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- Hägglund, Patricia, et al.
(författare)
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Study protocol for the SOFIA project : Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial
- 2017
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Extensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia). Methods/Design: This project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality. Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT < 10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups. Discussion: The results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people.
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| 2. |
- Andersson, Maria, 1969-, et al.
(författare)
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Good in Providing Oral Care, but we Could be Better-Nursing Staff Identification of Improvement Areas in Oral Care
- 2021
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Ingår i: Sage Open Nursing. - : Sage Publications. - 2377-9608. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Oral care to older people in short-term care units is a complex and challenging everyday practice for nursing staff. Oral care research and knowledge about prerequisites and obstacles is extensive. However, there is a lack of knowledge about how nursing staff in short-term care units describe their satisfaction about provided oral care in order to maintain older people's oral health. Objective: The purpose of this study was to describe how nursing staff perceive their satisfaction of oral care provided for older people in short-term care units and to identify oral care improvements. Methods: This study reports on the results of two open-ended questions that were part of a larger study. Informants (n = 54) were nursing staff working in the involved short-term care units in municipalities from both densely and sparsely populated regions in central and northern Sweden. The answers to the open-ended questions were analyzed using content analysis. Results: The analysis yielded one main category; "Working together to improve satisfaction with older people's oral care" and four subcategories: "Older people's oral health," " Consideration and respect for the older person's autonomy," "Having access to adequate products," and "Working together in the same direction." Conclusion: Identification of older people's oral health problems together with adequate nursing intervention will increase older people's health outcomes and quality of life. However, regardless of work role, the nursing staff might have difficulty changing their behavior or transforming intentions into actions. Oral care is a complicated and proactive practice that requires nursing staff's attention as well as both educational and organizational initiatives. Working in a supportive and collaborative relationship provides prerequisites for optimal oral care in short-term care units.
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| 4. |
- Andersson, Maria, 1969-, et al.
(författare)
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Intensive care nurses fail to translate knowledge and skills into practice : A mixed-methods study on perceptions of oral care
- 2019
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 52, s. 51-60
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To identify intensive care nurses’ perceptions of oral care according to Coker et al.'s (2013) conceptual framework and to contribute to the knowledge base of oral care in intensive care. Design/methods: This was a concurrent embedded mixed-methods design, with more weight given to the quantitative part. Participants responded to the Nursing Care related to Oral Health questionnaire, including perceptions of oral care antecedents (18 items), defining attributes (17 items), and consequences (6 items) and two open-ended questions. The data were analysed with descriptive and correlation statistics and qualitative content analysis. Setting: Intensive care nurses (n = 88) in six general intensive care units. Results: Intensive care nurses perceived that an important part of nursing care was oral care, especially to intubated patients. They perceived that the nursing staff was competent in oral care skills and had access to different kinds of equipment and supplies to provide oral care. The oral cavity was inspected on a daily basis, mostly without the use of any assessment instruments. Oral care seemed to be task-oriented, and documentation of the patients’ experiences of the oral care process was rare. Conclusions: The antecedents, knowledge and skills are available to provide quality oral care, but intensive care nurses seem to have difficulties translating these components into practice. Thus they might have to shift their task-oriented approach towards oral care to a more person-centred approach in order to be able to meet patients’ needs. © 2018 Elsevier Ltd
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| 5. |
- Andersson, Maria, 1969-, et al.
(författare)
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Oral care : identifying quality improvement areas
- 2019
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Ingår i: International Journal of Health Care Quality Assurance. - : Emerald Group Publishing Limited. - 0952-6862 .- 1758-6542. ; 32:1, s. 45-58
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe and compare nurses' and healthcare assistants' oral care qualityperceptions, including perceived reality and subjective importance, to identify improvementareas in intensive care and short-term care, and to explore potential nursing satisfactionpredictors regarding oral care.Design/methodology/approach: Swedish staff, 154 within intensive care and 278 withinshort-term care responded to a modified Quality of Care from a Patient Perspectivequestionnaire. Descriptive and analytical statistics were used.Findings: Staff scored oral care quality both high and low in relation to perceived reality andsubjective importance. Improvement areas were identified, despite high satisfaction valuesregarding oral care. Setting, subjective importance, and perceived reality explained 51.5% ofthe variance in staff satisfaction regarding oral care quality.Practical implications: Quality improvements could guide oral care development.Originality/value: This study describes oral care by comparing nurse perceptions of howimportant they perceive different oral care aspects and to what extent these oral care aspectsare performed.
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| 6. |
- Andersson, Maria, 1969-, et al.
(författare)
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Oral care quality - do humanity aspects matter? : Nursing staff and older people's perspectives
- 2020
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 7:3, s. 857-868
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Tidskriftsartikel (refereegranskat)abstract
- Aim (a) To describe and compare perceptions of humanity aspects of oral care quality in relation to nursing staff in short-term care units and intensive care units and older people in short-term care units and their person-related conditions; and (b) to compare humanity aspects of oral care quality perceptions between nursing staff and older people in short-term care units. Design Cross-sectional study. Self-reported questionnaire and clinical assessments. Methods Nursing staff (N = 417) and older people (N = 74) completed the modified Quality of Care from a Patient Perspective instrument and person-related items. Older people's oral health status was clinically assessed using the Revised Oral Assessment Guide. Data were analysed using descriptive and analytic statistics. The data were collected from 2013-2016. Results Nursing staff's perceptions of humanity aspects of oral care quality were related to gender, work role and care environment. Older people's perceptions of humanity aspects of oral care quality were related to self-reported physical health. Nursing staff in short-term care units perceived the subjective importance of humanity aspects of oral care quality higher compared with older people in short-term care units.
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| 7. |
- Andersson, Maria, 1969-
(författare)
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Oral care quality in intensive care units and short-term care units : Nursing staff and older people's perspectives
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to investigate oral care and its quality through the perspectives of nursing staff in intensive care units and short-term care units and from the perspectives of older people in short-term care units. Methods: The mix-method study (I) had a concurrent embedded design and was cross-sectional. Eighty-eight intensive care nurses (response rate (RR) 40%) responded to the Nursing Care related to Oral Health questionnaire, and the data were analysed with analytic statistics and qualitative content analysis. The quantitative studies (II-IV), which were also cross-sectional, included 432 nursing staff in intensive care and short-term care (RR 51–52%) and 391 older people (RR 77%) in short-term care units. Participants responded to the modified version of the Quality from Patients’ Perspective instrument and provided information about person-related conditions. Descriptive and analytical statistics were used. Main results: Intensive care nurses perceived having the antecedents, knowledge, and skills to provide optimal oral care quality, but the result indicated that they were having difficulties putting these into practice (I). Areas for improvement in oral care quality were identified in both care environments (II). Older people preferred personalised information about oral health and oral care (III). Nursing staff as well as older people’s perceptions of oral care quality and its humanity aspects, seemed to be related to person-related conditions and differed between the two care environments. In short-term care, nursing staff’s preferences for the humanity aspects of oral care quality were higher compared to older people’s preferences (IV). Conclusion: Oral care is complicated and proactive and requires registered nurses’ and other nursing staff’s attention as well as educational and organisational initiatives. Many older people were assessed to have oral health problems. With early identification and optimal oral care, unnecessary suffering might be prevented. The identified quality improvement areas might guide RNs, nurse managers, and other nursing staff to further oral care quality development.
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