With the ageing of the French population, the number of elderly people loosing their autonomy is increasing, leading to a growing need for care in residential establishments for dependent elderly people . For multiple reasons, the oral and dental health of the elderly is often when they're admitted to a nursing home (financiary issues, loss of mobility, cognitive impairement, etc.). It can continue to deteriorate after admission du to communication difficulties between care team and dentists. As these various constraints can limit the monitoring and management of the consequences of oral senescence, it is easy to understand the oral health deterioration in nursing home residents.
This worsening in oral health is all the more worrying because residents rarely express the need for care, until emergency. This lack of complaints calls for even greater vigilance. While general hygiene care is well carried out, the majority of nursing staff are uncomfortable with oral hygiene care, which sometimes end up neglected or insufficient. Among the reasons that could explain this lack of care, nursing homes staff often speak of a reluctance to carry them out, a lack of knowledge, or even a fear of investing in this oral sphere.
The purpose of this study is to demonstrate that nursing staff (nurse, orderlies, medical-psychological assistants and hospital service agents) oral health formation will help the development of knowledge and skills, and will improve the quality of life related to oral health of dependant people, while decreasing nursing staff anxiety levels in regards to dental care.
To this end, before and 6 months after training in oral hygiene care for carers, the quality of life in relation to the oral health of residents will be assessed using the GOHAI questionnaire. Caregivers' anxiety levels will be assessed using the STAI-Y questionnaire. At the end of the training, two caregivers will be designated as oral health referents in each nursing home and a support unit will be set up. Supporting documents to help make the decision to call the dentist and care protocols left on site will complete this system.
Are aged 65 or over.
Are present in the facility.
Are mentally independent (MMS score ≥ 20 assessed within the last 12 months).
Consent participating the study, or who have obtained consent from a legal tutor where applicable.
Those who are unable to understand or respond to the questionnaire.
Those who are not affiliated with a social insurance.
Those receiving palliative cares.
Those who refuse oral hygiene cares.
Single group
Caregivers training in oral health in nursing homes
Other interventionTraining for healthcare workers on oral hygiene and health in nursing homes will be organised around two modules. Modules will aim to improve/update the specific knowledge and skills required to provide oral care to dependent residents in order to reduce the level of anxiety that may be associated with it. To ensure that all caregivers have acquired the training content, an assessment will be carried out at the end of each module in the form of a quiz. At the end of this training course, a decision tree on 'Should I call the dentist?', summary sheets of the training course and protocol sheets will be made available in the various nursing homes to help maintain the knowledge acquired during the training and guide caregivers in organizing the care pathway.
Changes in the oral health-related quality of life of nursing home residents.
Measurement of oral health-related quality of life score, defined using the Geriatric Oral Health Assessment Index (GOHAI) before (D0) and 6 months after caregiver training (M6). In order to assess the link between this differential and the initial GOHAI score observed in the patient before the intervention, a linear regression model of the 'change-score model' type will be constructed after centring the variables.
Healthcare professionals' anxiety levels changes
Comparison of anxiety levels among healthcare professionals as defined by the State-Trait Anxiety Inventory (Stai-Y) just before (D7) and 6 months after caregiver training (M6)
Alignment between training, training tools and the needs of caregivers.
Assessment of training's suitability for healthcare professionals' needs immediately after training, using a self-administered questionnaire designed to assess the quality of the training's organisation and teaching methods, the level of satisfaction in terms of expectations, and the practical applicability of the training.
Changes in oral health care pathways for nursing home residents.
Oral healthcare pathways for nursing home residents will be defined based on oral healthcare referral and organisation procedures before (D0) and 6 months after caregiver's training (M6). The use of healthcare professionals involved in residents' oral care will be assessed through various referrals to healthcare facilities for oral care over the last 6 months (dentist, doctor, hospital or resident's refusal) and the organisation of the care pathway (resident, family, caregiver). These elements will be identified by interviewing residents and/or reviewing medical records.
Association between residents' quality of life related to oral health and caregivers' anxiety levels.
Relationship between quality of life in relation to oral health and the level of anxiety among caregivers will be approached by studying the correlation between the average differences between GOHAI and STAI-Y scores.
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Nantes University Hospital
Lead sponsor
University Hospital, Tours
Collaborator
University of New Orleans
Collaborator
Centre Hospitalier Jacques Cœur - Bourges
Collaborator
