An oral hygiene protocol improves oral health for patients in inpatient stroke rehabilitation
An oral hygiene protocol improves oral health for patients in inpatient stroke rehabilitation
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DOI：
10.1111/ger.12309
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发表时间：
2018-03-01
期刊：
影响因子：
2
通讯作者：
Scholten, Ingrid
中科院分区：
文献类型：
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作者：
Murray, Joanne;Scholten, Ingrid
目的确定简单的口腔卫生方案是否可以改善中风康复住院患者的口腔健康。讨论该领域现状的背景数据口腔健康状况不佳可能导致严重的并发症，例如肺炎。与中风相关的合并症，例如吞咽困难、偏瘫和认知障碍，可能会进一步阻碍独立的口腔护理。国际中风指南推荐常规口腔护理，但没有详细说明具体方案。材料和方法口腔健康评估工具 (OHAT) 由言语病理学家对三个大都市住院中风康复机构的 100 名患有或不患有吞咽困难的患者进行了评估。然后对所有参与者实施由护士主导的简单口腔卫生方案，其中包括每天两次刷牙和午餐后漱口，并在一周后再次测量口腔健康状况。结果最初，吞咽困难与 OHAT 评分呈负相关，而口腔卫生独立性与口腔健康呈正相关。经过一周简单的口腔卫生习惯后，89 名参与者的 OHAT 分数表明所有参与者的平均得分有所改善。特别是，59% 的吞咽困难参与者改善了 1 分或更多分。没有一名参与者出现肺炎。 结论 对于住院中风康复机构中患有或不患有吞咽困难的患者来说，简单、廉价的口腔卫生方案都能带来积极的结果。跨学科团队易于实施的口腔健康评估和口腔卫生制度可以纳入标准中风护理中，并产生积极效果。
The objectiveTo determine whether a simple oral hygiene protocol improves the oral health of inpatients in stroke rehabilitation.The background data discussing the present status of the fieldPoor oral health can lead to serious complications, such as pneumonia. The comorbidities associated with stroke, such as dysphagia, hemiparesis and cognitive impairment, can further impede independent oral care. International stroke guidelines recommend routine oral care but stop short of detailing specific regimes.Materials and methodsThe oral health assessment tool (OHAT) was conducted by speech-language pathologists with 100 patients with and without dysphagia in three metropolitan inpatient stroke rehabilitation facilities. A simple nurse-led oral hygiene regime was then implemented with all participants, which included twice daily tooth brushing and mouth rinsing after lunch, and oral health was measured again one week later.ResultsInitially, dysphagia was negatively associated with OHAT scores, and independence for oral hygiene was positively associated with oral health. After one week of a simple oral hygiene regime, the OHAT scores available for 89 participants indicated an improvement on average for all participants. In particular, 59% of participants with dysphagia had an improvement of 1 or more points. None of the participants developed pneumonia.ConclusionA simple, inexpensive oral hygiene regime resulted in positive outcomes for patients with and without dysphagia in inpatient stroke rehabilitation settings. Oral health assessments and oral hygiene regimes that are simple to implement by the interdisciplinary team can be incorporated into standard stroke care with positive effect.