Frenkel H F
Department of Oral and Dental Science, University of Bristol Dental School, UK.
Gerodontology. 1999 Dec;16(2):75-80. doi: 10.1111/j.1741-2358.1999.00075.x.
To identify qualitatively carer staff attitudes, practices and critical comments related to oral health care of functionally dependent nursing home clients.
Open-ended questions included in a longer quantitative questionnaire.
22 randomly selected nursing homes in the Bristol area.
416 carers employed in these homes.
The majority of carers thought that clients had a right to good oral health, accepted the carers' role in helping clients with oral and denture hygiene, but recognised that oral health care provision was deficient. However, some carers believed oral health care to be solely the clients' responsibility despite high disability levels. Main barriers to providing oral health care were low prioritization of oral health by nursing management, lack of co-operation from cognitively impaired clients, and lack of training. Carers were critical of homes' lack of arrangements for routine professional dental checks, lack of commitment to staff training, low standards of oral health care by colleagues, and lack of provision of oral hygiene aids and cleansing materials for clients. Many responses indicated ways in which nursing home oral health care could be improved. Carers reported contrasting experiences of dental treatment, and deplored recent decreased availability of subsidized dental care.
Carers' generally positive attitudes towards clients' oral health care should encourage health educators. Insights gained from qualitative data can help to identify the less obvious causes for poor oral care delivery, which can then be addressed in education and training initiatives in nursing home settings.
定性确定护理人员对功能依赖型养老院患者口腔保健的态度、做法及批判性意见。
在一份较长的定量调查问卷中纳入开放式问题。
布里斯托尔地区随机选取的22家养老院。
这些养老院雇佣的416名护理人员。
大多数护理人员认为患者有权享有良好的口腔健康，认可护理人员在帮助患者进行口腔和假牙卫生护理方面的作用，但认识到口腔保健服务存在不足。然而，一些护理人员认为，尽管患者残疾程度很高，但口腔保健完全是患者自己的责任。提供口腔保健的主要障碍包括护理管理层对口腔健康的重视程度低、认知障碍患者缺乏合作以及缺乏培训。护理人员批评养老院缺乏常规专业牙科检查安排、对员工培训缺乏投入、同事的口腔保健标准低以及缺乏为患者提供口腔卫生辅助工具和清洁材料。许多反馈指出了改善养老院口腔保健的方法。护理人员报告了不同的牙科治疗经历，并对近期补贴牙科护理的可及性下降表示遗憾。
护理人员对患者口腔保健总体上持积极态度，这应能鼓励健康教育工作者。从定性数据中获得的见解有助于找出口腔护理服务不佳的不太明显的原因，进而可在养老院环境中的教育和培训举措中加以解决。
