Tada Sayaka, Lee Gabriel Keng Yan, Koh Sarah Mun Yee, Wong Mun Loke
Faculty of Dentistry, National University of Singapore, Singapore, Singapore.
Gerodontology. 2024 Mar;41(1):169-181. doi: 10.1111/ger.12686. Epub 2023 Mar 14.
To address the following research questions: (i) What is the current situation and future vision on oral healthcare service in nursing homes (NHs) in Singapore? (ii) What are the enablers to achieve the future vision? (iii) How do views differ between dentists with and without clinical experiences in NHs?
Oral healthcare services in NHs need to reflect the perspectives of a diverse range of stakeholders and establish shared goals, however there is scarce evidence of in-depth dentists' insights.
Dentists were purposively recruited. Focus group discussions with 4-5 participants each were conducted via teleconferencing. Data were analysed thematically.
The participants (n = 19, median 36.0 years) recognised the need of comprehensive reform of the oral healthcare paradigm in NHs: symptomatic care to preventive care, disease-oriented care to person-centred care and more active collaborative care. Overall, five domains of enabling factors emerged: (1) to improve general system of oral healthcare in NHs, (2) to increase the number of dentists engaging in NHs, (3) to improve the quality of dental practice, (4) to improve the quality of daily oral care and (5) to promote seniors' cooperative attitude to oral healthcare. There was a noticeable difference in the perception on how to encourage dentists to serve in NHs.
There is a need for a comprehensive reform of the oral healthcare paradigm for seniors in NHs in Singapore. A multi-tiered strategy using both top-down and bottom-up approaches is required.
解决以下研究问题:(i)新加坡养老院口腔医疗服务的现状和未来愿景是什么?(ii)实现未来愿景的推动因素有哪些?(iii)有和没有养老院临床经验的牙医的观点有何不同?
养老院的口腔医疗服务需要反映不同利益相关者的观点并确立共同目标,然而,关于牙医深入见解的证据很少。
有目的地招募牙医。通过电话会议进行每组4 - 5名参与者的焦点小组讨论。对数据进行主题分析。
参与者(n = 19,中位数36.0岁)认识到养老院口腔医疗模式全面改革的必要性:从对症治疗转向预防保健,从以疾病为导向的护理转向以患者为中心的护理,以及更积极的协作护理。总体而言,出现了五个促成因素领域:(1)改善养老院口腔医疗的总体体系,(2)增加参与养老院服务的牙医数量,(3)提高牙科诊疗质量,(4)提高日常口腔护理质量,(5)促进老年人对口腔医疗保健的合作态度。在如何鼓励牙医在养老院服务的认知上存在明显差异。
新加坡养老院老年人的口腔医疗模式需要进行全面改革。需要采用自上而下和自下而上相结合的多层次策略。