Improving oral health in nursing home residents: A cluster randomized trial of a shared oral care intervention.
Improving oral health in nursing home residents: A cluster randomized trial of a shared oral care intervention.
复制标题
改善疗养院居民的口腔健康：一项共享口腔护理干预措施的整群随机试验。
DOI：
10.1111/cdoe.12638
复制
发表时间：
2021
影响因子：
2.3
通讯作者：
Karin Aagaard
中科院分区：
文献类型：
--
作者：
C. Overgaard;H. Bøggild;B. Hede;Maiken Bagger;Line Gøtz Hartmann;Karin Aagaard
目标
比较一组公立疗养院居民的指定共享口腔护理干预与标准口腔护理计划，重点是口腔菌斑和口腔炎症的水平。
方法
在14个丹麦公立疗养院进行了一项随机分组田间试验。干预组145人，对照组98人。我们进行了为期六个月的干预的基础上的原则，情境跨专业学习。主要结果是用粘膜斑块指数（MPS）测量的斑块和炎症水平;在基线、3个月和6个月（干预结束）以及随访（干预后6个月）时进行评估。采用有序回归法估计OR值和95%可信区间。
结果
两组基线时的社会人口学特征和口腔健康状况相当，但年龄除外：干预组明显年轻于对照组（中位数82岁vs 87岁）。三个月和六个月后，接受共享口腔护理干预的人的牙菌斑和炎症明显低于对照组。MPS降低的校正OR分别为11.8（CI：6.5-21.3）和11.0（CI：5.8-20.9）。在随访时，斑块水平和口腔炎症已接近干预前水平，无统计学显著性组间差异。
结论
基于情境学习观点的共享口腔护理干预对改善护理院居民的口腔健康是有效的。然而，干预结束后，效果迅速下降。这证实了实现长期改善疗养院居民口腔健康的挑战。实施战略的重点是实现在组织和个人层面的变化，持续关注口腔保健似乎需要长期改善。
OBJECTIVES
To compare a designated shared oral care intervention in a group of public nursing home residents with a standard oral care programme, focusing on levels of oral plaque and oral inflammation.
METHODS
A cluster randomized field trial was undertaken in 14 Danish public nursing homes. There were 145 participants included in the intervention group and 98 in the control group. We undertook a six-month intervention based on the principle of situated interprofessional learning. The primary outcomes were plaque and inflammation levels measured with the mucosal plaque index (MPS); this was assessed at baseline, after three and six months (end of intervention), and at follow-up (six months postintervention). The odds ratios (OR) and 95% confidence intervals (CI) were estimated with ordinal regression.
RESULTS
Socio-demographic characteristics and oral health status at baseline were comparable between the two groups, with the exception of age: the intervention group were significantly younger than controls (median 82 vs 87 years). After three and six months, those receiving the shared oral care intervention had significantly lower plaque and inflammation than the control group. The adjusted ORs for a reduction in MPS were 11.8 (CI: 6.5-21.3) and 11.0 (CI: 5.8-20.9), respectively. At follow-up, plaque levels and oral inflammation had approached the pre-intervention level, with no remaining statistically significant group differences.
CONCLUSIONS
The shared oral care intervention based on a situated learning perspective was effective in improving oral health among care home residents. However, after termination of the intervention, the effect quickly decreased. This confirms the challenges of achieving long-term improvement in oral health in nursing home residents. An implementation strategy focusing on achieving changes at both organizational and individual levels with persistent attention to oral health care seem required for long-term improvement.