• Oral Care and Dementia: The Nursing Aide Role

      Zens-Holtgrewe, Therese Angela; Fried, Jacquelyn L. (2011)
      Despite the nursing profession's charge to deliver basic oral hygiene services to residents of long term care (LTC) facilities, it appears that nursing aides are not performing acceptable oral care for their patients. Investigations addressing the motivation of nursing home staff have found that the main reasons nursing aides are not providing adequate oral hygiene care include lack of time, insufficient knowledge, lack of staff, inconsistent regulations and protocols, and uncooperative patients. The current study investigates the knowledge of and attitudes toward oral care and managing resistive behaviors reported by nursing aides employed at a LTC facility devoted to the care of residents with dementia in rural Maryland. The study design included volunteer subjects, an educational intervention and pre- and post-test measures generated from a self-administered questionnaire. Analyses utilized t-tests and ANOVA. The results of data analysis showed a significant improvement (p ≤ .05) in oral care knowledge, a statistically significant improvement (p ≤ .05) in attitude toward oral care, and a statistically significant improvement (p ≤ .05) in attitude toward managing resistance to oral care. These results indicate that an oral care intervention can improve the oral care knowledge, attitudes, and attitudes toward managing dementia patients who display resistance to oral hygiene services provided by nursing aides at a LTC facility in Maryland. Given the relationship between oral and systemic health, the nursing staff's role in providing comprehensive dental hygiene care to the residents of long term care facilities is critical.
    • Women, Infants, and Children (WIC) Certifiers' Knowledge and Attitudes regarding the Prevention of Early Childhood Caries

      Washko, Brittany Diane; Fried, Jacquelyn L. (2013)
      Purpose: WIC health curricula provide minimal information on oral health yet early childhood caries (ECC) and tooth decay constitute the most common chronic childhood disease. WIC clinic certifiers deliver health information to their clients. This study explored if an educational intervention could influence the knowledge and attitudes of WIC clinic certifiers regarding the prevention of ECC. Factors limiting their ability and willingness to educate clients about ECC and instructional options that could improve their delivery of oral health education also were elicited. Methods: A purposive sample of nine WIC clinic certifiers from the Anne Arundel County, WIC Program, Maryland, participated in this exploratory study. The design included a pre intervention observation, the educational intervention, and a post intervention observation and a follow-up interview. Close-ended checklists captured pre and post intervention data regarding certifiers' knowledge level and attitudes regarding ECC. A PowerPoint educational intervention included content addressing ECC and ways to apply it to client counseling. A semi-structured interview sought WIC educators' insights regarding the educational intervention's benefits and suggestions for improved learning experiences. All measuring instruments were pilot tested and assessed for content validity. Data analysis included summarizations of qualitative narrative data and frequency counts. The study was approved by the Institutional Review Board, University of Maryland, Baltimore. Results: All WIC certifiers increased the scope and depth of the oral health counseling that they provided, as assessed through a comparison of pre and post intervention observation responses. Key barriers to delivering comprehensive oral health education identified were client resistance, a mismatch of client/provider value systems and inadequate appointment time. Conclusion: Following an oral health educational intervention, WIC clinic certifiers augmented and enhanced their delivery of oral health education. A dental hygienist's educational intervention has the potential to improve WIC educators' knowledge and attitudes toward the prevention of ECC. Longitudinal studies using larger and more diverse samples need to be conducted to assess the long term benefits of oral health educational interventions. Broad scale educational interventions may help reduce future childhood oral disease.