Early childhood caries is the most common chronic childhood disease worldwide. Australian Aboriginal and Torres Strait Islander children are twice more likely to develop dental decay, and ...contributing factors include poor maternal oral health and underutilisation of dental services. Globally, Indigenous health workers are in a unique position to deliver culturally competent oral healthcare because they have a contextual understanding of the needs of the community.
This scoping review aimed to identify the role of Indigenous health workers in promoting maternal oral health globally. A systematic search was undertaken of six electronic databases for relevant published literature and grey literature, and expanded to include non-dental health professionals and other Indigenous populations across the lifespan when limited studies were identified.
Twenty-two papers met the inclusion criteria, focussing on the role of Indigenous health workers in maternal oral healthcare, types of oral health training programs and screening tools to evaluate program effectiveness. There was a paucity of peer-reviewed evidence on the role of Indigenous health workers in promoting maternal oral health, with most studies focusing on other non-dental health professionals. Nevertheless, there were reports of Indigenous health workers supporting oral health in early childhood. Although some oral health screening tools and training programs were identified for non-dental health professionals during the antenatal period, no specific screening tool has been developed for use by Indigenous health workers.
While the role of health workers from Indigenous communities in promoting maternal oral health is yet to be clearly defined, they have the potential to play a crucial role in 'driving' screening and education of maternal oral health especially when there is adequate organisational support, warranting further research.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Oral care is a fundamental nurse-led intervention in the critical care setting that provides patient comfort and prevents adverse outcomes in critically ill patients. To date, there has been minimal ...focus on nurse-focused interventions to improve adherence to oral care regimens in the adult intensive care unit setting.
The objectives of this study were to (i) identify types and characteristics of interventions to improve oral care adherence amongst critical care nurses and intervention core components, (ii) evaluate the effectiveness of interventions to improve adherence of oral care regimens, and (iii) identify the types of outcome measures used to assess oral care regimen adherence.
This is a systematic review in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.
Key bibliographic databases and platforms, including Scopus, Cochrane, MEDLINE, CINAHL, Embase, PsycINFO, ProQuest, and Web of Science, were searched for studies published before July 2020. The Joanna Briggs Institute's quality appraisal tool was used to assess risk of bias in included studies.
Results: A total of 21 original research studies were identified, of which 18 studies used multifaceted interventions. In accordance with the Joanna Briggs Institute's quality appraisal tools, four of the 20 quasi-experimental studies were rated as high quality. The one randomised control trial was of moderate quality. Outcome measures included oral care adherence behaviours, oral care knowledge, self-reported adherence, and documentation. Improved effectiveness in oral care adherence was reported in 20 studies.
Review findings confirm interventions to change behaviours improve oral care adherence. The most effective interventional approach could not be determined owing to heterogeneity in intervention design and outcome measures. Oral care in the intensive care unit is a vital, nurse-led activity that reduces the risk of hospital-acquired infection. It is recommended that future research adopt implementation science methods to ensure stakeholder engagement and feasibility.
This review was submitted and subsequently registered on PROSPERO, the International Perspective Register of Systematic Reviews PROSPERO 2019 CRD42019123142.
Stroke is a serious cerebrovascular disease and is one of the world's leading causes of disability. Maintaining good oral health is a challenge among those hospitalised after stroke. A ...multidisciplinary approach to oral care involving non-dental professionals can be beneficial in improving oral health outcomes for patients. The aim of this study was to understand the perceptions of stroke survivors regarding oral healthcare across acute and rehabilitation settings.
A descriptive qualitative approach was used. Face-to-face semi-structured interviews were conducted. A framework analysis was employed to analyse the data. Patients who had recently experienced a stroke were purposively recruited across both acute and rehabilitation settings, at two metropolitan hospitals in Sydney, Australia. In total, 11 patients were interviewed.
Although participants recognised the importance of oral health, few understood the link between oral and general health. Regular oral hygiene practices varied since having stroke, with a few receiving oral care assistance from nurses. Time, cost and lack of information were some barriers to accessing dental services, while supportive measures such as coordination of oral care, financial subsidy and nurse assistance were strategies proposed to support oral care practices amongst stroke survivors.
There is scope to improve current models of oral care in stroke. While stroke survivors understand the importance of oral care, an integrated oral health model with a multidisciplinary approach could improve health outcomes.
Background:
Maintaining good oral health remains a challenge among those hospitalised after stroke. Stroke nurses and allied health clinicians have a potential role in providing oral care, but no ...studies in Australia to date have explored their perceptions and needs.
Aims:
To explore the perspectives of nursing and allied health stroke clinicians regarding oral care for stroke patients across acute care and stroke rehabilitation settings.
Methods:
This study followed an exploratory qualitative design, using a constructivist approach. Participants from two metropolitan public hospitals were purposively recruited to participate in focus groups. Data was thematically analysed.
Results:
Twenty-one clinicians participated. Clinicians’ knowledge and practices relating to oral healthcare for stroke patients were inadequate. Most staff felt they did not have adequate knowledge, resources and training to administer oral care in this setting and proposed enhancing education of stroke clinicians, patients and informal caregivers, as well as improving quality point of care resources. There was overall support for the integrated dental care after stroke model of care.
Discussion:
This study revealed many gaps in current care and highlighted areas for improvement. Patients and their caregivers needed to be actively engaged as partners to improve oral healthcare within acute and rehabilitation stroke settings.
Conclusion:
This study provided insight into nurses’ and allied health stroke clinicians’ current knowledge and practices of oral care in various stroke settings. The findings from this study will inform development of a model of care to train stroke nurses in providing oral care.
Objective
This study aimed to look at the practices and perspectives of residential aged care facility (RACF) care staff regarding the provision of oral health care in RACFs.
Background
Emphasis has ...been placed on the provision of adequate oral health care in RACFs through the Better Oral Health in Residential Aged Care programme. Endorsed by the Australian government, this programme provided oral health education and training for aged care staff. However, recent evidence suggests that nearly five years after the implementation of this programme, the provision of oral care in RACFs in NSW remains inadequate.
Materials and Methods
This project utilised an exploratory qualitative design which involved a focus group with 12 RACF care staff. Participants were asked to discuss the current oral health practices in their facility, and their perceived barriers to providing oral health care.
Results
The key findings demonstrated current oral health practices and challenges among care staff. Most care staff had received oral health training and demonstrated positive attitudes towards providing dental care. However, some participants identified that ongoing and regular training was necessary to inform practice and raise awareness among residents. Organisational constraints and access to dental services also limited provision of dental care while a lack of standardised guidelines created confusion in defining their role as oral healthcare providers in the RACF.
Conclusion
This study highlighted the need for research and strategies that focus on capacity building care staff in oral health care and improving access of aged care residents to dental services.
Although guidelines recommend antenatal care providers such as midwives promote oral health during pregnancy, oral health training is not routinely provided in undergraduate midwifery curricula. The ...aim of this study was to implement an oral health module into an Australian undergraduate midwifery program, and evaluate its effectiveness in improving the oral health knowledge and confidence of midwifery students.
Pre-test post-test study (2015–2017).
An undergraduate midwifery program within an Australian university.
All first-year undergraduate midwifery students enrolled in two core units at the above university (N = 56).
Oral health modules were implemented into each of the two core units within the first year of the Bachelor of Midwifery course. Changes in knowledge and confidence were measured using a standardised questionnaire, administered at baseline, immediately following module completion, and at 2 and 3 years following module completion.
44 students participated in the baseline survey (79% response rate), of which 41 completed the first post-module questionnaire, 21 completed the second post-questionnaire, and 24 completed the third post-questionnaire. Knowledge scores significantly increased from baseline (mean 13.12) to follow-up (mean 17.78, p < 0.001), with increases being retained through to the 3-year mark (mean 18.29, p < 0.001). Confidence scores also showed a sustained increase following the module, particularly regarding introducing oral health in the first antenatal appointment (62.1% increase, p < 0.001) and referring pregnant women to a dentist (48.2% increase, p < 0.001). However, the 48.2% increase (p < 0.001) in confidence in conducting a visual mouth check on a pregnant woman following the module was not sustained at subsequent time points, reducing to a 31.5% increase (p = 0.118) by the third year post-module.
The module is effective in improving and sustaining the knowledge and confidence of midwifery students to promote maternal oral health. Ongoing updates may be required to keep confidence high regarding visual mouth checks.
Issue addressed: All pregnant women should have a comprehensive oral health evaluation. Unfortunately, many pregnant women seldom seek dental care and some dentists are hesitant to treat during ...pregnancy. To address these issues, the Midwifery Initiated Oral Health Dental Service (MIOH-DS) program was developed in Australia. The aim of this study was to undertake a process evaluation and explore the perceptions of dental professionals involved in the program to determine the acceptability, feasibility and effectiveness of the program if it were to be upscaled.
Methods: A qualitative approach using content analysis was conducted on data from two focus groups involving 12 dental professionals.
Results: All participants were supportive of the MIOH-DS program. They thought pregnant women were receptive to their care, and reported markedly improved oral health. The provision of free dental care and the involvement of midwives were cited as major factors that improved the uptake of the program. Some of the challenges encountered were the prevailing misconceptions about the safety of dental treatment and pregnancy-related impairments.
Conclusions: Dental professionals found the MIOH-DS to be acceptable, feasible and effective in improving oral health of pregnant women and their uptake of dental services. However, some challenges need to be addressed as the MIOH-DS program is upscaled into a cost-effective model.
So what?: Dental professionals are important stakeholders in the MIOH-DS model. The process evaluation of the successful dental intervention is necessary to understand how and why such interventions work, and is an important step in scaling up to a population-wide intervention.
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.
Oral health problems among people receiving palliative care are common and can significantly affect quality of life. Nurses are at the frontline of palliative care in Australia. However, how optimal ...oral health care is addressed in clinical practice by palliative nurses is not known.
To explore the perceptions of nurses working in Australian palliative care settings to determine the acceptability, challenges and recommendations that need to be considered to develop and implement an oral health care model in palliative care settings.
Two focus groups were conducted with community (n = 8) and inpatient nurses (n = 10) working in urban palliative care settings.
Four main themes were developed through consensus: 1) Oral health is important in the palliative care setting; 2) Additional training could enhance what nurses already do; 3) Barriers to receiving oral care: a structural issue; 4) Exploring alternative pathways to dental services.
Nurses recognised the importance of oral health in palliative care; however, the paucity of set protocols based on existing guidelines meant that oral care was often unstructured. Systemic factors reduced the number of available options for people receiving palliative care to access professional dental treatment. Although alternative solutions, including teledentistry services, were explored, there were some constraints.
A palliative care oral health model of care would need to integrate existing formal guidelines into a comprehensive framework specific for palliative care nurses and develop palliative care oral health training for them taking into consideration existing barriers for people to receive professional dental treatment.
Issue addressed: All pregnant women should have a comprehensive oral health evaluation. Unfortunately, many pregnant women seldom seek dental care and some dentists are hesitant to treat during ...pregnancy. To address these issues, the Midwifery Initiated Oral Health Dental Service (MIOH-DS) program was developed in Australia. The aim of this study was to undertake a process evaluation and explore the perceptions of dental professionals involved in the program to determine the acceptability, feasibility and effectiveness of the program if it were to be upscaled.
Methods: A qualitative approach using content analysis was conducted on data from two focus groups involving 12 dental professionals.
Results: All participants were supportive of the MIOH-DS program. They thought pregnant women were receptive to their care, and reported markedly improved oral health. The provision of free dental care and the involvement of midwives were cited as major factors that improved the uptake of the program. Some of the challenges encountered were the prevailing misconceptions about the safety of dental treatment and pregnancy-related impairments.
Conclusions: Dental professionals found the MIOH-DS to be acceptable, feasible and effective in improving oral health of pregnant women and their uptake of dental services. However, some challenges need to be addressed as the MIOH-DS program is upscaled into a cost-effective model.
So what?: Dental professionals are important stakeholders in the MIOH-DS model. The process evaluation of the successful dental intervention is necessary to understand how and why such interventions work, and is an important step in scaling up to a population-wide intervention.
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