Division of Dentistry, School of Medical Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
Division of Psychology & Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
Health Expect. 2020 Oct;23(5):1086-1095. doi: 10.1111/hex.13074. Epub 2020 Jun 19.
Dental disease is highly prevalent in people with stroke. Stroke survivors regard oral hygiene as an important, yet neglected, area. The aim was to explore experiences of and barriers to oral care, particularly in relation to oral hygiene practice and dental attendance, among stroke survivors in the community.
This was a qualitative study incorporating a critical realist approach. Interviews were conducted with community-dwelling stroke survivors requiring assistance with activities of daily living, and focus groups were held with health and care professionals. Interviews and focus groups were recorded and transcribed verbatim. Thematic analysis was conducted.
Twenty-three stroke survivors were interviewed, and 19 professionals took part in 3 focus groups. Professionals included nurses, speech and language therapists, occupational therapists, dieticians, professional carers and dental staff. Interviews revealed difficulties in carrying out oral hygiene self-care due to fatigue, forgetfulness and limb function and dexterity problems. Routine was considered important for oral hygiene self-care and was disrupted by hospitalization resulting from stroke. Professionals highlighted gaps in staff training and confidence in supporting patients with oral care. Access to dental services appeared particularly problematic for those who were not registered with a dentist pre-stroke.
Oral hygiene routines may be disrupted by stroke, and resulting disabilities may make regular oral self-care more difficult. This study has identified specific barriers to oral hygiene self-care and dental service access. Findings from this study are feeding into the development of an intervention to support stroke survivors with oral care.
患有中风的人群中，牙齿疾病的发病率极高。中风幸存者认为口腔卫生很重要，但却常常被忽视。本研究旨在探索社区中风幸存者的口腔护理体验和障碍，特别是与口腔卫生实践和看牙医相关的方面。
这是一项定性研究，采用了批判现实主义方法。研究对象为需要日常生活活动帮助的社区居住的中风幸存者，采访了他们，并与卫生保健专业人员进行了焦点小组讨论。采访和焦点小组都进行了录音，并逐字记录。采用主题分析方法进行分析。
对 23 名中风幸存者进行了采访，有 19 名专业人员参加了 3 个焦点小组。专业人员包括护士、言语和语言治疗师、职业治疗师、营养师、专业护理人员和牙科工作人员。采访结果显示，由于疲劳、健忘和肢体功能及灵活性问题，进行口腔卫生自我护理存在困难。常规被认为对口腔卫生自我护理很重要，但由于中风住院，常规被打乱。专业人员强调了员工培训和支持患者口腔护理方面的信心存在差距。对于那些中风前没有注册牙医的人来说，获得牙科服务的机会似乎特别困难。
口腔卫生常规可能因中风而中断，由此产生的残疾可能使常规的口腔自我护理更加困难。本研究确定了口腔卫生自我护理和获得牙科服务的具体障碍。本研究的结果正在为支持中风幸存者进行口腔护理的干预措施的开发提供信息。
