Effect of an educational program in oral hygiene care for a group of older persons with schizophrenia
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Abstract
Objective: Schizophrenia patients may lack self-care and are at risk of poor oral hygiene. They tend to develop oral diseases due to the secondary effects of medications. This research aimed to evaluate the efficiency of the educational program in oral hygiene care based on the health belief model (HBM) and encouragement from caregivers to improve oral health and oral health behaviors of schizophrenia older persons.
Materials and Methods: The study consisted of 24 schizophrenia out-patients at Srithanya Hospital and their caregivers. Participants were randomly allocated to testing and controlling groups. The test group received the educational program. The control group got instruction at the chairside. Oral health status, behaviors, health beliefs, and patients’ perception of support from caregivers were assessed before and after intervention and at 1-and 4- month follow-ups and compared. The oral health knowledge of caregivers was also assessed.
Results: There were no statistically significant differences between the test and control groups in oral health status, behaviors, health beliefs, the patients’ perception of support, and oral health knowledge of caregivers at baseline (p ≤0.05). After the intervention, all mentioned variable scores of the test group improved significantly and were better than the control group (p ≤0.05). There were an 83.3% improvement in social support scores in the test group and 56.9% in the control group. The knowledge scores of caregivers in the test group were significantly higher than the control group (p ≤0.05).
Conclusion: This educational program based on the HBM was effective in reducing plaque scores, increasing perception of oral diseases, and leading to better oral health behaviors while the caregivers also paid more attention to the patients’ oral health.
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References
Jablensky A. Epidemiology of schizophrenia: the global burden of disease and disability. Eur Arch Psychiatry Clin Neurosci 2000; 250: 274-85.
Department of mental health. Annual report 2019. Bangkok: Lamom Co.; 2019.
Seeman MV. An outcome measure in schizophrenia: mortality. Can J Psych 2007; 55: 55-60.
Torales J, Barrios I, González I. Oral and dental health issues in people with mental disorders. Medwave 2017; 17: e7045.
Janardhanan T, Cohen CI, Kim S, Rizvi BF. Dental care and associated factors among older adults with schizophrenia. J Am Dent Assoc 2011; 142: 57-65.
Andersson P, Hallberg IR, Lorefált B, Unosson M, Renvert S. Oral health problems in elderly rehabilitation patients. Int J Dent Hyg 2004; 2: 70-7.
Tsai C, Hayes C, Taylor GW. Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population. Community Dent Oral Epidemiol 2002; 30: 182-92.
Geismar K, Stoltze K, Sigurd M, Gyntelberg F, Holmstrup P. Periodontal disease and coronary heart disease. J Periodontol 2006; 77: 1547-54.
Nielsen J, Munk-Jørgensen P, Skadhede S, Correll CU. Determinants of poor dental care in patients with schizophrenia: a historical, prospective database study. J Clin Psychiatr 2011; 72: 140-3.
McCreadie RG, Stevens H, Henderson J, Hall D, McCaul R, Filik R, et al. The dental health of people with schizophrenia. Acta Psychiatr Scand 2004; 110: 306-10.
Poole R, Smith D, Simpson S. Patients’ perspectives of the feasibility, acceptability and impact of a group-based psychoeducation programme for bipolar disorder: a qualitative analysis. BMC Psychiatry 2015; 15: 184.
Dhanarun T. Multimedia design for learning diabetes with old age patients. Veridian e-Journal Silapakorn University 2013; 6: 1-15.
Goodkind RJ, Loupe MJ, Clay DJ, DiAngelis AJ. Modifying the knowledge, skills and habits of denture patients. Gerodontics 1988; 4: 95-100.
Rueanphoo S, Sinavarat P, Rattanasuwan K, Muangpaisan W, Jitramontree N, Rojanavipart P, Pisalsarakij D. Effects of using oral hygiene care pamphlets for housebound older persons. M Dent J 2021; 41: 35-48.
Clark DB. Dental care for the patient with schizophrenia. Can J Dent Hygiene 2008; 42: 17-24.
Wongsanao S, Sumpowthong K. Oral health care promotion program in pregnant women by application of the health belief model and the encouragement from their husbands to prevent gingivitis. J Med Health Sci 2015; 22: 34-40.
Bridle C, Riemsma RP, Pattenden J, Sowden AJ, Mather L, Watt IS, et al. Systematic review of the effectiveness of health behavior interventions based on the transtheoretical model. Psychol Health 2005; 20: 283-301.
Janz NK, Becker MH. The Health Belief Model: a decade later. Health Educ Q 1984; 11: 1-47.
Chitten M, Vemulakonda S, Byrapaneni RB. Using behavior change theory to guide health promotion to prevent noncommunicable diseases in India. In: Chopra HK, editor. Cardiological Society of India: Cardiology Update. 2014. 1st ed. New Delhi: Jaypee, 2015: p. 201-4.
Becker MH. The health belief model and sick role behavior. Health Educ Monogr 1974; 2: 409-19.
Rosenstock IM. The health belief model and preventive health behavior. Health Educ Monogr 1974; 2: 354-86.
House JS. Social support and social structure. Sociological Forum 1987; 2: 135-46.
Almomani F, William K, Catley D, Brown C. Effects of an oral health promotion program in people with mental illness. J Dent Res 2009; 88: 648-52.
World Health Organization. International statistical classification of diseases and related health problems, 10th revision. 5th ed. France: WHO; 2016.
Collin C, Wade DT, Davis S, Horne V. The Barthel ADL Index: a reliability study. Int Disabil Studies 1988; 10: 61-3.
Anderson J, Larsen JK, Korner A, Nielsen BM, Schultz V, Behnke K, et al. The brief psychiatric rating scale: schizophrenia, reliability and validity studies. Nordisk Psykiatrisk Tidsskrift 1986; 40: 135-8.
Muangpaisan W, Assantachai P, Sitthichai K, Richardson K, Brayne C. The distribution of Thai Mental State Examination scores among non-demented elderly in suburban Bangkok metropolitan and associated factors. J Med Assoc Thai 2015; 98: 916-24.
Petersen PE, Baez RJ, editors. Oral health surveys: basic methods. 5th ed. France: WHO; 2013.
Osailan SM, Pramanik R, Shirlaw P, Proctor GB, Challacombe SJ. Clinical assessment of oral dryness: development of a scoring system related to salivary flow and mucosal wetness. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114: 597-603.
Löe H. The Gingival Index, the Plaque Index and the Retention Index Systems. J Periodontol 1967; 38: 610-6.
O'Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol 1972; 43: 38.
Augsburger RH, Elahi JM. Evaluation of seven proprietary denture cleansers. J Prosthet Dent 1982; 47: 356-9.
Keyong E, Thitasomakul S, Tianviwat S. Effectiveness of an oral health promotion program for the elderly in Khiri Mat district, Sukhothai province: A randomized control trial. J Int Soc Prev Community Dent 2019; 9: 225-31.
Dental Health Bureau. The 8th National oral health survey report,2017. Bangkok: Samcharoen-panit Co.; 2018.
Wey MC, Loh S, Doss JG, Abu Bakar AK, Kisely S. The oral health of people with schizophrenia: A neglected public health burden. Aust N Z J Psychiatry 2016; 50: 685-94.
Barker T. Role of health beliefs in patient compliance with preventive dental advice. Community Dent Oral Epidemiol 1994; 22: 327-30.
Boyer EM, Nikias MK. Self-reported compliance with a preventive dental regimen. Clin Prev Dent 1983; 5: 3-7.
Davies KW, Whittle JG. Dental health education: training of homecarers of mentally handicapped adults. Community Dent Health 1990; 7: 193-7.
Kaewmongkol S. A randomized, controlled study of dental care intervention in schizophrenia patients. J Ment Health Thai 2015; 23: 102-11.