Factors associated with nurses’ challenges in providing oral care at Oulu University Hospital, Finland
DOI:
https://doi.org/10.2340/aos.v84.44806Keywords:
Challenges in oral care, infection-sensitive patients, self-efficacy, oral health, university hospitalAbstract
Objective: To investigate factors associated with nurses’ challenges in providing oral care to infection- sensitive patients.
Material and methods: A total of 114 nurses from four internal medicine wards and one oncology ward participated in the study. Data were collected using a questionnaire containing six items about challenges in providing oral care to patients. A multivariate linear regression model was used to analyze the association between explanatory variables and challenges in oral care.
Results: Practical nurses reported more challenges in evaluating patients’ oral problems compared to registered nurses (B = 1.8, p ≤ 0.01). Nurses reporting fairly good or poor oral health reported more challenges in managing resisting patients than those who reported good oral health (B = 1.1, p < 0.05). Higher self- efficacy in Practical skills was associated with fewer challenges related to having a lack of knowledge about cleaning a patient’s mouth (B= −0.9, p ≤ 0.01) and evaluating patients’ oral problems (B = −0.5, p ≤ 0.01). Higher self-efficacy in Confidence to detect oral problems was associated with fewer challenges in managing resisting patients (B= −0.6, p ≤ 0.01) and evaluating patients’ oral problems (B = −0.5, p ≤ 0.001).
Conclusions: Nursing education, self-perceived oral health, and self-efficacy were associated with perceived challenges.
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References
Hanne K, Ingelise T, Linda C, Ulrich PP. Oral status and the need for oral health care among patients hospitalised with acute medical conditions. J Clin Nurs. 2012 Oct;21(19-20):2851-9. Epub 2012 Aug 21. PMID: 22905928. https://doi.org/10.1111/j.1365-2702.2012.04197.x DOI: https://doi.org/10.1111/j.1365-2702.2012.04197.x
Nicolae FM, Bennardo F, Barone S, Șurlin P, Gheorghe DN, Burtea D, et al. The need for oral hygiene care and periodontal status among hospitalized gastric cancer patients. J Pers Med. 2022;12(5):684. https://doi.org/10.3390/jpm12050684 DOI: https://doi.org/10.3390/jpm12050684
Weiss S, Tinsky N, Oren L, Chodick G, Spierer S, Yarom N, et al. Effect of prolonged hospitalization on the maintenance of oral health: a self-report survey. Int J Dent Hyg. 2024;22(4):870–7. https://doi.org/10.1111/idh.12804 DOI: https://doi.org/10.1111/idh.12804
Terezakis E, Needleman I, Kumar N, Moles D, Agudo E. The impact of hospitalization on oral health: a systematic review. J Clin Periodontol. 2011;38(7):628–36. https://doi.org/10.1111/j.1600-051X.2011.01727.x DOI: https://doi.org/10.1111/j.1600-051X.2011.01727.x
Pompei R, Ingianni A, Cagetti MG, Rizzo A, Cotti S. Evaluation of the opportunistic microbial flora and of some antimicrobial factors in the oral cavity of leukaemic patients. Microbios. 1993;75(304):149–57.
McMahon S, Sahasrabhojane P, Kim J, Franklin S, Chang CC, Jenq RR, et al. Contribution of the oral and gastrointestinal microbiomes to bloodstream infections in leukemia patients. Microbiol Spectr. 2023;11(3):1–14. https://doi.org/10.1128/spectrum.00415-23 DOI: https://doi.org/10.1128/spectrum.00415-23
Rathbun KP, Bourgault AM, Sole ML. Oral microbes in hospital-acquired pneumonia: practice and research implications. Crit Care Nurse. 2022;42(3):47–54. https://doi.org/10.4037/ccn2022672 DOI: https://doi.org/10.4037/ccn2022672
Hirschfeld J, Kawai T. Oral inflammation and bacteremia: implications for chronic and acute systemic diseases involving major organs. Cardiovasc Hematol Disord Drug Targets. 2015;15(1):70–84. https://doi.org/10.2174/1871529x15666150108115241 DOI: https://doi.org/10.2174/1871529X15666150108115241
Santibañez-Bedolla KE, Orozco-Uriarte MJ, Alvarez-Canales JA, Macias AE, Amador-Medina LF. Oral colonization by gram-negative bacilli in patients with hematologic malignancies and solid tumors compared with healthy controls. BMC Oral Health. 2023;23(1):465. https://doi.org/10.1186/s12903-023-03172-y DOI: https://doi.org/10.1186/s12903-023-03172-y
Manger D, Walshaw M, Fitzgerald R, Doughty J, Wanyonyi KL, White S, et al. Evidence summary: the relationship between oral health and pulmonary disease. Br Dent J. 2017;222(7):527–33. https://doi.org/10.1038/sj.bdj.2017.315 DOI: https://doi.org/10.1038/sj.bdj.2017.315
Ehrenzeller S, Klompas M. Association between daily toothbrushing and hospital-acquired pneumonia: a systematic review and meta-analysis. JAMA Intern Med. 2024;184(2):131–42. https://doi.org/10.1001/jamainternmed.2023.6638 DOI: https://doi.org/10.1001/jamainternmed.2023.6638
Kubo A, Sakai K, Ueki S, Fujita K. Effect of perioperative oral care on postoperative infections in patients with cancer: a systematic review and meta-analysis. Jpn J Nurs Sci. 2024;21(3):e12600. https://doi.org/10.1111/jjns.12600 DOI: https://doi.org/10.1111/jjns.12600
Dagnew ZA, Abraham IA, Beraki GG, Tesfamariam EH, Mittler S, Tesfamichael YZ. Nurses attitude towards oral care and their practicing level for hospitalized patients in Orotta National Referral Hospital, Asmara-Eritrea: a cross-sectional study. BMC Nurs. 2020;19:63. https://doi.org/10.1186/s12912-020-00457-3 DOI: https://doi.org/10.1186/s12912-020-00457-3
Ab Malik N, Mohamad Yatim S, Hussein N, Mohamad H, McGrath C. Oral hygiene practices and knowledge among stroke-care nurses: a multicentre cross-sectional study. J Clin Nurs. 2018;27(9–10):1913–9. https://doi.org/10.1111/jocn.14241 DOI: https://doi.org/10.1111/jocn.14241
Kuramoto C, Watanabe Y, Tonogi M, Hirata S, Sugihara N, Ishii T, et al. Factor analysis on oral health care for acute hospitalized patients in Japan. Geriatr Gerontol Int. 2011;11(4):460–6. https://doi.org/10.1111/j.1447-0594.2011.00709.x DOI: https://doi.org/10.1111/j.1447-0594.2011.00709.x
Pai RR, Ongole R, Banerjee S. Oral care in cancer nursing: practice and barriers. Indian J Dent Res. 2019;30(2):226–30. https://doi.org/10.4103/ijdr.IJDR_343_17 DOI: https://doi.org/10.4103/ijdr.IJDR_343_17
Koike T, Ohta R, Matsuda Y, Sano C, Kanno T. Oral care awareness and factors related to the burden of nurses at a community hospital in Japan. Healthcare (Basel). 2022;10(6):1073. https://doi.org/10.3390/healthcare10061073 DOI: https://doi.org/10.3390/healthcare10061073
Li X, Yao L, Yang X, Huang M, Zhang B, Yu T, et al. Perceptions, barriers, and challenges of oral care among nursing assistants in the intensive care unit: a qualitative study. BMC Oral Health. 2024;24(1):235. https://doi.org/10.1186/s12903-024-03979-3 DOI: https://doi.org/10.1186/s12903-024-03979-3
Chan EY, Hui-Ling Ng I. Oral care practices among critical care nurses in Singapore: a questionnaire survey. Appl Nurs Res. 2012;25(3):197–204. https://doi.org/10.1016/j.apnr.2010.12.002 DOI: https://doi.org/10.1016/j.apnr.2010.12.002
Tehan PE, Browne K, Matterson G, Cheng AC, Dawson S, Graves N, et al. Oral care practices and hospital-acquired pneumonia prevention: a national survey of Australian nurses. Infect Dis Health. 2024;29(4):212–7. https://doi.org/10.1016/j.idh.2024.04.006 DOI: https://doi.org/10.1016/j.idh.2024.04.006
Zimmerman S, Sloane PD, Cohen LW, Barrick AL. Changing the culture of mouth care: mouth care without a battle. Gerontologist. 2014;54 Suppl 1:S25–34. https://doi.org/10.1093/geront/gnt145 DOI: https://doi.org/10.1093/geront/gnt145
Kivilahti RM, Ahomäki-Hietala T, Vähänikkilä H, Aro T, Anttonen V, Laitala ML, et al. Factors associated with nurses’ self-efficacy in oral care at Oulu University Hospital, Finland. Acta Odontol Scand. 2024;83:616–21. https://doi.org/10.2340/aos.v83.42220 DOI: https://doi.org/10.2340/aos.v83.42220
Aro T, Laitala M-L, Vähänikkilä H, Kyngäs H, Tiisanoja A, Syrjälä A-M. Developing an instrument to measure self-efficacy, challenges and knowledge in oral care among geriatric home care nurses – a pilot study. Int J Environ Res Public Health. 2021;18:10019. https://doi.org/10.3390/ijerph181910019 DOI: https://doi.org/10.3390/ijerph181910019
Jablonski RA, Kolanowski AM, Azuero A, Winstead V, Jones-Townsend C, Geisinger ML. Randomised clinical trial: efficacy of strategies to provide oral hygiene activities to nursing home residents with dementia who resist mouth care. Gerodontology. 2018;35(4):365–75. https://doi.org/10.1111/ger.12357 DOI: https://doi.org/10.1111/ger.12357
Oulu University of Applied Sciences (OAMK) (2023–2024). Degree Programme in Nursing and Healthcare, Option of Nursing (210 cr) [Internet]. [cited 2024 Oct 30]. Available from: https://opetussuunnitelmat.oamk.fi/68096/fi/68089/68131/1160
Metropolia University of Applied Sciences. Nursing Curricula autumn 2021 [Internet]. 2021 [cited 2024 Oct 30]. Available from: https://opinto-opas.metropolia.fi/en/88095/en/70320/SXO21S2/year/2021https://opetussuunnitelmat.oamk.fi/68096/fi/68089/68131/1160
Ashkenazi M, Yaish Y, Yitzhak M, Sarnat H, Rakocz M. The relationship between nurses’ oral hygiene and the mouth care of their patients. Special Care Dentist. 2012;33(6):280–5. DOI: https://doi.org/10.1111/j.1754-4505.2012.00306.x
Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215. https://doi.org/10.1037//0033-295x.84.2.191 DOI: https://doi.org/10.1037//0033-295X.84.2.191
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Acta Odontologica Scandinavica publishes original research papers as well as critical reviews relevant to the diagnosis, epidemiology, health service, prevention, aetiology, pathogenesis, pathology, physiology, microbiology, development and treatment of diseases affecting tissues of the oral cavity and associated structures including papers on cause and effect or explanatory/associative relationships for experimental or observational studies.
