Model Development of Oral Health Care for Homebound or Bedridden Elderly at Nakhonchaisi District, Nakhon Pathom

Abstract

This action research aimed to develop an oral health care model for homebound or bedridden elderly in the community and evaluate the model's implementation results through integrated collaboration among network partners. This participatory action research approach involved planning, action, observation, and reflection. Samples consisted of 33 families of homebound or bedridden elderly and their caregivers in Nakhonchaisi and Bangkrabao subdistricts. Data collection tools included oral health behavior questionnaires, oral health screening forms and a plaque level scale (Simplified Oral Hygiene Index and Winkel Tongue Coating index). Qualitative data were analyzed using content analysis, while quantitative data were analyzed using descriptive statistics and paired t-test (p=0.05).

The results revealed that the developed model had five steps: 1) learning the community context, searching homebound or bedridden elderly; 2) planning the implementation in collaboration with multidisciplinary teams from the hospital and local network partners; 3) conducting oral health education activities for volunteers and caregivers, visit homes to examine oral health, empower, provide advice and train practical skills for the elderly and caregivers, arrange channels for coordination and referrals, and local organizations provide budget support; 4) observe, follow up, and evaluate the performance; and 5) Summarize the results of the work and provide feedback to improve the operation. The evaluation results of the model found that the oral health care behavior of the homebound or bedridden elderly, having an average level of more correct and appropriate behavior, from 2.32±0.96 to 3.57±1.02 (p<0.001). The average dental plaque and tongue coating level decreased from 1.85±0.98 to 0.16±0.27 (p<0.001) and 1.80±0.39 to 0.33±0.47 (p<0.001) respectively.