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Barriers and facilitators for provision of oral health care in dependent older people: a systematic review.
Clinical Oral Investigations ( IF 3.4 ) Pub Date : 2019-02-02 , DOI: 10.1007/s00784-019-02812-4
Gerd Göstemeyer 1 , Sarah R Baker 2 , Falk Schwendicke 1
Affiliation  

OBJECTIVES Provision of oral health care (OHC), including oral hygiene (OH) or oral/dental treatment, to dependent older people (DOP) is frequently insufficient. We aimed to assess barriers and facilitators perceived by different healthcare professionals towards providing OHC to DOP. MATERIALS AND METHODS A systematic review was performed. Studies reporting on knowledge, attitudes, and beliefs acting as barriers and facilitators for provision of OHC were included. One database (PubMed) was searched and data extraction independently performed by two reviewers. Thematic analysis was used and identified themes translated to the domains and constructs of the theoretical domains framework (TDF) and aligned with the domains of the behavior change wheel (BCW). Analyses were stratified for the two target behaviors (providing oral hygiene and providing oral/dental treatment) and according to different stakeholders' perspective. For quantitative analysis, frequency effect sizes (FES) were calculated. RESULTS In total, 1621 articles were identified and 41 (32 quantitative, 7 qualitative, 2 mixed method) studies included. Within these 41 studies, there were 7333 participants (4367 formal caregivers, 67 informal caregivers, 1100 managers of care, 1322 dentists, 340 DOP). Main barriers for providing OH were "lack of knowledge" (FES 65%, COM-B domain: capability, TDF domain: knowledge) and "patients refusing care" (62%, opportunity, environmental context and resources). Main facilitators were "OHC training/education" (41%, capability, skills) and "presence of a dental professional" (21%, opportunity, environmental context and resources). Main barriers for provision of dental treatment were "lack of suitable facilities for treatment/transportation of patients" (76%) and "patients refusing care" (53%) (both: opportunity, environmental context and resources). Main facilitators were "regular visiting dentist" (35%) and "routine assessment/increased awareness by staff" (35%) (both: opportunity, environmental context and resources). CONCLUSIONS A number of barriers and facilitators for providing different aspects of OHC were identified for different stakeholders. CLINICAL RELEVANCE Our findings help provide the evidence to develop implementation strategies for providing high-quality systematic OHC to DOP. REGISTRATION This review was registered at Prospero (CRD42017056078).

中文翻译:

为依赖老年人提供口腔保健的障碍和促进因素:系统评价。

目标 向依赖老年人 (DOP) 提供口腔保健 (OHC),包括口腔卫生 (OH) 或口腔/牙科治疗,通常是不够的。我们旨在评估不同医疗保健专业人员在向 DOP 提供 OHC 方面所认为的障碍和促进因素。材料和方法 进行了系统评价。研究报告了知识、态度和信念成为提供 OHC 的障碍和促进因素。搜索了一个数据库 (PubMed),并由两名评审员独立进行数据提取。使用主题分析并确定主题转化为理论领域框架 (TDF) 的领域和结构,并与行为改变轮 (BCW) 的领域保持一致。分析针对两种目标行为(提供口腔卫生和提供口腔/牙科治疗)并根据不同利益相关者的观点进行分层。对于定量分析,计算了频率效应大小 (FES)。结果 总共确定了 1621 篇文章,包括 41 篇(32 篇定量、7 篇定性、2 种混合方法)研究。在这 41 项研究中,共有 7333 名参与者(4367 名正式护理人员,67 名非正式护理人员,1100 名护理经理,1322 名牙医,340 名 DOP)。提供 OH 的主要障碍是“缺乏知识”(FES 65%,COM-B 领域:能力,TDF 领域:知识)和“患者拒绝护理”(62%,机会、环境背景和资源)。主要促进者是“OHC 培训/教育”(41%,能力、技能)和“
更新日期:2019-02-01
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