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Original Article
- The Effects of Oral Care Education on Caregivers’ Knowledge, Attitude, & Behavior toward Oral Hygiene for Elderly Residents in a Nursing Home
- Myung Sook Park1, Smi Choi-Kwon2
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Journal of Korean Academy of Nursing 2011;41(5):684-693.
DOI: https://doi.org/10.4040/jkan.2011.41.5.684
Published online: October 12, 2011
1Assistant professor, Department of Nursing Science, Sun Moon University, Asan, Korea
2Professor, College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Korea
1Assistant professor, Department of Nursing Science, Sun Moon University, Asan, Korea
2Professor, College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Korea
- Address reprint requests to : Choi-Kwon, Smi College of Nursing, Research Institute of Nursing Science, Seoul National University, 28 Yoengun-dong Jongro-gu, Seoul 110-744, Korea Tel: +82-2-740-8830 Fax: +82-2-745-8017 E-mail: smi@snu.ac.kr
• Received: February 1, 2011 • Revised: February 17, 2011 • Accepted: October 24, 2011
Copyright © 2011 Korean Society of Nursing Science
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
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Purpose
- To investigate the effects of oral care education on knowledge, attitudes & behavior of caregivers in oral care and oral hygiene for residents in nursing homes.
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Methods
- In this quasi-experimental study, the intervention group (n=27) of residents received oral care from intervention group caregivers (n=28) who had received 6 weeks of oral care education. The control group (n=27) of residents received usual oral care from control group caregivers (n=26). Data on knowledge, attitude, and behavioral change in oral health care by the caregivers and plaque index & halitosis of the residents were collected. Data were analyzed using SPSS WIN 16.0.
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Results
- 1) Scores on caregivers’ knowledge (p<.001) and behavior (p<.001) for oral care were higher in the intervention group 6 and 12 weeks. The caregivers’ attitude (p<.001) score for oral care was higher in the intervention group 12 weeks. 2) The plaque index (p=.004) and halitosis (p=.002) of the nursing home residents were lower in the intervention group than the control group at 6 and 12 weeks.
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Conclusion
- Oral care education programs for caregivers are effective in improving the oral hygiene of elderly residents in nursing homes through enhancement of caregiv-ers’ knowledge, attitude, and behavioral change.
Table 1.Oral Health Care Education Program for Caregivers in this Study
Table 2.Homogeneity Test of General Characteristics of Caregivers
Table 3.Homogeneity Test of General Characteristics of Nursing Home Residents
Table 4.Knowledge, Attitude & Behavior Score for Oral Health Care in Caregivers
Table 5.Plaque Index & Halitosis of Nursing Home Residents
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The Effects of Oral Care Education on Caregivers’ Knowledge, Attitude, & Behavior toward Oral Hygiene for Elderly Residents in a Nursing Home
| Oral Care Education Programme for Caregivers |
||||
|---|---|---|---|---|
| Week | Purpose | Contents | Time | Methods |
| 1st | To increase knowledge and to recognize the importance of oral care | • The importance of oral care | 30 min | Lecture using slides & oral care education material |
| • Normal tooth & oral cavity | ||||
| • Oral diseases | ||||
| • Oral health problems with aging Influence of oral diseases on systemic health | ||||
| • Influence of oral diseases on systemic health • Prevention of decay & gingivitis | ||||
| • Prevention of decay & gingivitis | ||||
| • Strategies for residents who have behavioral problems | ||||
| 2nd | To improve knowledge & skills in oral care | • Oral health assessment | 60 min | Lecture 20 min Practice 40 min |
| • Effective oral care for natural teeth & denture | ||||
| • Oral care in the case of full dependence using teeth manikin & oral hygiene materials | ||||
| 3rd | To increase skill & self confidence in effective tooth brushing | • Practice in tooth brushing | 10 min | Individual hands-on training |
| 4th | To confirm the practice of denture care | • Practice in denture cleansing & storage | 10 min | Individual hands-on training |
| 5th | To increase skill & self confidence in handling cognitive impaired residents | • Practice in handling residents who have behavioral problem | 10 min | Individual hands-on training |
| 6th | To increase ability in handling oral hygiene materials | • Practice in dental flossing & interdental brushing | 10 min | Individual hands-on training |
| Characteristics | Intervention group (n=28) |
Control group (n=26) |
χ2 or t | p |
|---|---|---|---|---|
| n (%) | ||||
| Gender | ||||
| F | 28 (100) | 25 (96.2) | 1.10 | .481* |
| M | 0 | 1 (3.8) | ||
| Education level (yr) | ||||
| 7-12 | 23 (82.1) | 16 (61.6) | 1.88 | .171 |
| >12 | 5 (17.9) | 10 (38.5) | ||
| Type of occupation | ||||
| Nurse or nurse aid | 3 (10.7) | 4 (15.4) | 0.26 | .699* |
| Care aid | 25 (89.3) | 22 (84.6) | ||
| Employment condition | ||||
| Permanent position | 3 (10.7) | 4 (15.4) | 0.26 | .699* |
| Contract worker | 25 (89.3) | 22 (84.6) | ||
| Job satisfaction | ||||
| High | 11 (39.3) | 13 (50.0) | 0.63 | .584 |
| Moderate | 17 (60.7) | 13 (50.0) | ||
| The experience of | ||||
| oral care education | 12 (42.9) | 16 (61.5) | 0.09 | .775 |
| Yes | 16 (57.1) | 10 (38.5) | ||
| No | ||||
| M±SD | M±SD | |||
| Age (yr) | 50.19±5.04 | 48.92±6.72 | -0.77 | .446 |
| Experience in LTC (months) | 20.81±19.58 | 37.92±58.15 | 1.45 | .154 |
| Characteristics | Intervention group (n=27) |
Control group (n=27) |
χ2 or t | p |
|---|---|---|---|---|
| n (%) | ||||
| Gender | ||||
| M | 10 (37.0) | 16 (59.3) | 2.67 | .173 |
| F | 17 (63.0) | 11 (40.7) | ||
| Education (yr) | ||||
| 0-6 | 23 (85.2) | 19 (70.4) | 1.17 | .327* |
| >7 | 4 (14.8) | 8 (29.6) | ||
| Underlying disease | ||||
| Dementia | 15 (55.5) | 10 (37.0) | 0.30 | .285 |
| CVD | 10 (37.0) | 15 (55.5) | 1.86 | .275 |
| PD | 5 (18.5) | 0 | 5.51 | .051* |
| DM | 11 (40.7) | 8 (29.6) | 0.73 | .569 |
| Musculoskeletal disease | 5 (18.5) | 5 (18.5) | 0.00 | 1.0 |
| The ability in oral care | ||||
| Independent | 7 (25.9) | 13 (48.2) | 3.09 | .091 |
| Dependent | 20 (74.1) | 14 (51.8) | ||
| M±SD | M±SD | |||
| Age (yr) | 78.71±5.44 | 79.18±6.69 | 0.31 | .757 |
| No. of medication drugs | 5.30±3.51 | 5.87±3.51 | 0.62 | .537 |
| No. of drugs related to dry mouth | 2.01±1.70 | 2.03±1.62 | 0.08 | .935 |
| Dry mouth | 1.10±0.81 | 0.74±0.83 | -1.54 | .130 |
| ADLs | 47.73±30.32 | 64.41±35.32 | 1.58 | .070 |
| MMSE-KC | 13.40±6.23 | 16.01±4.43 | 1.77 | .083 |
| Number of teeth | 17.73±7.70 | 14.87±8.42 | -1.25 | .216 |
| Time | Intervention group (n=28) |
Control group (n=26) |
t | p | Source | F | p | |
|---|---|---|---|---|---|---|---|---|
| M±SD | ||||||||
| Knowledge | Baseline | 26.64±3.42 | 27.85±4.15 | 1.17 | .249 | Group | 8.62 | .005 |
| 6 weeks | 32.96±4.27 | 28.81±3.69 | -3.81 | <.001 | Time | 40.75 | <.001 | |
| 12 weeks | 33.61±3.76 | 28.96±3.38 | -4.76 | <.001 | Group*Time | 13.92 | <.001 | |
| Attitude | Baseline | 41.79±3.52 | 43.30±2.21 | 2.00 | .051 | Group | 0.17 | .682 |
| 6 weeks | 42.89±3.36 | 43.76±2.93 | 1.02 | .313 | Time | 5.70 | .004 | |
| 12 weeks | 46.07±3.85 | 42.85±2.61 | -3.18 | .002 | Group*Time | 10.44 | <.001 | |
| Behavior | 6 weeks | 7.25±2.96 | 0.81±0.69 | -10.80 | <.001 | Group | 564.46 | <.001 |
| 12 weeks | 15.79±2.41 | 1.08±0.80 | -29.65 | <.001 | Time | 188.66 | <.001 | |
| Group*Time | 166.29 | <.001 | ||||||
| Time | Intervention group (n=27) |
Control group (n=27) |
t | p | Source | F | p | |
|---|---|---|---|---|---|---|---|---|
| M±SD | ||||||||
| Plaque index | Baseline | 47.9 (22.6) | 44.0 (26.4) | -0.55 | .568 | Group | 2.17 | .147 |
| 6 weeks | 34.7 (18.8) | 43.9 (26.6) | 1.48 | .145 | Time | 3.49 | .038 | |
| 12 weeks | 30.6 (19.2) | 48.8 (25.6) | 2.96 | .005 | Group*Time | 6.09 | .004 | |
| Halitosis | Baseline | 1.23 (1.17) | 1.01 (1.05) | -0.71 | .481 | Group | 2.38 | .129 |
| 6 weeks | 0.64 (1.02) | 1.04 (1.37) | 1.21 | .233 | Time | 5.37 | .006 | |
| 12 weeks | 0.19 (0.52) | 1.07 (1.05) | 3.92 | <.001 | Group*Time | 6.64 | .002 | |
Table 1. Oral Health Care Education Program for Caregivers in this Study
Table 2. Homogeneity Test of General Characteristics of Caregivers
SD=Standard deviation; LTC=Long-term care facility; *Fisher’s exact test.
Table 3. Homogeneity Test of General Characteristics of Nursing Home Residents
*Fisher’s exact test. SD=Standard deviation; CVD=Cerebrovascular disease; PD=Parkinson’s disease; DM=Diabetes mellitus; ADLs=Activities of daily living; MMSE-KC= Mini-mental state examination in the Korean version of CERAD assessment packet.
Table 4. Knowledge, Attitude & Behavior Score for Oral Health Care in Caregivers
SD=Standard deviation.
Table 5. Plaque Index & Halitosis of Nursing Home Residents
SD=Standard deviation.
