Stewart Carrie, Thomas Nicole, Witton Robert, McColl Ewen, Schofield Patricia
Ageing Clinical and Experimental Research Team, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen AB25 2ZD, UK.
School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK.
Geriatrics (Basel). 2025 Mar 5;10(2):35. doi: 10.3390/geriatrics10020035.
: Experiences of dental pain among older people living with dementia, particularly those residing in care homes, have been identified as an under-researched area. There is an urgent need for initiatives, co-developed with experts according to their experience, to address key challenges for oral health improvement among older people living with dementia. This paper reports the findings from a participatory activity which informed the development of an intervention. : Informed by discussions with a prominent PPI representative in the field of caring for persons with dementia and a prior multi-disciplinary stakeholder event, a discussion involving ten caregivers of individuals with dementia was conducted. Caregivers were invited from different regions of the UK, with seven joining an online group discussion and three engaging in one-on-one conversations. Transcripts of the conversations based on three topics of discussion (dental experiences, dental challenges and thoughts on a dental pain risk assessment tool) were analysed using thematic analysis to inform a proposed co-developed model of an intervention which can improve dental care for those living with dementia. : Areas which informed the next phase of discussions and intervention development were access to dental services, lack of alignment between dental care services and health and social care, and low support for carers in how to carry out mouthcare, specific to the type of dementia lived with. Carers felt that preventing, monitoring and managing dental pain should form part of the care package and that it should not be the responsibility of the carer to conduct a dental pain risk assessment. The key recommendation made by carers was the need for a multi-component intervention. This should be flexible according to individual needs and provide education and support to carers to assist with mouthcare, with responsibility for assessing dental pain risk sitting firmly with a nominated professional. : Our findings from this discussion group with carers of persons living with dementia identified which areas of mouthcare responsibility should be part of the unpaid caring role and which should form part of a healthcare professional role. This shaped a final stakeholder event and facilitated the development of a grant proposal (which includes one of the caregivers as a co-investigator) to test a co-developed intervention for the prevention of dental pain in persons living with dementia.
患有痴呆症的老年人，尤其是那些住在养老院的老人的牙齿疼痛经历，已被确定为一个研究不足的领域。迫切需要根据专家经验共同制定相关举措，以应对改善患有痴呆症的老年人口腔健康的关键挑战。本文报告了一项参与性活动的结果，该活动为一项干预措施的制定提供了信息。
在与痴呆症护理领域一位杰出的公众参与（PPI）代表进行讨论以及此前的一次多学科利益相关者活动的基础上，开展了一次由十位痴呆症患者照料者参与的讨论。照料者来自英国不同地区，七人参加了在线小组讨论，三人进行了一对一交谈。基于三个讨论主题（牙齿经历、牙齿挑战以及对牙齿疼痛风险评估工具的看法）的谈话记录采用主题分析法进行分析，以形成一个拟共同开发的干预模型，该模型可改善痴呆症患者的牙齿护理。
为下一阶段的讨论和干预措施制定提供信息的领域包括获得牙科服务、牙科护理服务与健康和社会护理之间缺乏协调，以及针对特定类型痴呆症患者，照料者在如何进行口腔护理方面得到的支持不足。照料者认为，预防、监测和管理牙齿疼痛应成为护理套餐的一部分，并且进行牙齿疼痛风险评估不应是照料者的责任。照料者提出的关键建议是需要采取多方面的干预措施。该措施应根据个人需求灵活调整，并为照料者提供教育和支持以协助进行口腔护理，而评估牙齿疼痛风险的责任应由指定的专业人员承担。
我们在这个与痴呆症患者照料者的讨论小组中的发现，确定了口腔护理责任的哪些领域应成为无偿护理角色的一部分，哪些应成为医疗保健专业人员角色的一部分。这形成了最后一次利益相关者活动，并促成了一份资助提案（其中包括一位照料者作为共同研究者）的制定，以测试一项共同开发的预防痴呆症患者牙齿疼痛的干预措施。
