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- Lindén, Ingela Grönbäck, et al.
(author)
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Evaluation of the Oral Hygiene Ability Instrument (OHAI): Test of reliability
- 2024
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In: INTERNATIONAL JOURNAL OF DENTAL HYGIENE. - : Wiley-Blackwell Publishing Ltd. - 1601-5029 .- 1601-5037.
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Journal article (peer-reviewed)abstract
- Objectives: To evaluate the reliability of the new Oral Hygiene Ability Instrument (OHAI) developed to assess the cause of any inability for older adults to manage oral hygiene self-care. Oral hygiene is an important part of oral health. The inability to manage oral hygiene, combined with other risk factors, often results in poor oral health and impaired quality of life. A reliable OHAI could benefit preventive oral health care. Methods: The preliminary OHAI uses 33 items in three parts: (I) interview, (II) clinical examination and (III) observation of oral hygiene activities. A total of 37 older adults participated in a test-retest study of Part I. Inclusion criteria were age >= 65 years, have at least one tooth and be able to oral hygiene self-care. The intra- and inter-rater reliability of parts II and III used films and photographs of OHAI assessments of 15 different individuals. These films/photographs were assessed twice by four dental professionals who had participated in the OHAI data collection. For statistical analyses of the reliability, per cent agreement, Krippendorff's alpha and E. Svensson's method were used. Results: The test-retest for Part I items showed acceptable-to-good agreement and no systematic disagreement. In Part II, two items showed somewhat limited reliability. Part III showed good intra- and inter-rater reliability. Conclusion: The OHAI items seem stable and reliable for the intended sample, and the instrument may be a valuable tool to identify older adults at risk of impaired oral health. However, two items may need to be reformulated.
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| 2. |
- Lindén, Ingela Grönbäck
(author)
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The Oral Hygiene Ability Instrument-OHAI Development and evaluation of an instrument measuring the cause of poor oral hygiene self-care in older adults
- 2023
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Doctoral thesis (other academic/artistic)abstract
- Oral hygiene is an important preventive measure to maintain good oral health in the growing group of older adults. Oral hygiene often deteriorates with age, but the causes of this at the individual level are rarely investigated. One reason of several may be that a multifactorial assessment instrument is missing. The aim of this thesis was therefore to develop and evaluate an instrument to assess the cause of any inability for older adults to manage daily oral care. The qualitative Study I aimed to identify factors that affect older adults’ ability to manage oral hygiene. Focus group interviews (n = 4) were conducted with dental hygienists, occupational therapists, assistant nurses, and older adults. Data were analysed using content analysis. The results were formulated into the core category “Oral hygiene is a complex activity” that is influenced by psycho-logical, functional, and environmental factors. Inclusion criteria for Studies II-IV were: 1) age ≥ 65 years, 2) at least one natural tooth or osseointegrated implant, and 3) ability to manage oral hygiene independently. Study II describes the development process of the Oral Hygiene Ability Instrument (OHAI), which comprised three phases: planning, construction, and evaluation. The construction phase was based largely on the results of Study I. The evaluation phase resulted in the reduction of OHAI from 47 to 33 items. OHAI came to consist of three parts: Part I – interview, Part II – clinical examination, and Part III – observation of the oral hygiene activity. Based on the results of Parts I-III, the rater (a dental staff member) conducts a summary assessment of the impact of ten factors (cognitive function, frailty, motivation, vision, fine motor skills, coordination knowledge of oral hygiene, spatial ability, oral clearance, and balance) on the individual’s oral hygiene ability. Study III concerned the reliability of OHAI. Part I (interview) was tested for test–retest reliability on 37 older adults. Parts II and III were tested for intra-/interrater reliability. Four dental professionals assessed 15 films and intraoral photos of older adults undergoing OHAI assessment. Parts I and III were found to have acceptable-to-good test-retest and intra-/interrater reliability, respectively; however, five items in Part II displayed limited reliability. In Study IV, the OHAI was tested for criterion and construct validity in a stroke group (n = 50), a group with cognitive impairment (n = 49), and a group of general dental patients (n = 50). Criterion validity was analysed, with sensitivity/ specificity showing acceptable-to-good agreement. To test for construct validity, known-group validity analysis, factor analysis, and Rasch analysis were used. In general, OHAI demonstrated good criterion and construct validity. However, Study IV, like Study III, showed potential for improvement for some items, which meant that some minor changes were implemented in the OHAI to obtain a more robust and easier-to-use instrument. In conclusion, oral hygiene was found to be a complex activity that needs to be supported in different ways depending on the cause of the lack of ability. The development of the OHAI means that there now is a valid and reliable instrument for the assessment of the cause of an older adult’s inability to manage oral hygiene.
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| 3. |
- Persson, Jessica, et al.
(author)
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Aspects of Expansive Learning in the Context of Healthy Ageing—A Formative Intervention between Dental Care and Municipal Healthcare
- 2022
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:3
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Journal article (peer-reviewed)abstract
- There are great risks of diseases in the ageing population, and oral diseases are no exception. Poor oral health has profound negative impacts on the quality of life. It is therefore crucial to include the oral health perspective in the care for older adults. To meet the challenges associated with oral health in the ageing population, a formative intervention was launched. The intervention, called the TAIK project (=“Dental hygienist in a municipality organization”, in Swedish: Tandhygienist i kommunal verksamhet), meant that six dental hygienists served non-clinically as oral health consultants in five Swedish municipal organizations. The intervention formed an infrastructure and platform for work that benefits the ageing population and created a new basis for decisions regarding oral health in homecare. The aim of this paper is to explore how aspects of collaboration in an interprofessional and interorganizational intervention may lead to expansive learning. Expansive learning forms the theoretical framework of this study. The dental hygienists and the local head nurses were interviewed individually in-depth. Reflection documents from the dental hygienists were also part of the analyzed data. The conclusion is that the formative intervention was reliant of change which created a foundation for reciprocal understanding that led to expansive learning between dental care and municipal healthcare, with resilience and empowerment as crucial factors. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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