Kistler Christine E, Scott Jessica, Ward Kimberly, Zeigler Robin, Sullivan Louise, Tomlinson Sarah E, Wretman Christopher J, Zimmerman Sheryl
The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA.
J Am Med Dir Assoc. 2021 Jun;22(6):1190-1193.e2. doi: 10.1016/j.jamda.2020.11.038. Epub 2020 Dec 29.
Poor oral care may lead to systemic disease, and there is evidence that assisted living (AL) residents lack quality oral care; in AL, poor care may be due to staff knowledge and attitudes, as well as organizational barriers to providing care.
Determine AL staff knowledge and attitudes regarding mouth care and barriers to changing care.
Self-administered repeated-measures questionnaires completed before and after oral care training.
A total of 2012 direct care staff and administrators from 180 AL communities.
Nine knowledge questions and 8 attitude and practice intention questions, and open-ended questions regarding training and obstacles to providing oral care.
Overall, 2012 participants completed pretraining questionnaires, and 1977 completed posttraining questionnaires. Baseline knowledge was high, but staff were not uniformly aware of the systemic-oral link whereby mouth care affects pneumonia and diabetes. Almost all staff reported learning a new technique (96%), including for residents who resist care (95%). Suggested areas to improve mouth care included having more hands-on experience. The primary perceived obstacles to care centered around residents who resist care and a lack of time.
Based on reports of having benefitted from training, AL staff overwhelmingly noted that new knowledge was helpful, suggesting the benefit of skills-based training, especially in dementia care. Mouth care in AL has been sorely understudied, and merits additional attention.
口腔护理不佳可能导致全身性疾病，且有证据表明辅助生活（AL）机构的居民缺乏高质量的口腔护理；在辅助生活机构中，护理不佳可能是由于工作人员的知识和态度，以及提供护理的组织障碍。
确定辅助生活机构工作人员关于口腔护理的知识和态度以及改变护理的障碍。
在口腔护理培训前后完成的自我管理重复测量问卷。
来自180个辅助生活社区的2012名直接护理人员和管理人员。
九个知识问题、八个态度和实践意图问题，以及关于培训和提供口腔护理障碍的开放式问题。
总体而言，2012名参与者完成了培训前问卷，1977名完成了培训后问卷。基线知识水平较高，但工作人员并非都了解口腔护理与全身性疾病的联系，即口腔护理对肺炎和糖尿病的影响。几乎所有工作人员都报告学到了一种新技术（96%），包括针对抗拒护理的居民的技术（95%）。建议改善口腔护理的方面包括增加实践经验。护理的主要感知障碍集中在抗拒护理的居民和时间不足上。
基于从培训中受益的报告，辅助生活机构工作人员绝大多数指出新知识很有帮助，这表明基于技能的培训有益，尤其是在痴呆症护理方面。辅助生活机构中的口腔护理研究严重不足，值得更多关注。
