Developing an Instrument to Measure Self-Efficacy, Challenges and Knowledge in Oral Care among Geriatric Home Care Nurses—A Pilot Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population and Collection of Data
2.2. Questionnaire
2.2.1. Background Factors of the Participants
2.2.2. Self-Efficacy Beliefs (10 Items)
2.2.3. Nurses’ Challenges in Oral Health-Related Practices among Older People (7 Items)
2.2.4. Oral Health-Related Knowledge (9 Items)
2.3. Structured Intervention Event to Support Nurses in Oral Health Care
2.4. Psychological Models
2.5. Statistical Methods
2.6. Qualitative Analysis
2.7. Ethical Consideration
3. Results
3.1. Self-Efficacy
3.2. Challenges
3.3. Oral Health-Related Knowledge
3.4. Qualitative Analysis of the Participants’ Comments
3.4.1. Knowledge
3.4.2. Skills
3.4.3. Resource Challenges
3.4.4. Solutions
3.4.5. Older People’s Self-Determination and Self-Empowerment
3.4.6. Habits of Older People
4. Discussion
Implications
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Time | Content | Details |
---|---|---|
5 min | Introduction | Welcome, the aim of the day, presentation of the participants |
15 min | Filling in the questionnaire | |
30–45 min | Lecture with Power Point -presentation | Basic oral problems of older people, demonstration with a model for how to clean older people’s teeth and removable dentures. |
20 min | Coffee break | |
45–60 min | Hands-on training in pairs and interactive discussion | Two of the authors demonstrated cleaning of the mouth and oral mucosa, toothbrushing, dental flossing and the use of interdental brushes. |
15 min | Filling in the questionnaire | |
Reflection on the session | Comments and opinions of the participants |
Variable | n | % | |
---|---|---|---|
Age (years) | 20–29 | 3 | 16.7 |
30–39 | 1 | 5.6 | |
40–49 | 3 | 16.7 | |
50–59 | 10 | 55.6 | |
≥60 | 1 | 5.6 | |
Basic education | Secondary level (high/vocational school) | 14 | 77.8 |
Tertiary level | 3 | 16.7 | |
No answer | 1 | 5.6 | |
Nursing education | Assistant nurse | 9 | 50.0 |
Registered general nurse | 5 | 27.8 | |
Assistant without degree in nursing | 2 | 11.1 | |
No answer | 2 | 11.1 | |
Time since graduation (years) | <5 | 2 | 11.1 |
5–9 | 3 | 16.7 | |
10–14 | 2 | 11.1 | |
>14 | 11 | 61.1 | |
Working experience in geriatric home care (years) | <5 | 2 | 11.1 |
5–9 | 3 | 16.7 | |
10–14 | 2 | 11.1 | |
>14 | 11 | 61.1 |
Proposition: I Am Confident that I… | Before Mean (SD) | After Mean (SD) |
---|---|---|
…know how to brush older people’s teeth | 6.6 (1.7) | 8.2 (2.2) |
…know how to clean older people’s removable dentures | 7.5 (1.5) | 8.9 (1.3) |
…am able to notice dry mouth of older people | 6.4 (1.6) | 8.1 (1.4) |
…am able to notice cavities in older people’s teeth | 4.1 (1.9) | 6.2 (2.3) |
…am able to notice older people’s inflamed gums | 5.4 (1.6) | 7.6 (1.7) |
…am able to notice mucosal inflammation related to older people’s use of removable dentures | 4.5 (1.6) | 7.2 (1.7) |
…brush older people’s teeth, unless I’m pressed for time | 5.0 (2.4) | 5.4 (3.1) |
…clean older people’s mouth even if co-operation with them is problematic | 4.3 (2.1) | 4.6 (2.4) |
…look at older people’s mouth every day | 3.4 (2.4) | 3.8 (3.0) |
…make an appointment with a dentist if there is a problem in older people’s mouth | 8.1 (2.6) | 8.9 (1.6) |
Proposition: The Oral Care of Older People Is Challenging Because… | Before Mean (SD) | After Mean (SD) |
---|---|---|
…I haven’t got time enough for it | 5.6 (1.8) | 6.1 (3.0) |
…I haven’t got enough knowledge of how to clean older people’s mouths | 5.8 (1.5) | 2.7 (2.7) |
…older people don’t let me look into their mouths | 6.6 (2.2) | 6.1 (1.4) |
…I am disgusted by dirty removable dentures | 2.0 (2.4) | 2.1 (2.4) |
…I am disgusted smelly, dirty mouths | 3.2 (2.8) | 2.9 (2.8) |
…I can’t evaluate what the problem is in older people’s mouths | 6.2 (1.8) | 4.2 (2.2) |
…older people do not have decent oral cleaning instruments such as a toothbrush and toothpaste | 5.3 (3.2) | 6.1 (2.3) |
Proposition: The Oral Care of Older People Is Challenging Because… | Completely Disagree (%) | Disagree (%) | No Idea (%) | Agree (%) | Completely Agree (%) | |
---|---|---|---|---|---|---|
I have received enough information about the factors that affect oral health | before | 11.1 | 33.3 | 27.8 | 27.8 | 0 |
after | 0 | 0 | 0 | 22.2 | 77.8 | |
Oral health has an impact on general health | before | 0 | 0 | 0 | 5.6 | 94.4 |
after | 0 | 0 | 0 | 0 | 100 | |
It’s not normal that gums bleed while brushing teeth | before | 0 | 0 | 5.6 | 16.7 | 77.8 |
after | 0 | 0 | 5.6 | 11.1 | 83.3 | |
Bad breath depends on the bacteria in the mouth | before | 0 | 16.7 | 0 | 61.1 | 22.2 |
after | 0 | 0 | 0 | 16.7 | 83.3 | |
Poor dental hygiene increases the risk of pneumonia | before | 0 | 0 | 5.6 | 50.0 | 44.4 |
after | 0 | 0 | 0 | 0 | 100 | |
Gingivitis depends on the bacteria in the mouth | before | 0 | 5.6 | 5.6 | 61.1 | 27.8 |
after | 0 | 0 | 0 | 5.6 | 94.4 | |
Repeated usage of sugar increases the risk of dental caries | before | 0 | 5.6 | 0 | 11.1 | 83.3 |
after | 0 | 0 | 0 | 0 | 100 | |
Long-lasting inflammation in the mouth can increase the risk of memory disorder | before | 0 | 0 | 56.6 | 16.7 | 27.8 |
after | 0 | 0 | 0 | 16.7 | 83.3 | |
Tooth loss is not normal when aging | before | 0 | 5.6 | 11.1 | 50.0 | 33.3 |
after | 5.6 | 11.1 | 0 | 16.7 | 63.1 |
Knowledge | Skills | Resource Challenges | Solutions | Older Peoples’ Self-Determination and Self-Empowerment | Habits of Older People |
---|---|---|---|---|---|
Appearance of oral cancer | Plaque removal from removable dentures | Lower education level in countryside | Education increased nurses’ awareness | Older people want to take care of themselves | Not used to using services |
Cleaning removable dentures | Removing removable dentures from mouth | Less money for services | Regular oral health examination for older people | Living at home and self-determination | Not used to oral health care |
First aid when dentures cause pressure | First aid when removable dentures cause pressure | Nurses do not have enough time | Oral health care in daily treatment plan | Older people take care of their own mouths | Cleaning of own, old removable dentures |
Dementia and filling a tooth cavity | Easier to clean removable dentures than natural teeth | Nurse cannot do anything when an older person’s mouth is in bad condition | Education to be a necessity | Older people are used to using specific tools for oral hygiene | Older people feel that it is useless to go to a dentist |
Plaque removal from removable dentures | Nurse encourages client to book an appointment with a dentist | ||||
Removing removable dentures from mouth | Practical training in nursing education | ||||
Scarce oral health education in nursing education | |||||
Nurse cannot do anything when an older person’s mouth is in bad condition |
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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
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. International Journal of Environmental Research and Public Health. 2021; 18(19):10019. https://doi.org/10.3390/ijerph181910019
Chicago/Turabian StyleAro, Taru, Marja-Liisa Laitala, Hannu Vähänikkilä, Helvi Kyngäs, Antti Tiisanoja, and Anna-Maija Syrjälä. 2021. "Developing an Instrument to Measure Self-Efficacy, Challenges and Knowledge in Oral Care among Geriatric Home Care Nurses—A Pilot Study" International Journal of Environmental Research and Public Health 18, no. 19: 10019. https://doi.org/10.3390/ijerph181910019