Oral care knowledge, attitude and practice: Caregivers' survey and observation

Abstract

Objectives: This study aims to assess caregivers' knowledge, perception and perceived barriers as well as their daily usual practice concerning oral care provision in a geriatric hospital.

Methods: A semi-structured questionnaire was developed and administered to caregivers in a geriatric ward. Furthermore, oral care delivery to dependent and independent patients was clinically observed.

Results: One hundred and fifty-two caregivers (60% nurses, 40% nursing aids) completed the survey (78% response rate). Clinical oral care was observed in 97 inpatients. Observations revealed that brushing was done in 94% of opportunities in independent patients but in only 55% of dependent patients. This corresponded to the frequency indicated in the questionnaire for independent elders (97%, n.s.), whereas it was significantly different for dependent elders (89%, P < .001). 95% of caregivers stated in the questionnaire never verifying self-administered oral care, whereas 12.3% were actually observed verifying intraorally its efficiency (P = .07 chi-squared test). 71% of the respondents stated storing the prostheses dry, and 8% stated that they reinserted it after cleaning. Caregivers' observation revealed that 35.1% of prostheses were reinserted in the mouth, indicating a significantly higher rate than in the questionnaire (P < .05). Respondents felt that their training to perform oral hygiene measures was suboptimal (VAS 48 ± 34.4). Patients verbally refusing oral care were stated as a barrier by 14% of respondents and were witnessed in 15.6% of observation opportunities (n.s).

Conclusion: Various measures, such as hospital health policy, improved logistics or advanced hands-on training, might help to converge the clinical practice towards the theoretical knowledge.

Keywords: caregivers; dependent elder; geriatric ward; hospitalised patients; oral care; oral hygiene.