George Ajesh, Lombardo Lien, Ajwani Shilpi, Wynne Rochelle, Sanchez Paula, Kong Ariana, Talluri Bhavya, William Scott, Ferguson Caleb
Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia.
Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia.
J Clin Nurs. 2025 Apr 28. doi: 10.1111/jocn.17795.
To explore the characteristics of oral healthcare education interventions for stroke clinicians and the effectiveness of these interventions in improving the oral health knowledge, attitudes, confidence, and practice among acute stroke clinicians.
Scoping review, guided by Arksey and O'Malley's (2005) framework.
Original full-text studies reporting educational oral healthcare interventions for stroke clinicians, including but not limited to nurses, were eligible for inclusion. Included studies were extracted and appraised using the Joanna Briggs Institute (JBI) Checklist aligned to the study methodology. Narrative synthesis was used to describe heterogeneous findings.
Key electronic bibliographic databases including CINAHL, Cochrane, MEDLINE (Ovid), ProQuest, Pubmed, and Scopus, in addition to grey literature, were searched for studies published between 1st January 2000 and 20th January 2024.
Five studies conducted in acute inpatient settings were included: two randomised controlled trials, two mixed-methods studies, and one quality improvement project. Most (n = 4) studies developed complex interventions that included education and other components (products, referral pathways, assessment tools), and were delivered either face-to-face or as an online program. Most studies reported positive changes in oral health knowledge, attitudes, and confidence. There was limited measurement of the acceptability and feasibility of the interventions, with only one study reporting positive feedback from clinicians. There was no evidence to support changes in clinical practice following any of the included interventions.
Existing evidence indicates interventions for stroke clinicians have some potential for building stroke clinicians' capacity to provide adequate oral healthcare. There is however no evidence linking these interventions to optimised patient outcomes. There is a need for research focused on the implementation and dissemination of tailored oral health educational interventions incorporating clinically meaningful outcomes.
IMPLICATIONS FOR PROFESSION/PATIENT CARE: Existing oral healthcare educational interventions appear to have a positive effect on stroke clinicians' oral health knowledge, confidence, and attitudes. Educational interventions in oral healthcare are perceived to be acceptable and feasible; however, further research is needed to design and test the effect of new interventions.
Integrated oral healthcare is particularly important for stroke survivors who are at greater risk of preventable aspiration pneumonia. This scoping review highlights the characteristics of existing educational programs for stroke clinicians, their effectiveness, and gaps in existing evidence. Review findings substantiate the need for future research to enhance existing oral healthcare interventions, to translate knowledge acquired from training into clinical practice, and to capture appropriate measures of effect.
The PRISMA-ScR Checklist.
This review was registered with the Open Science Framework registry (https://doi.org/10.17605/OSF.IO/4BWVF).
探讨针对中风临床医生的口腔保健教育干预措施的特点，以及这些干预措施在提高急性中风临床医生的口腔健康知识、态度、信心和实践方面的有效性。
循证综述，以阿克西和奥马利（2005年）的框架为指导。
报告针对中风临床医生（包括但不限于护士）的口腔保健教育干预措施的原始全文研究均符合纳入标准。使用与研究方法一致的乔安娜·布里格斯研究所（JBI）清单对纳入的研究进行提取和评估。采用叙述性综合法描述异质性研究结果。
检索了关键电子文献数据库，包括CINAHL、Cochrane、MEDLINE（Ovid）、ProQuest、Pubmed和Scopus，此外还检索了灰色文献，以查找2000年1月1日至2024年1月20日期间发表的研究。
纳入了五项在急性住院环境中进行的研究：两项随机对照试验、两项混合方法研究和一项质量改进项目。大多数（n = 4）研究开发了复杂的干预措施，包括教育和其他组成部分（产品、转诊途径、评估工具），并通过面对面或在线课程的方式提供。大多数研究报告了口腔健康知识、态度和信心方面的积极变化。对干预措施的可接受性和可行性的测量有限，只有一项研究报告了临床医生的积极反馈。没有证据支持任何纳入的干预措施后临床实践有变化。
现有证据表明，针对中风临床医生的干预措施在培养中风临床医生提供充分口腔保健的能力方面有一定潜力。然而，没有证据表明这些干预措施与优化患者结局相关。需要开展侧重于实施和推广纳入具有临床意义结局的量身定制的口腔健康教育干预措施的研究。
对专业/患者护理的启示：现有的口腔保健教育干预措施似乎对中风临床医生的口腔健康知识、信心和态度有积极影响。口腔保健教育干预措施被认为是可接受和可行的；然而，需要进一步研究来设计和测试新干预措施的效果。
综合口腔保健对中风幸存者尤为重要，他们发生可预防的吸入性肺炎的风险更高。本循证综述强调了现有针对中风临床医生教育项目的特点、其有效性以及现有证据中的差距。综述结果证实了未来研究的必要性，以加强现有的口腔保健干预措施，将从培训中获得的知识转化为临床实践，并获取适当的效果衡量指标。
PRISMA-ScR清单。
本综述已在开放科学框架注册中心（https://doi.org/10.17605/OSF.IO/4BWVF）注册。
