Simons D, Baker P, Jones B, Kidd E A, Beighton D
West Herts Community Dental Services, Principal Health Centre, Civic Close, St Albans.
Br Dent J. 2000 Feb 26;188(4):206-10. doi: 10.1038/sj.bdj.4800432.
The objectives of this study were: to evaluate carers' knowledge of oral health; to provide a high quality, consistent, oral health training programme for carers in residential homes; to evaluate the quality of this programme by examining both carers' changes in knowledge and any changes in carers' behaviour as reported by residents and to assess any changes in the oral health of the elderly residents after one year.
A cross-sectional, multi-centre study using a carer training programme, evaluated by both a questionnaire conducted with carers and residents and oral examination of residents.
In August 1996, 20 (20%) of the residential/nursing homes, in West Hertfordshire were chosen at random and all managers contacted and offered an oral examination for all their residents. Ten (10%) of the homes were also offered an oral health training programme for their carers. Eighteen homes accepted the oral examination for all consenting residents and 7 of the 10 homes offered accepted the carer training.
Thirty-nine carers from 7 of the residential homes attended an oral health training course and 213 elderly residents in the 18 homes were examined both at baseline and after 12 months.
Carers' baseline knowledge about oral health was poor; the oral health training programme was enjoyed and their knowledge gain after one week was high. However, the elderly residents perceived no change in the oral care given by carers either after one week or after one year and there was no measurable improvement in the oral health of residents after carer training, except for an increase in filled coronal surfaces. Few of the carers originally trained were still working in the same residential homes after one year.
Although the carer training programme was well received, no changes in oral health practice resulted. Barriers to practice of oral care by carers remained and training, even when including practical skills, evaluation by peers and a high knowledge gain, failed to reduce these barriers.
本研究的目的是：评估护理人员的口腔健康知识；为养老院的护理人员提供高质量、一致的口腔健康培训项目；通过检查护理人员知识的变化以及居民报告的护理人员行为的任何变化来评估该项目的质量；并评估老年居民一年后的口腔健康变化。
一项横断面、多中心研究，采用护理人员培训项目，通过对护理人员和居民进行问卷调查以及对居民进行口腔检查来评估。
1996年8月，随机选择了西赫特福德郡20家（20%）养老院/疗养院，联系了所有管理人员，并为其所有居民提供口腔检查。其中10家（10%）养老院还为其护理人员提供了口腔健康培训项目。18家养老院接受了为所有同意检查的居民进行口腔检查，提供培训的10家养老院中有7家接受了护理人员培训。
来自7家养老院的39名护理人员参加了口腔健康培训课程，18家养老院的213名老年居民在基线时和12个月后均接受了检查。
护理人员对口腔健康的基线知识较差；他们喜欢口腔健康培训项目，一周后的知识收获较高。然而，老年居民认为护理人员在一周后或一年后提供的口腔护理没有变化，护理人员培训后居民的口腔健康没有可测量的改善，除了充填牙冠面增加。最初接受培训的护理人员一年后很少仍在同一家养老院工作。
尽管护理人员培训项目受到好评，但口腔健康实践没有变化。护理人员进行口腔护理的实践障碍仍然存在，即使培训包括实践技能、同行评估和较高的知识收获，也未能减少这些障碍。
