Inter-rater reliability of the Oral Assessment Guide for oral cancer patients between nurses and dental hygienists: the difficulties in objectively assessing oral health
Inter-rater reliability of the Oral Assessment Guide for oral cancer patients between nurses and dental hygienists: the difficulties in objectively assessing oral health
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DOI：
10.1007/s00520-018-4412-x
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发表时间：
2019-05-01
影响因子：
3.1
通讯作者：
Ota, Yoshihide
中科院分区：
文献类型：
--
作者：
Aoki, Takayuki;Kudo, Miyuki;Ota, Yoshihide
目的围手术期口腔护理是预防和减少术后并发症的有效措施。然而，口腔癌患者的口腔健康状况往往很差。在住院期间，口腔癌患者经常接受病房护士的口腔护理以及牙科医生的专业口腔护理。保持良好的口腔卫生，在这些病人理想的需要之间的合作，护士和牙科医生。因此，需要用于共享有关患者口腔健康状况的信息的通信工具。其中一个工具是口语评估指南（OAG）。然而，评价者之间的可靠性的OAG没有一贯的报告，因此，我们研究了这之间的护士和dental prophenists.MethodsParticipants包括76例住院治疗口腔癌。手术后，一名护士和一名牙科医生使用OAG进行口腔评估。进行比较统计分析，以检查护士和牙科医生的分数的差异和sweetenists.ResultsAlthough几乎所有的患者的口腔健康状况都很差，没有得到最差的分数在粘膜或牙龈类。此外，舌头，唾液，粘膜，牙龈，和牙齿/假牙类别的系数较低，表明差的护士，牙科医师间的可靠性。相反，语音和吞咽的系数和一致率较高。牙科医生的分数显着较高的舌头，牙龈，牙齿/假牙类别比nursscores.ConclusionsThis研究显示，低护士牙科医生评分间的可靠性OAG和突出的困难，客观地评估患者的症状和口腔健康状况。因此，评估不应仅依赖于临床医生对症状的客观评估，还应包括患者对症状的主观报告。在开发出新的评估工具之前，可能会使用OAG。可能需要进行客观评估培训和/或编写用户手册，以提高OAG的可靠性。目前一年一课的培训是不够的，应努力改进，以获得更可靠的结果。
PurposePerioperative oral care is effective for the prevention and reduction of complications following surgery. However, oral cancer patients' oral health is often poor. During hospitalization, oral cancer patients frequently receive oral care from ward nurses as well as professional oral care from dental hygienists. Maintenance of good oral hygiene in these patients ideally requires cooperation between nurses and dental hygienists. Consequently, communication tools used to share information about the status of patients' oral health are needed. One such tool is the Oral Assessment Guide (OAG). However, the inter-rater reliability of the OAG has not been consistently reported; therefore, we examined this between nurses and dental hygienists.MethodsParticipants comprised 76 patients hospitalized for oral cancer treatment. After surgery, a nurse and a dental hygienist performed oral assessments using the OAG. Comparative statistical analyses were conducted to examine differences and consistencies in the scores of nurses and dental hygienists.ResultsAlthough almost all patients' oral health status was poor, none were given the worst score in the mucous membrane or gingiva categories. Further, the tongue, saliva, mucous membrane, gingiva, and teeth/denture categories had low coefficients, indicating poor nurse-dental hygienist inter-rater reliability. In contrast, the coefficients and agreement rates for voice and swallowing were high. Dental hygienists' scores were significantly higher for the tongue, gingiva, and teeth/denture categories than were nurses' scores.ConclusionsThis study showed low nurse-dental hygienist inter-rater reliability for the OAG and highlighted the difficulties in objectively assessing patients' symptoms and oral health conditions. Therefore, rather than only relying on an objective assessment of symptoms by a clinician, assessments should also include patients' subjective reporting of symptoms. OAG will likely be used until a new assessment tool is developed. Objective assessment training and/or user manual development may be required to improve the reliability of OAG. The present training of one lesson a year is insufficient, and efforts should be made to improve this to get more reliable outcomes.