Luc De Visschere1,2, Cees de Baat3,2, Lize De Meyer1, Gert-Jan van der Putten4,5,2, Bart Peeters6, Bjorn Söderfelt7, Jacques Vanobbergen1,2. 1. Community Dentistry and Oral Public Health, Dental School, Ghent University, Ghent, Belgium. 2. BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium, Nijmegen, The Netherlands. 3. Department of Oral Function and Prosthetic Dentistry, Radboud University Nijmegen Medical Centre, The Netherlands. 4. University of Applied Sciences, Utrecht, The Netherlands. 5. The Opbouw Foundation Birkhoven Zorggoed Soesterweg 533, Amersfoort, The Netherlands. 6. Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium. 7. Department of Oral Public Health Faculty of Odontology, Malmö University, Malmo, Sweden.
Abstract
OBJECTIVE: This qualitative study explored barriers and enabling factors to the implementation of an oral hygiene protocol in nursing homes. BACKGROUND: Oral health care in nursing homes in Flanders (Belgium) is inadequate. MATERIALS AND METHODS: Qualitative data were obtained from nurses employed in 13 nursing homes involved in two randomised controlled trials in Flanders-Belgium. Data were collected by focus group and face-to-face interviews during April 2005 and December 2009. All transcripts were analysed with support of NVivo 8 (Version 2008). Transcripts were intuitively analysed in a two-step method. RESULTS: Most revealed barriers were consistent with previous findings in the literature. Newly reported barriers were respect for residents' self-determination, experience based oral health care by nurses, residents' oral health status and nurses' inability to notice residents' oral health status. Demand-driven oral health care was found to be a strong enabling factor. CONCLUSION: The integration of oral health care into day-to-day care seems to be a major problem due to a multitude of barriers. In future implementation innovations in oral health care an a priori assessment of influencing factors is recommended.
OBJECTIVE: This qualitative study explored barriers and enabling factors to the implementation of an oral hygiene protocol in nursing homes. BACKGROUND: Oral health care in nursing homes in Flanders (Belgium) is inadequate. MATERIALS AND METHODS: Qualitative data were obtained from nurses employed in 13 nursing homes involved in two randomised controlled trials in Flanders-Belgium. Data were collected by focus group and face-to-face interviews during April 2005 and December 2009. All transcripts were analysed with support of NVivo 8 (Version 2008). Transcripts were intuitively analysed in a two-step method. RESULTS: Most revealed barriers were consistent with previous findings in the literature. Newly reported barriers were respect for residents' self-determination, experience based oral health care by nurses, residents' oral health status and nurses' inability to notice residents' oral health status. Demand-driven oral health care was found to be a strong enabling factor. CONCLUSION: The integration of oral health care into day-to-day care seems to be a major problem due to a multitude of barriers. In future implementation innovations in oral health care an a priori assessment of influencing factors is recommended.
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