Perceived Oral Care Needs of Terminally Ill Adults – A Qualitative Investigation

Individuals with advance-stage illnesses frequently face illness or treatment-related adverse effects in the mouth. These adverse effects can have serious consequences. Despite that, the importance of oral care in this population is often overlooked and there are no definitive guidelines as to what kind of oral care should be provided to these individuals. Given that, our study aims were to explore and better understand the oral health-related concerns, perceived oral care needs of palliative care patients and the berries that face in accessing dental care services. We conducted a qualitative description study by recruiting a purposive sample of 11 participants with advanced stage health conditions from the outpatient palliative care services of the University of Iowa Hospitals and Clinics. Data were collected using in-depth, semi-structured interviews using an interview guide. All interviews were fully transcribed, with the data managed with Atlas.ti software to facilitate the analysis. All participants had oral concerns although they varied widely from person to person and their illness statuses. The most significant concerns were related to dry mouth, loose dentures, and eating difficulties. Among those who stated that they would seek dental care if required, they were not planning on seeking dental care even though they had treatable oral problems, suggesting a mismatch between their oral health status and their perceived needs. The frequently observed barriers that prevented them from seeking dental care were their illness and illness related priorities, finances, feeling discriminated against by the dentist, and a dislike towards the dentist. Providing information to the palliative care clinicians about the significance of oral health and its impact, incorporating a dental care provider in palliative care team, and providing timely information to individuals with advanced health conditions may enhance the understanding of their oral health problems and help them better manage their oral health and may enhance their dental care seeking behavior

Information and its importance in head and neck cancer care

Head and Neck (H&N) cancers are a diverse group of malignant tumors arising in the mouth, nose, pharynx and larynx. They are the 8th most common cancers in the world. Individuals who receive a diagnosis of these cancers often have enormous unmet informational needs. In spite of a large quantity of literature advocating the necessity to move from "one size fits all" to a tailored approach while providing information to cancer patients, the majority of hospitals provide information in an ad hoc manner. The primary aim of this study was to investigate the impacts of a multimedia based tailored information service on H&N cancer patients' anxiety, depression, satisfaction and cancer knowledge ratings. Our secondary aim was to describe and compare the experiences of H&N cancer patients' receiving information concerning their cancer and treatment at two hospitals with different approaches to deliver information. We used an embedded mixed methods research design within a non-randomized controlled trial within which we nested a qualitative study to address the aforementioned secondary aims. The project was conducted with stage III and IV H&N cancer patients at the participating hospitals. Ethical approval was obtained from the Institutional Review Board and the Research Ethics Boards of the participating hospitals. The test hospital delivered the Multimode Comprehensive Tailored Information Package (MCTIP) and the control hospital received the normal care. A total of 103 individuals with H&N cancer took part in the quantitative study, out of which 96 participants completed baseline and all follow up evaluations. In the qualitative study, a subsample of 11 participants of the main study and 2 Nurse Pivots took part. Quantitative and qualitative data were collected concurrently. Our study findings show that the participants who received the test intervention experienced significantly lower levels of anxiety, had higher levels of cancer knowledge, were better satisfied with the information they received and had a good information provision experience in comparison to the subjects who received the normal care. Therefore, we conclude that MCTIP is a potentially beneficial adjuvant in H&N cancer care.Les cancers de la tête et du cou (T & C), constituent un groupe hétérogène de tumeurs malignes qui se présentent dans la bouche, le nez, le pharynx et le larynx. Ils sont les huitièmes cancers les plus fréquents dans le monde. Les personnes qui reçoivent le diagnostic d'un de ces cancers ont souvent de grands besoins d'information qui ne sont pas comblés. En dépit d'une grande quantité d'écrits prônant la nécessité de passer d'une approche « à solution unique » vers une approche sur mesure tout en fournissant des informations aux patients atteints de cancer, la majorité des hôpitaux fournissent des informations de manière ad hoc. L'objectif principal de cette étude était d'étudier les effets d'un ensemble complet d'information sur mesure multimode (ECIMM) sur l'anxiété, la dépression, la satisfaction à l'égard des soins reçus et la connaissance du cancer chez les patients atteints de cancer T & C. Notre objectif secondaire était de décrire et de comparer les expériences des patients atteints de cancer T & C qui reçoivent des informations sur leur cancer et leur traitement à ceux de deux hôpitaux ayant des approches différentes de diffuser l'information. Nous avons utilisé des méthodes de recherche mixtes intégrées conçues dans un essai non randomisé contrôlé dans lesquelles nous avons imbriqué une étude qualitative pour répondre aux objectifs secondaires mentionnés précédemment. L'ensemble du projet a été mené auprès des patients atteints de cancer T & C de stade III et IV dans les hôpitaux participants. L'étude a reçu l,'approbation éthique du Comité de protection des personnes et des comités d'éthiques locaux des hôpitaux participants. Un total de 103 personnes atteintes de cancer du T & C ont pris part à l'étude quantitative, à laquelle 96 participants ont reçu une évaluation au tout début de l'étude et des évaluations de suivi. Un sous-échantillon de 11 participants de l'étude principale et de 2 infirmières pivots y ont pris part à l'étude qualitative. Les données quantitatives et qualitatives ont été recueillies en même temps. Les résultats de notre étude montrent que les participants qui ont bénéficié de l'intervention ont connu des niveaux significativement inférieurs d'anxiété, des niveaux supérieurs de connaissances sur le cancer, sont davantage satisfaits de l'information qu'ils ont reçue et ont eu une bonne expérience pour ce qui fut de recevoir de l'information, si on les compare aux sujets qui ont reçu les soins normaux. Par conséquent, nous concluons que le ECIMM est un adjuvant potentiellement bénéfique pour les soins contre le cancer T & C

ESR Studies on the Copper(II) Complexes of Phenothiazines

183-18

Interaction of phenothiazines with nitroso-R salt and extractive spectrophotometric determination of phenothiazine drugs

A selective and sensitive method is based on the interaction of phenothiazines with nitroso-R salt to form 1:1 complexes which are extracted into chloroform and measured spectrophotometrically

How accurate is the assessment of certified nursing assistants on resident's oral self‐care function in three North Carolina assisted‐living facilities?

Aims To examine the association between the assessments of certified nursing assistants (CNAs) on resident's oral self‐care function and resident's oral hygiene outcomes in three North Carolina assisted‐living (AL) facilities. Methods and results Sixty‐five dentate AL residents were included in this secondary analysis. CNAs were asked to rate the AL residents’ overall oral self‐care function using a 6‐point Likert scale. Their assessments were then compared with the objective, performance‐based Dental Activities Test and the oral hygiene and gingival health measures. The analysis showed that nearly 90% of the participants presented with at least one untreated decayed or broken tooth. On average, nearly two‐thirds of the surfaces were covered by soft deposits (Debris Index = 1.83, SD = 0.60). Generalized mild to moderate inflammation (Gingival Index = 1.51, SD = 0.53) commonly presented on residents’ gingiva. CNAs were able to accurately identify the residents with substantial impairment in oral self‐care function, yet they tended to overestimate the oral self‐care function of residents with mild to moderate impairment. CNAs assessments were also not significantly correlated with residents’ oral hygiene measures. Conclusion CNAs failed to identify and provide assistance to AL residents with impaired oral self‐care function, contributing to poor oral oral hygiene in these vulnerable individuals

Preventing early childhood caries through oral health promotion and a basic package for oral care: A pragmatic trial

Introduction: Untreated caries in mothers is one of the common risk factors for early childhood caries (ECC). Aim: The aim of the study was to investigate the impact of an oral health promotion program on ECC. Methodology: We conducted a pragmatic trial at 12 primary health centers in a rural community of India with 311 pregnant women using fluoride toothpaste, oral health information through pamphlets, and referral to urgent dental care or atraumatic dental treatment as the test intervention. Data were collected through structured interviews at baseline and oral examination of the children at 2 years of age. Results: Of the 311 women who participated, 274 children were followed up with at 2 years of age. ECC was low and comparable in both groups. When compared with the control group, significantly, more children from the intervention group were breastfed for over 6 months of age (P = 0.012) and consumed less sugar (P < 0.001). The number of mothers' decayed teeth (P = 0.01), children's sweet scores (P < 0.001), and the age at which brushing commenced for children (P = 0.04) increased the likelihood of tooth decay in children. Conclusion: The oral health promotion program had some beneficial effects in preventing caries in children when provided to pregnant women

Information and its impact on co-survivors of cancer patients

1 page(s

Oral Health in Adult Patients Receiving Palliative Care: A Mixed Method Study

Oral disease is highly prevalent in persons receiving palliative care (PRPC). Yet, little is known about how PRPC perceive their oral health status and related treatment needs. This mixed-method study included 49 English-speaking PRPC (age≥18) recruited from the University of Iowa Palliative Care Clinic. Participants first completed a structured review of oral symptoms, followed by an oral exam. A nested sample of 11 participants also completed a semi-structured, in-depth interview querying their perceived oral health concerns and related treatment needs. Quantitative and qualitative data was analyzed and integrated for interpretation. Participants averaged 58.4 years. Nearly 70% had terminal cancer and 25% had advanced organ failure. Eighty-six percent of participants reported at least one oral symptom, including dry mouth (83.7%), a pain-related symptom (40.8%), or oral function difficulties (51.0%). Among the 31 dentate participants, 52% had untreated decayed/broken teeth and 33.3% had oral soft tissue lesions. Ill-fitting dentures and denture sores were common among denture users. About 40% of participants reported compromised health and/or quality of life due to oral conditions; however, the perceived impacts were modest. With the exception of painful conditions, oral treatment was not a priority for most of the participants. Oral disease was highly prevalent in PRPC, yet its overall impact was modest. In the absence of painful symptoms, most participants reported limited desire to seek treatment for oral health conditions. However, given the serious impacts of untreated oral diseases, oral healthcare decision should not be based solely on self-reported symptoms or distress