Sanchez Paula, Everett Bronwyn, Salamonson Yenna, Ajwani Shilpi, Bhole Sameer, Bishop Joshua, Lintern Karen, Nolan Samantha, Rajaratnam Rohan, Redfern Julie, Sheehan Maria, Skarligos Fiona, Spencer Lissa, Srinivas Ravi, George Ajesh
School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
South Western Sydney Local Health District, Sydney, Australia.
PLoS One. 2017 Jul 20;12(7):e0181189. doi: 10.1371/journal.pone.0181189. eCollection 2017.
The aim of this study was to explore the perception of patients with cardiovascular disease towards oral health and the potential for cardiac care clinicians to promote oral health.
A needs assessment was undertaken with twelve patients with cardiovascular disease attending cardiac rehabilitation between 2015 and 2016, in three metropolitan hospitals in Sydney, Australia. These patients participated in face-to-face semi-structured interviews. Data was analysed using thematic analysis.
Results suggested that while oral health was considered relevant there was high prevalence of poor oral health among participants, especially those from socioeconomic disadvantaged background. Awareness regarding the importance of oral health care its impact on cardiovascular outcomes was poor among participants. Oral health issues were rarely discussed in the cardiac setting. Main barriers deterring participants from seeking oral health care included lack of awareness, high cost of dental care and difficulties in accessing the public dental service. Findings also revealed that participants were interested in receiving further information about oral health and suggested various mediums for information delivery. The concept of cardiac care clinicians, especially nurses providing education, assessment and referrals to ongoing dental care was well received by participants who felt the post-acute period was the most appropriate time to receive oral health care advice. The issues of oral health training for non-dental clinicians and how to address existing barriers were highlighted by participants.
The lack of oral health education being provided to patients with cardiovascular disease offers an opportunity to improve care and potentially, outcomes. In view of the evidence linking poor oral health with cardiovascular disease, cardiac care clinicians, especially nurses, should be appropriately trained to promote oral health in their practice. Affordable and accessible dental care services for people with cardiovascular disease should be considered and offered by health services in Australia.
本研究旨在探讨心血管疾病患者对口腔健康的认知以及心脏科临床医生促进口腔健康的潜力。
2015年至2016年期间,在澳大利亚悉尼的三家大都市医院,对12名参加心脏康复的心血管疾病患者进行了需求评估。这些患者参与了面对面的半结构化访谈。采用主题分析法对数据进行分析。
结果表明,虽然口腔健康被认为是相关的,但参与者中口腔健康状况不佳的患病率很高,尤其是那些来自社会经济弱势背景的人。参与者对口腔保健的重要性及其对心血管疾病结局的影响认识不足。在心脏科环境中很少讨论口腔健康问题。阻碍参与者寻求口腔保健的主要障碍包括缺乏认识、牙科护理费用高昂以及难以获得公共牙科服务。研究结果还显示,参与者有兴趣获得更多关于口腔健康的信息,并提出了各种信息传播媒介。心脏科临床医生,尤其是提供教育、评估和转介至持续牙科护理的护士的概念,受到了参与者的欢迎,他们认为急性后期是接受口腔健康护理建议的最合适时间。参与者强调了非牙科临床医生的口腔健康培训问题以及如何解决现有障碍。
未向心血管疾病患者提供口腔健康教育,这为改善护理及潜在的改善结局提供了机会。鉴于有证据表明口腔健康不佳与心血管疾病有关,心脏科临床医生,尤其是护士,应接受适当培训以在其实践中促进口腔健康。澳大利亚的卫生服务机构应考虑并提供为心血管疾病患者提供负担得起且可获得的牙科护理服务。