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Park and Choi-Kwon: The Effects of Oral Care Education on Caregivers’ Knowledge, Attitude, & Behavior toward Oral Hygiene for Elderly Residents in a Nursing Home
Original Article

J Korean Acad Nurs 2011;41(5):684-693.

Published online: 12 October 2011

DOI: https://doi.org/10.4040/jkan.2011.41.5.684

The Effects of Oral Care Education on Caregivers’ Knowledge, Attitude, & Behavior toward Oral Hygiene for Elderly Residents in a Nursing Home

Myung Sook Park1, Smi Choi-Kwon2

1Assistant professor, Department of Nursing Science, Sun Moon University, Asan, Korea

2Professor, College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Korea

Address reprint requests to : Choi-Kwon, Smi College of Nursing, Research Institute of Nursing Science, Seoul National University, 28 Yoengun-dong Jongro-gu, Seoul 110-744, Korea Tel: +82-2-740-8830 Fax: +82-2-745-8017 E-mail: smi@snu.ac.kr

Received 1 February 2011       Revised 17 February 2011       Accepted 24 October 2011

Copyright © 2011 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the effects of oral care education on knowledge, attitudes & behavior of caregivers in oral care and oral hygiene for residents in nursing homes.

Methods

In this quasi-experimental study, the intervention group (n=27) of residents received oral care from intervention group caregivers (n=28) who had received 6 weeks of oral care education. The control group (n=27) of residents received usual oral care from control group caregivers (n=26). Data on knowledge, attitude, and behavioral change in oral health care by the caregivers and plaque index & halitosis of the residents were collected. Data were analyzed using SPSS WIN 16.0.

Results

1) Scores on caregivers’ knowledge (p<.001) and behavior (p<.001) for oral care were higher in the intervention group 6 and 12 weeks. The caregivers’ attitude (p<.001) score for oral care was higher in the intervention group 12 weeks. 2) The plaque index (p=.004) and halitosis (p=.002) of the nursing home residents were lower in the intervention group than the control group at 6 and 12 weeks.

Conclusion

Oral care education programs for caregivers are effective in improving the oral hygiene of elderly residents in nursing homes through enhancement of caregiv-ers’ knowledge, attitude, and behavioral change.

Keywords: Oral hygiene, Nursing homes, Aged, Education, Caregivers

References

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Table 1.
Oral Health Care Education Program for Caregivers in this Study
Oral Care Education Programme for Caregivers
Week Purpose Contents Time Methods
1st To increase knowledge and to recognize the importance of oral care • The importance of oral care 30 min Lecture using slides & oral care education material
• Normal tooth & oral cavity
• Oral diseases
• Oral health problems with aging Influence of oral diseases on systemic health
• Influence of oral diseases on systemic health • Prevention of decay & gingivitis
• Prevention of decay & gingivitis
• Strategies for residents who have behavioral problems
2nd To improve knowledge & skills in oral care • Oral health assessment 60 min Lecture 20 min Practice 40 min
• Effective oral care for natural teeth & denture
• Oral care in the case of full dependence using teeth manikin & oral hygiene materials
3rd To increase skill & self confidence in effective tooth brushing • Practice in tooth brushing 10 min Individual hands-on training
4th To confirm the practice of denture care • Practice in denture cleansing & storage 10 min Individual hands-on training
5th To increase skill & self confidence in handling cognitive impaired residents • Practice in handling residents who have behavioral problem 10 min Individual hands-on training
6th To increase ability in handling oral hygiene materials • Practice in dental flossing & interdental brushing 10 min Individual hands-on training
Table 2.
Homogeneity Test of General Characteristics of Caregivers
Characteristics Intervention group (n=28)
 Control group (n=26)
 χ2 or t p
n (%)
Gender
  F 28 (100) 25 (96.2) 1.10 .481*
  M 0 1 (3.8)
Education level (yr)
  7-12 23 (82.1) 16 (61.6) 1.88 .171
  >12 5 (17.9) 10 (38.5)
Type of occupation
  Nurse or nurse aid 3 (10.7) 4 (15.4) 0.26 .699*
  Care aid 25 (89.3) 22 (84.6)
Employment condition
  Permanent position 3 (10.7) 4 (15.4) 0.26 .699*
  Contract worker 25 (89.3) 22 (84.6)
Job satisfaction
  High 11 (39.3) 13 (50.0) 0.63 .584
  Moderate 17 (60.7) 13 (50.0)
The experience of
  oral care education 12 (42.9) 16 (61.5) 0.09 .775
  Yes 16 (57.1) 10 (38.5)
  No
M±SD M±SD
Age (yr) 50.19±5.04 48.92±6.72 -0.77 .446
Experience in LTC (months) 20.81±19.58 37.92±58.15 1.45 .154

SD=Standard deviation; LTC=Long-term care facility; *Fisher’s exact test.

Table 3.
Homogeneity Test of General Characteristics of Nursing Home Residents
Characteristics Intervention group (n=27)
 Control group (n=27)
 χ2 or t p
n (%)
Gender
  M 10 (37.0) 16 (59.3) 2.67 .173
  F 17 (63.0) 11 (40.7)
Education (yr)
  0-6 23 (85.2) 19 (70.4) 1.17 .327*
  >7 4 (14.8) 8 (29.6)
Underlying disease
  Dementia 15 (55.5) 10 (37.0) 0.30 .285
  CVD 10 (37.0) 15 (55.5) 1.86 .275
  PD 5 (18.5) 0 5.51 .051*
  DM 11 (40.7) 8 (29.6) 0.73 .569
  Musculoskeletal disease 5 (18.5) 5 (18.5) 0.00 1.0
The ability in oral care
  Independent 7 (25.9) 13 (48.2) 3.09 .091
  Dependent 20 (74.1) 14 (51.8)
M±SD M±SD
Age (yr) 78.71±5.44 79.18±6.69 0.31 .757
No. of medication drugs 5.30±3.51 5.87±3.51 0.62 .537
No. of drugs related to dry mouth 2.01±1.70 2.03±1.62 0.08 .935
Dry mouth 1.10±0.81 0.74±0.83 -1.54 .130
ADLs 47.73±30.32 64.41±35.32 1.58 .070
MMSE-KC 13.40±6.23 16.01±4.43 1.77 .083
Number of teeth 17.73±7.70 14.87±8.42 -1.25 .216

*Fisher’s exact test.

SD=Standard deviation; CVD=Cerebrovascular disease; PD=Parkinson’s disease; DM=Diabetes mellitus; ADLs=Activities of daily living; MMSE-KC= Mini-mental state examination in the Korean version of CERAD assessment packet.

Table 4.
Knowledge, Attitude & Behavior Score for Oral Health Care in Caregivers
Time Intervention group (n=28)
 Control group (n=26)
 t p Source F p
M±SD
Knowledge Baseline 26.64±3.42 27.85±4.15 1.17 .249 Group 8.62 .005
6 weeks 32.96±4.27 28.81±3.69 -3.81 <.001 Time 40.75 <.001
12 weeks 33.61±3.76 28.96±3.38 -4.76 <.001 Group*Time 13.92 <.001
Attitude Baseline 41.79±3.52 43.30±2.21 2.00 .051 Group 0.17 .682
6 weeks 42.89±3.36 43.76±2.93 1.02 .313 Time 5.70 .004
12 weeks 46.07±3.85 42.85±2.61 -3.18 .002 Group*Time 10.44 <.001
Behavior 6 weeks 7.25±2.96 0.81±0.69 -10.80 <.001 Group 564.46 <.001
12 weeks 15.79±2.41 1.08±0.80 -29.65 <.001 Time 188.66 <.001
Group*Time 166.29 <.001

SD=Standard deviation.

Table 5.
Plaque Index & Halitosis of Nursing Home Residents
Time Intervention group (n=27)
 Control group (n=27)
 t p Source F p
M±SD
Plaque index Baseline 47.9 (22.6) 44.0 (26.4) -0.55 .568 Group 2.17 .147
6 weeks 34.7 (18.8) 43.9 (26.6) 1.48 .145 Time 3.49 .038
12 weeks 30.6 (19.2) 48.8 (25.6) 2.96 .005 Group*Time 6.09 .004
Halitosis Baseline 1.23 (1.17) 1.01 (1.05) -0.71 .481 Group 2.38 .129
6 weeks 0.64 (1.02) 1.04 (1.37) 1.21 .233 Time 5.37 .006
12 weeks 0.19 (0.52) 1.07 (1.05) 3.92 <.001 Group*Time 6.64 .002

SD=Standard deviation.

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