University College Cork, Cork, Ireland.
Cork University Hospital, Cork, Ireland.
Gerodontology. 2024 Sep;41(3):346-356. doi: 10.1111/ger.12709. Epub 2023 Aug 2.
To explore the attitudes, facilitators and barriers in providing oral care for inpatients with dysphagia post-stroke as perceived by healthcare professionals.
Dysphagia is a common complication of stroke and is associated with a higher incidence of aspiration pneumonia, malnutrition and dehydration. In the acute phase of stroke recovery, a dental professional is not usually part of the multidisciplinary team caring for the patient and oral care is the responsibility of the healthcare professionals in the stroke unit. There is a lack of high-quality evidence to demonstrate the most effective method of providing oral care for patients with dysphagia post-stroke.
This was a single-site study conducted with healthcare professionals working in the Stroke Unit of Cork University Hospital in Ireland, using focus groups and a qualitative thematic analysis approach.
A total of three focus groups were conducted in the Stroke Unit with 17 healthcare professionals. The focus groups included representation from all healthcare professional groups providing direct clinical care to patients on the Stroke Unit including geriatric medicine, dietetics, speech and language therapy, healthcare assistance, nursing, occupational therapy and physiotherapy. A qualitative thematic analysis was carried out and seven overarching themes emerged from the data. Three themes related to facilitators to providing oral care for this patient group: (i) a focus on oral care in both policy and practice, (ii) expanding professional roles in the provision of oral care, (iii) perceived importance of oral care in recovery and rehabilitation. Four themes related to barriers to the provision of oral care for this patient group: (i) lack of confidence and concerns related to the perceived risk for patients with dysphagia, (ii) unique challenges of patient and stroke-related factors, (iii) lack of resources and time and (iv) perceived importance of oral care in recovery and its relative importance with competing demands.
Members of the stroke multidisciplinary team believe that they all have a part to play in the delivery of oral care for patients with dysphagia post-stroke. Opportunities exist for the development of multidisciplinary interventions to improve the oral cavity assessment and oral care provided in the Stroke Unit.
探讨医护人员对脑卒中后吞咽障碍患者提供口腔护理的态度、促进因素和障碍。
吞咽障碍是中风的常见并发症，与更高的吸入性肺炎、营养不良和脱水发生率相关。在中风恢复的急性期，牙科专业人员通常不是多学科团队照顾患者的一部分，口腔护理是中风病房医护人员的责任。缺乏高质量的证据来证明为中风后吞咽障碍患者提供口腔护理的最有效方法。
这是一项在爱尔兰科克大学医院中风病房进行的单站点研究，使用焦点小组和定性主题分析方法。
在中风病房共进行了 3 次焦点小组，共有 17 名医护人员参加。焦点小组包括来自为中风病房患者提供直接临床护理的所有医护人员群体的代表，包括老年医学、饮食学、言语和语言治疗、医疗协助、护理、职业治疗和物理治疗。进行了定性主题分析，从数据中出现了 7 个总体主题。与为这一患者群体提供口腔护理的促进因素相关的 3 个主题：（i）在政策和实践中都注重口腔护理，（ii）扩大在提供口腔护理方面的专业角色，（iii）认为口腔护理在恢复和康复中的重要性。与为这一患者群体提供口腔护理的障碍相关的 4 个主题：（i）缺乏对吞咽障碍患者的风险的信心和担忧，（ii）患者和中风相关因素的独特挑战，（iii）缺乏资源和时间，（iv）认为口腔护理在恢复中的重要性及其与竞争需求的相对重要性。
中风多学科团队的成员认为他们都在为中风后吞咽障碍患者提供口腔护理方面发挥作用。存在发展多学科干预措施的机会，以改善中风病房的口腔评估和口腔护理。
