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Factors That Affect Oral Care Outcomes for Institutionalized Elderly.

ABSTRACT: The aim of this study was to evaluate the effect of an oral care intervention program on the incidence of pneumonia and fever as a surrogate endpoint. In addition, we tried to determine the oral care risk factors for the incidence of fever. We provided an oral care program for the elderly at one private nursing home in July 2013. The maximum capacity of the nursing home was 60 residents. The body temperatures of all residents were measured twice a day and were summarized as the incidence of fever over a one-month period, which was used as the dependent variable. The residents' life conditions, number of teeth, and prescribed diet were used as independent variables. The factors that affected the incidence of fever were the number of remaining teeth, a prescribed diet of sliced food, the meal care level, and the oral Candida levels. These risk factors affected the incidence of fever independently or interactively with oral care. Some risk factors for the incidence of fever were enhanced by the oral care program. It is important to evaluate and control these factors before the implementation of an oral care program.

SUBMITTER: Nomura Y

PROVIDER: S-EPMC6311881 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Factors That Affect Oral Care Outcomes for Institutionalized Elderly.

Nomura Yoshiaki Y Takei Noriko N Ishii Takanori T Takada Koji K Amitani Yasuharu Y Koganezawa Hitomi H Fukuhara Shizuko S Asai Keita K Uozumi Ryuji R Bessho Kazuhisa K

International journal of dentistry 20181210

The aim of this study was to evaluate the effect of an oral care intervention program on the incidence of pneumonia and fever as a surrogate endpoint. In addition, we tried to determine the oral care risk factors for the incidence of fever. We provided an oral care program for the elderly at one private nursing home in July 2013. The maximum capacity of the nursing home was 60 residents. The body temperatures of all residents were measured twice a day and were summarized as the incidence of feve ...[more]

PMID: 30651730

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Project description:The oral health of an ageing population, especially that of the institutionalized elderly population, constitutes a significant concern because it is closely linked to general health and the quality of life. Shared common risk factors drive the development and worsening of poor oral health and non-communicable diseases, which eventually lead to self-care inability. Several studies have reported on the poor oral health of the institutionalized elderly population. However, few comprehensive reports exist regarding the relationship between poor oral health, the oral health-related quality of life (OHRQoL) and the associated factors in this specific population. Objective: The objective is to describe recently reported oral health levels, the OHRQoL and the associated factors among older institutional residents. Methods: Studies published between July 2009 and June 2019 in MEDLINE, EMBASE and CINAHL were searched. The population, intervention, comparison and outcome (PICO) strategy was used as a guide. The reported factors related to poor oral health were identified (i.e., age, gender, educational level, acquired systemic conditions or dementia/cognitive impairment). Results: Twenty-five surveys (or study series) from 19 countries were included. The level of evidence reported by these studies was generally moderate to strong. The reported oral cleanliness and health of the surveyed institutionalized elderly were poor (>50% of residents had calculus; denture hygiene index > 80%). Gum (approximately 30% of dentate residents had moderate to severe periodontitis), teeth (decayed, missing or filled teeth >20), mucosa (>10% had mucosal lesions) and denture problems (up to 40%) were prevalent and were associated with a poor OHRQoL, especially in females, socially deprived residents or those with mild or above cognitive impairment. Those with a poor OHRQoL might show signs of poor nutrition. Conclusions: This report reviewed evidence-based knowledge on oral health, the OHRQoL and the associated factors among elderly institutional residents. Further research is needed to confirm these observations. For improved oral health, a better OHRQoL and the general well-being of older residents, clinical trials are needed, targeting modifiable factors, such as social inequality, oral healthcare accessibility, and/or nursing home service quality. The relationship between oral health, the OHRQoL and nutrition in this at-risk population also warrants exploration.

Project description:The oral health of elderly populations is a significant concern, as it is closely linked to general health and health-related quality of life. Poor oral health exacerbates oral diseases, leading to an increased risk of non-communicable diseases and self-care dependence, particularly in the elderly, worldwide. Knowledge, attitudes, and practices (KAP) play influential roles in individual oral care. However, the evidence of KAP related to oral care among the elderly is still inadequate. This study aimed to examine KAP and their associated factors related to oral care among the elderly community. A cross-sectional descriptive design was used. The eligible subjects were recruited, using convenience sampling and snowball sampling. A total of 385 elderly individuals were included, and 51.4% were women. The mean age was 71.66 (SD 6.28). Knowledge was reportedly poor, as more than 50% elderly answered several questions incorrectly. The mean attitude and practices scores were 44.94 (SD 6.33) and 68.90 (SD 10.44), respectively. There was a significant correlation among knowledge, attitudes, and practices (p < 0.001). Multivariable regression analysis revealed numerous factors had remarkably significant association with knowledge [R2 = 0.30, F (4,380) = 11.96, p < 0.001], attitudes [R2 = 0.28, F (6,378) = 9.27, p < 0.001], and practices [R2 = 0.31, F (5,379) = 12.34, p < 0.001], particularly education levels, full-time employment, and self-care independence. Based on the KAP theoretical model, KAP are closely interrelated. Identified factors associated with KAP are useful to understand at-risk groups. Elderly individuals at lower education levels, with poor family support and inadequate self-care independence, have poor KAP related to oral care. Therefore, this study improves insight for health promotion developers, suggesting that more attention should be paid to at-risk elderly groups' oral health. To enhance participation in dental care and improve oral care performance in the elderly, educational program containing oral health knowledge should be offered to at-risk groups. Family support and involvement are also important for improving oral care among elderly individuals.

Dataset Information

Factors That Affect Oral Care Outcomes for Institutionalized Elderly.

Publications

Factors That Affect Oral Care Outcomes for Institutionalized Elderly.

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