Melbye Elisabeth Lind, Bull Vibeke Hervik, Hidle Kristin Søllesvik
Research Department, Oral Health Centre of Expertise Rogaland, Stavanger, Norway.
JMIR Res Protoc. 2023 Oct 6;12:e46926. doi: 10.2196/46926.
Poor oral health is common in nursing home residents, and health care professionals report numerous barriers when it comes to the provision of oral care for care-dependent older adults, such as a lack of oral health knowledge and skills, care-resistant behaviors in residents, lack of adequate oral care routines, insufficient systems for documentation of issues related to oral health, a high workload, and unclear responsibilities. An intervention, SmartJournal, has been developed to assist health personnel in preserving older patients' oral health. SmartJournal is a digital tool with three components: (1) documentation of oral hygiene routines; (2) monthly oral health assessment; and (3) education on geriatric oral care. An updated framework for research on complex interventions has been used to guide the various phases in the development of this intervention. This study focuses on the evaluation phase.
We aim to assess (1) the effectiveness of SmartJournal use in enhancing nursing home caregivers' capability, opportunity, motivation, and routines related to oral care; and (2) whether SmartJournal use results in improved oral health for nursing home residents.
We will use a cluster randomized controlled trial to assess impacts of SmartJournal use as specified under study objectives. Nursing homes located in Rogaland, Norway, will be recruited and randomly assigned to an intervention and a control group. The intervention group will be provided with tablets containing SmartJournal and support from research staff, while the control group will continue with existing oral care routines. Both groups will receive oral hygiene packages. The intervention will last for 12 weeks. Measurements will be performed in both groups at baseline, 3 months, and 9 months and include (1) a survey assessing caregivers' capability, opportunity, motivation, and routines related to oral care; and (2) assessment of oral health status in residents using mucosal-plaque score as a primary outcome measure. Analyses will include descriptive statistics and statistical techniques to look for changes and differences in the study variables within and between the intervention and control groups throughout the study period. Associations between study variables will also be investigated.
Recruitment of nursing homes for the intervention and control groups was completed in February 2023. Recruitment of individual participants (ie, nursing home residents and caregivers) is ongoing, and baseline measurements are being performed consecutively. Results are expected to be ready for analyses in fall 2024.
We aim to assess the effects of SmartJournal use on oral care and oral health in nursing homes. Results from this work may inform further development and implementation of SmartJournal and similar digital tools aiming to enhance health care services offered to care-dependent people. Finally, SmartJournal may have potential as a learning tool in educational programs for nurses and other health care professionals.
ClinicalTrials.gov NCT05724043; https://clinicaltrials.gov/study/NCT05724043.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/46926.
口腔健康状况不佳在养老院居民中很常见，医疗保健专业人员报告称，在为需要护理的老年人提供口腔护理方面存在诸多障碍，例如缺乏口腔健康知识和技能、居民的抗拒护理行为、缺乏适当的口腔护理常规、记录口腔健康相关问题的系统不完善、工作量大以及职责不明确。已开发出一种名为SmartJournal的干预措施，以协助医护人员维护老年患者的口腔健康。SmartJournal是一种数字工具，包含三个组成部分：（1）记录口腔卫生常规；（2）每月进行口腔健康评估；（3）开展老年口腔护理教育。一个更新的复杂干预研究框架已被用于指导该干预措施开发的各个阶段。本研究聚焦于评估阶段。
我们旨在评估（1）使用SmartJournal在提高养老院护理人员与口腔护理相关的能力、机会、动机和常规方面的有效性；（2）使用SmartJournal是否能改善养老院居民的口腔健康。
我们将采用整群随机对照试验来评估如研究目标中所规定的使用SmartJournal的影响。将招募位于挪威罗加兰郡的养老院，并随机分为干预组和对照组。干预组将获得装有SmartJournal的平板电脑以及研究人员的支持，而对照组将继续采用现有的口腔护理常规。两组都将收到口腔卫生套装。干预将持续12周。将在基线、3个月和9个月时对两组进行测量，测量内容包括：（1）一项调查，评估护理人员与口腔护理相关的能力、机会、动机和常规；（2）以黏膜菌斑评分作为主要结局指标评估居民的口腔健康状况。分析将包括描述性统计和统计技术，以寻找整个研究期间干预组和对照组内及组间研究变量的变化和差异。还将调查研究变量之间的关联。
干预组和对照组养老院的招募工作已于2023年2月完成。个体参与者（即养老院居民和护理人员）的招募正在进行中，基线测量正在连续进行。预计结果将于2024年秋季准备好进行分析。
我们旨在评估使用SmartJournal对养老院口腔护理和口腔健康的影响。这项工作的结果可能为SmartJournal及类似数字工具的进一步开发和实施提供参考，这些工具旨在加强为需要护理的人群提供的医疗服务。最后，SmartJournal可能有潜力作为护士和其他医疗保健专业人员教育项目中的学习工具。
ClinicalTrials.gov NCT05724043；https://clinicaltrials.gov/study/NCT05724043。
国际注册报告识别码（IRRID）：DERR1-10.2196/46926。
