge gained. Approximately 80% of the 145 participants indicated that they would make a change in patient care. Findings indicate that the in-service training sessions and half-day seminar/live webinar supported development of the geriatric work force by utilizing an interprofessional educational approach which will assist in meeting the oral health care needs of the geriatric population.
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Affiliation(s)
- Patricia Brown Bonwell
- a Dental Hygiene Program, Department of Oral Health Promotion and Community Outreach, School of Dentistry , Virginia Commonwealth University , Richmond , Virginia , USA
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Abstract
OBJECTIVE To assess the association of diet-related practices and BMI with diet quality in rural adults aged ≥74 years. DESIGN Cross-sectional. Dietary quality was assessed by the twenty-five-item Dietary Screening Tool (DST). Diet-related practices were self-reported. Multivariate linear regression models were used to analyse associations of DST scores with BMI and diet-related practices after controlling for gender, age, education, smoking and self- v. proxy reporting. SETTING Geisinger Rural Aging Study (GRAS) in Pennsylvania, USA. SUBJECTS A total of 4009 (1722 males, 2287 females; mean age 81·5 years) participants aged ≥74 years. RESULTS Individuals with BMI < 18·5 kg/m2 had a significantly lower DST score (mean 55·8, 95 % CI 52·9, 58·7) than those individuals with BMI = 18·5-24·9 kg/m2 (mean 60·7, 95 % CI 60·1, 61·5; P = 0·001). Older adults with higher, more favourable DST scores were significantly more likely to be food sufficient, report eating breakfast, have no chewing difficulties and report no decline in intake in the previous 6 months. CONCLUSIONS The DST may identify potential targets for improving diet quality in older adults including promotion of healthy BMI, breakfast consumption, improving dentition and identifying strategies to decrease concern about food sufficiency.
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Salamone K, Yacoub E, Mahoney AM, Edward KL. Oral care of hospitalised older patients in the acute medical setting. Nurs Res Pract 2013; 2013:827670. [PMID: 23819046 PMCID: PMC3683489 DOI: 10.1155/2013/827670] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/28/2013] [Accepted: 04/30/2013] [Indexed: 11/18/2022] Open
Abstract
Oral health care is an essential aspect of nursing care. There are many variances in the quality and frequency of the oral care that is delivered to patients by nursing staff, such as oral care being given a low priority when compared to other nursing care elements, oral care being neglected, and oral care delivery being dependent on the nurse's knowledge of oral hygiene. Additionally, there are some particular patient groups known to be at risk of oral health problems or who have existing oral diseases and conditions. As people age their susceptibility increases to chronic and life-threatening diseases, and they can be at increased risk of acute infections increases compromised by ageing immune systems. The aim of this literature review was to ignite the discussion related to the oral care practices of nurses for older acute medical hospitalised patients. The review revealed that nursing staff know that good nursing includes oral health care, but this knowledge does not always mean that oral health care is administered. Oral health care seems to be separated from other nursing activities and is not discussed when nursing care plans are written, only when oral problems are obvious.
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Affiliation(s)
| | - Elaine Yacoub
- Austin Health, P.O. Box 5555, Heidelberg, 3084 VIC, Australia
| | - Anne-Marie Mahoney
- Clinical Education Unit, Austin Health, P.O. Box 5555, Heidelberg, 3084 VIC, Australia
| | - Karen-leigh Edward
- Nursing Research Unit, Faculty of Health Sciences, Street Vincent's Private Hospital, Australian Catholic University, VECCI Building, Locked Bag 4115, Fitzroy MDC, Melbourne, 3065 VIC, Australia
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Jablonski RA, Swecker T, Munro C, Grap MJ, Ligon M. Measuring the Oral Health of Nursing Home Elders. Clin Nurs Res 2009; 18:200-17. [DOI: 10.1177/1054773809335306] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The primary purposes of this descriptive and prospective pilot study was to test the feasibility of a nursing and dental hygiene team to measure specific oral health indices in a sample of older adults residing in nursing homes (NHs). The secondary purpose was to determine the relationship between plaque and dentate status. Oral health indicators, functional status scores, and behavioral scores were collected and analyzed from 38 female NH residents from two geographically, organizationally, and economically diverse NHs. Persons with dentures had significantly lower plaque scores than those with natural dentition. Rural NH residents and African American NH residents had fewer filled teeth, indicating a potential lack of access to dental care. Oral health indicators were collected safely and efficiently from NH residents using a nursing and dental hygiene collaborative approach. Nursing and dental hygiene collaborations hold promise for improving the oral health in institutionalized elders.
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Miegel K, Wachtel T. Improving the oral health of older people in long-term residential care: a review of the literature. Int J Older People Nurs 2009; 4:97-113. [PMID: 20925809 DOI: 10.1111/j.1748-3743.2008.00150.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background. Unrefutable evidence now links poor oral health with the development of preventable systemic illnesses and debilitating conditions that threaten quality of life and life itself. This is especially significant for an increasing older population who are dependent on others for care. Aims and objectives. The majority of studies analysing the oral health of older dependent people in long-term residential care have been undertaken by dental professionals. This critical literature review examines the issue from a nursing perspective because nursing care providers have a fundamental role in daily oral health provision for dependent residents. Conclusions. Multiple barriers were found to negatively impact on daily oral healthcare provision, including lack of care provider education, oral health values, availability of resources, implementation of supportive policies, documentation and oral health assessment tools. Relevance to clinical practice. The nursing profession, at all levels, must become pro-active in removing financial, political and workforce barriers that impact negatively on oral health outcomes. A multi-faceted approach is required to address these barriers, including development and implementation of oral health education programmes, assessment screening tools, care plans, documentation, supply of oral hygiene aids and the appointment of oral care 'champions'.
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Affiliation(s)
- Karen Miegel
- Graduate Registered Nurse, Riverland Regional Health Services, Berri, SA, AustraliaLecturer in Nursing, School of Nursing and Midwifery, Flinders University Renmark Campus, Renmark, SA, Australia
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Jung YM, Shin DS. Oral health, nutrition, and oral health-related quality of life among Korean older adults. J Gerontol Nurs 2009; 34:28-35. [PMID: 18942537 DOI: 10.3928/00989134-20081001-09] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Oral health affects older adults and their quality of life. Oral care is reported to have a low priority in nursing care of older adults, and repeated assessments to detect oral health problems are seldom performed. The purpose of this study was to investigate the relationships among level of oral health, nutrition, and oral health-related quality of life (OHRQL) and to identify predictors of OHRQL in Korean older adults. The design was a descriptive, correlational study. The level of oral pain contributed most significantly to OHRQL, followed by nutrition and number of teeth. These three predictor variables explained 46.4% of the variance in OHRQL. Older adults could benefit from oral health care, such as routine screening for oral health and nutritional status. Nurses are at the forefront in providing such services, and it is recommended they integrate oral health care into their routine nursing care plans.
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Affiliation(s)
- Young-Mi Jung
- Department of Nursing, Daegu Haany University, Daegu
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Ergül S, Akar GC. Reliability and Validity of The Geriatric Oral Health Assessment Index in Turkey. J Gerontol Nurs 2008; 34:33-9. [DOI: 10.3928/00989134-20080901-05] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Brady M, Furlanetto D, Hunter RV, Lewis S, Milne V. Staff-led interventions for improving oral hygiene in patients following stroke. Cochrane Database Syst Rev 2006:CD003864. [PMID: 17054189 DOI: 10.1002/14651858.cd003864.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND For people with limitations due to neurological conditions such as stroke, the routine practice of oral care may become a challenge. Evidence-based supported oral care intervention is essential for this patient group. OBJECTIVES To compare the effectiveness of staff-led oral care interventions with standard care for ensuring oral hygiene for individuals after a stroke. SEARCH STRATEGY We searched the trials registers of the Cochrane Stroke Group and Oral Health Group (August 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2006), MEDLINE (1966 to February 2006), CINAHL (1982 to February 2006), Research Findings Electronic Register (February 2006), National Research Register (Issue 1, 2006), ISI Science and Technology Proceedings (August 2005), Dissertation Abstracts and Conference Papers Index (August 2005). We scanned reference lists from relevant papers and contacted authors and researchers in the field. SELECTION CRITERIA We identified randomised controlled trials that evaluated one or more interventions designed to improve oral hygiene. Trials based on a mixed population were included, provided it was possible to extract the data specific to the individuals post stroke. DATA COLLECTION AND ANALYSIS Two review authors independently classified identified trials according to the inclusion and exclusion criteria, assessed the trial quality and extracted data. Clarification was sought from study authors when required. MAIN RESULTS Eight eligible randomised controlled trials were identified but only one provided stroke-specific information. It compared an oral health care education training programme (OHCE) delivered to nursing home care assistants to delayed training intervention in the control group. Comparisons were made at one and six months after the intervention, using the primary outcome measures dental plaque and denture plaque, and three secondary outcomes. The data available for the 67 individuals with a stroke (obtained from the larger cluster randomised controlled trial) showed that denture plaque scores were significantly reduced up to six months (p < 0.00001) after the intervention. Staff knowledge (P = 0.0008) and attitudes (P = 0.0001) towards oral care also improved significantly. AUTHORS' CONCLUSIONS Based on one study with a small number of stroke survivors, providing oral care training for carers in a nursing home setting improves their knowledge of and attitudes towards the provision of oral care. In turn, residents' dentures were cleaner, though other oral hygiene measures did not change. Further evidence relating to oral care interventions is severely lacking, in particular with reference to care in hospital for those following stroke.
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Affiliation(s)
- M Brady
- Glasgow Caledonian University, Nursing, Midwifery and Allied Health Professions Research Unit, Cowcaddens Road, Glasgow, UK.
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