Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
Undergraduate Student, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
Gerodontology. 2021 Mar;38(1):95-103. doi: 10.1111/ger.12502. Epub 2020 Oct 18.
This study aims to assess caregivers' knowledge, perception and perceived barriers as well as their daily usual practice concerning oral care provision in a geriatric hospital.
A semi-structured questionnaire was developed and administered to caregivers in a geriatric ward. Furthermore, oral care delivery to dependent and independent patients was clinically observed.
One hundred and fifty-two caregivers (60% nurses, 40% nursing aids) completed the survey (78% response rate). Clinical oral care was observed in 97 inpatients. Observations revealed that brushing was done in 94% of opportunities in independent patients but in only 55% of dependent patients. This corresponded to the frequency indicated in the questionnaire for independent elders (97%, n.s.), whereas it was significantly different for dependent elders (89%, P < .001). 95% of caregivers stated in the questionnaire never verifying self-administered oral care, whereas 12.3% were actually observed verifying intraorally its efficiency (P = .07 chi-squared test). 71% of the respondents stated storing the prostheses dry, and 8% stated that they reinserted it after cleaning. Caregivers' observation revealed that 35.1% of prostheses were reinserted in the mouth, indicating a significantly higher rate than in the questionnaire (P < .05). Respondents felt that their training to perform oral hygiene measures was suboptimal (VAS 48 ± 34.4). Patients verbally refusing oral care were stated as a barrier by 14% of respondents and were witnessed in 15.6% of observation opportunities (n.s).
Various measures, such as hospital health policy, improved logistics or advanced hands-on training, might help to converge the clinical practice towards the theoretical knowledge.
本研究旨在评估老年病房护理人员在提供口腔护理方面的知识、认知和感知障碍，以及他们的日常常规做法。
设计了一份半结构化问卷并在老年病房的护理人员中进行了问卷调查。此外，还对依赖和独立患者的口腔护理提供情况进行了临床观察。
共有 152 名护理人员（60%为护士，40%为护理助理）完成了调查（应答率为 78%）。观察了 97 名住院患者的临床口腔护理。观察结果表明，独立患者中有 94%的机会进行了刷牙，但在依赖患者中只有 55%。这与问卷中对独立老年人的频率（97%，无显著性差异）相对应，但在依赖老年人中差异显著（89%，P<.001）。95%的护理人员在问卷中表示从未验证过自我进行的口腔护理，但实际上有 12.3%被观察到验证了口腔内护理的效果（P=.07，卡方检验）。71%的受访者表示将义齿储存在干燥处，8%的受访者表示在清洁后将其重新插入。护理人员的观察结果显示，35.1%的义齿被重新插入口腔，这表明实际重新插入的比例明显高于问卷中的比例（P<.05）。受访者认为他们接受的口腔卫生措施培训效果不佳（VAS 48±34.4）。14%的受访者认为患者拒绝口腔护理是一个障碍，在 15.6%的观察机会中观察到了这一点（无显著性差异）。
各种措施，如医院卫生政策、改善后勤保障或先进的实践培训，可能有助于使临床实践与理论知识趋同。
