Niesten D, Gerritsen A E, Leve V
Ned Tijdschr Tandheelkd. 2021 Oct;128(10):485-494. doi: 10.5177/ntvt.2021.10.21065.
To identify facilitators and barriers to integrate oral health care into general healthcare for frail elderly, 41 participants from 10 different groups of (professional) caregivers and care-recipients (residents living at home and nursing home patients) in the east of the Netherlands were interviewed. They were asked about normative integration (vision, attitude, culture) at the macro (system), meso (organizational and interprofessional), and micro (patient care) level. After thematic analysis of the interviews, the results were refined on the basis of a workshop with 52 stakeholders. Subsequently, two main themes were identified: 1. a compartmentalized care culture in which oral healthcare and general healthcare are seen as two separate domains; 2. prioritization, awareness, and attitude towards oral healthcare integration. Barriers to integration are: low political attention (macro level); unclear responsibilities, hierarchical relationships, and lack of vision (meso level); poor awareness and low prioritization by healthcare providers and patients (micro level). Leadership (meso level), a supportive personality of individual caregivers, and ownership of patients (micro level) promote integration.
为确定将口腔保健纳入体弱老年人综合医疗保健的促进因素和障碍，我们对荷兰东部10个不同群体（专业）护理人员和护理对象（居家居民和疗养院患者）的41名参与者进行了访谈。我们询问了他们在宏观（系统）、中观（组织和跨专业）和微观（患者护理）层面的规范整合情况（愿景、态度、文化）。在对访谈进行主题分析后，基于与52名利益相关者的研讨会对结果进行了完善。随后，确定了两个主要主题：1. 一种将口腔保健和综合医疗保健视为两个独立领域的分隔护理文化；2. 对口腔保健整合的优先排序、认识和态度。整合的障碍包括：政治关注度低（宏观层面）；职责不明确、层级关系不清以及缺乏愿景（中观层面）；医疗服务提供者和患者的认识不足且优先级低（微观层面）。领导力（中观层面）、个体护理人员的支持性格以及患者的自主性（微观层面）促进整合。
