Nurses' knowledge, attitude, and practice regarding oral management for outpatients with type 2 diabetes: a national survey on certified diabetes educators.

The association among certified diabetes educator nurses' knowledge, attitudes, and practices related to oral management has not been well examined. The aim of this study was to examine the association between knowledge and attitude as variables for nurses' practice of oral management as certified diabetes educators at medical facilities in Japan. The questionnaires were administered to 300 certified diabetes educator nurses from 1277 medical facilities. The items regarding knowledge, attitude, and practice of oral management were assessed using items from the guidelines, reports, and books on diabetes and periodontal disease, as well as the exhaustive findings of previous studies. More than 70% of the participants did not practice adequate oral management. Logistic regression analysis revealed that all the items were negatively associated with nurses' confidence in oral management (Factor 1: odds ratio [OR] = 0.55; 95% confidence interval [CI] 0.37-0.83; Factor 2: OR = 0.35; 95% CI 0.18-0.70; Factor 3: OR = 0.38; 95% CI 0.24-0.61; Factor 4: OR = 0.29; 95% CI 0.18-0.49). The practice of oral management coupled with an explanation regarding periodontal disease as a diabetic complication (OR = 2.67; 95% CI 1.01-7.02), and supporting collaboration with multiple medical departments (OR = 2.65; 95% CI 1.24-5.65) were positively associated with nurses' education. These results suggest that more strategies for nurses' education are needed to understand the importance of oral management practices and to improve knowledge, attitudes, and confidence in patient oral management.