Tynan Anna, Deeth Lisa, McKenzie Debra
Research Support Team, Darling Downs Hospital and Health Service, Baillie Henderson Hospital, PO Box 405, Toowoomba, QLD, 4350, Australia.
Rural Clinical School, The University of Queensland, 152, West Street, Toowoomba, QLD, 4350, Australia.
BMC Health Serv Res. 2018 Jul 3;18(1):515. doi: 10.1186/s12913-018-3321-5.
People in residential aged care facilities (RACF) are at very high risk of developing complex oral diseases and dental problems. A multidisciplinary approach incorporating oral health professionals and RACF staff is important for improving and sustaining oral health in RACFs. However, difficulties exist with access to oral health services for RACFs, particularly those in regional and rural areas. This study investigated the impact and experience of an integrated oral health program utilising tele-dentistry and Oral Health Therapists (OHT) in RACFs in a rural setting within Australia.
A mixed method comparison study was undertaken. Two hundred fifty-two clinical audits were completed across nine facilities with and without access to the integrated oral health program. Twenty-seven oral health quality of life surveys were completed with eligible residents. One focus group discussions (FGD) and eight interviews were completed with RACF staff. Thematic analysis was conducted on the transcribed FGDs and IDIs. Quantitative data were analysed using descriptive statistics.
Audits showed an improved compliance to Australian Aged Care Quality Accreditation Standards for oral health in the facilities with access to the integrated program compared to those without the program. Thematic analysis revealed that facilities with the integrated program reported improvements in importance placed on OH, better access to OH services and training, and decreased disruption of residents, particularly those with high care needs.
The integrated oral health program incorporating OHTs and tele-dentistry shows potential to improve the oral health outcomes of residents of RACFs. Improvements for managing oral health of residents with high care needs were observed. RACFs without easy access to an oral health service will also likely benefit from the increased support and training opportunities that the program enables.
居住在老年护理机构（RACF）的人群患复杂口腔疾病和牙齿问题的风险非常高。采用包括口腔健康专业人员和RACF工作人员在内的多学科方法对于改善和维持RACF中的口腔健康很重要。然而，RACF获得口腔健康服务存在困难，尤其是在地区和农村地区的机构。本研究调查了在澳大利亚农村地区的RACF中利用远程牙科和口腔健康治疗师（OHT）开展的综合口腔健康项目的影响和经验。
进行了一项混合方法比较研究。在九个有或没有获得综合口腔健康项目的机构中完成了252次临床审计。对符合条件的居民完成了27份口腔健康生活质量调查。与RACF工作人员进行了一次焦点小组讨论（FGD）和八次访谈。对转录的FGD和IDI进行了主题分析。定量数据采用描述性统计进行分析。
审计显示，与未实施该综合项目的机构相比，实施该项目的机构对澳大利亚老年护理质量认证标准中口腔健康部分的合规性有所提高。主题分析表明，实施综合项目的机构报告称，对口腔健康的重视程度有所提高，获得口腔健康服务和培训的机会更好，居民受到的干扰减少，尤其是那些高护理需求者。
纳入OHT和远程牙科的综合口腔健康项目显示出改善RACF居民口腔健康结果的潜力。观察到在管理高护理需求居民的口腔健康方面有改善。难以获得口腔健康服务的RACF也可能会从该项目带来的更多支持和培训机会中受益。
