School of Nursing, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China.
Department of Childcare, Elderly and Community Services, Hong Kong Institute of Vocational Education (Sha Tin), Hong Kong Special Administrative Region, Hong Kong, China.
PLoS One. 2023 Aug 15;18(8):e0289953. doi: 10.1371/journal.pone.0289953. eCollection 2023.
Investigating the oral care delivered by nursing staff in acute hospital setting is having a remarkable shortage within the current literature. This was provoked due to lack of previous performed investigation in the acute hospital setting besides inconsistent existence of a standardized and comprehensive oral care knowledge, attitude and practice (KAP) instrumentation. Therefore, the purpose of this study is to assess the oral care KAP level for inpatients among nursing staff; to identify possible barriers to the provision of oral care; and to identify training preferences to improve the oral care of inpatients, in acute hospital settings in Hong Kong; and to provide standardized comprehensive KAP based assessment tool that would benefit and guide other future studies. In this study, a cross-sectional survey was conducted after a 55-item self-administered structured questionnaire was developed. A modified KAP tool was developed. The tool includes 4 domains: oral care knowledge, attitude, practice, and experience. Nursing staff was recruited from July 2018 to April 2019 via convenience sampling. Either online or printed questionnaires were completed. Proportions of nursing staff with good KAP, as defined by having 60% of the total score in the respective domain, were estimated with 95% confidence intervals (CI). Analysis of covariance was used to compare the mean scores of KAP among different independent variables and identify the factors associated with good KAP. 404 nursing staff were recruited. Approximately 29.5%, 33.7% and 14.9% of the respondents had good oral care knowledge, attitude and practice, respectively, and 53.2% of the respondents had unpleasant oral care experience. Better oral care practice was associated with higher levels of oral care knowledge (β = 0.1) and oral care attitude (β = 0.3). To conclude: nursing staff in acute hospital settings reported low levels of oral care KAP with variations between the RN, EN and HCA. This study adds to the literature the association between oral care unpleasant experiences and the oral care practice, as well as oral care knowledge and attitude which also in turns associated with practice. The developed standardised tool could be applied for future studies. Recommendations on the future research, training and practices were made.
调查在急性医院环境中提供的护理人员口腔护理在当前文献中存在显著不足。这是由于之前在急性医院环境中没有进行过调查，并且口腔护理知识、态度和实践（KAP）的标准化和综合工具也不一致。因此，本研究的目的是评估香港急性医院环境中住院患者的口腔护理 KAP 水平；确定提供口腔护理的可能障碍；并确定改善急性医院住院患者口腔护理的培训偏好；并提供基于标准化综合 KAP 的评估工具，使其他未来研究受益并提供指导。在这项研究中，在开发了一份包含 55 个项目的自我管理结构化问卷后，进行了横断面调查。开发了一个改良的 KAP 工具。该工具包括 4 个领域：口腔护理知识、态度、实践和经验。2018 年 7 月至 2019 年 4 月，通过便利抽样招募护理人员。通过在线或打印问卷完成。用 95%置信区间（CI）估计具有相应领域总分 60%的护理人员具有良好 KAP 的比例。使用协方差分析比较不同独立变量之间 KAP 的平均得分，并确定与良好 KAP 相关的因素。共招募了 404 名护理人员。大约 29.5%、33.7%和 14.9%的受访者具有良好的口腔护理知识、态度和实践，53.2%的受访者有不愉快的口腔护理经验。更好的口腔护理实践与更高的口腔护理知识水平（β=0.1）和口腔护理态度（β=0.3）相关。总之：急性医院环境中的护理人员报告的口腔护理 KAP 水平较低，注册护士、注册护师和保健助理之间存在差异。这项研究在文献中增加了口腔护理不愉快经历与口腔护理实践之间的关联，以及口腔护理知识和态度与实践之间的关联。所开发的标准化工具可用于未来的研究。对未来的研究、培训和实践提出了建议。
