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Introducción: La ética profesional permite calificar los actos humanos desde una perspectiva afirmativa o negativa, donde los valores éticos y sociales permiten relacionarse eficazmente en el entorno profesional. Objetivo: Identificar el nivel de satisfacción de los pacientes desde la perspectiva de los valores éticos de la relación odontólogo-paciente de los consultorios "Centro Odontológico Integral" del Dr. Guillermo Méndez y "Design Dental" del Dr. Freddy Santillán, Santo Domingo de los Tsáchilas, Ecuador. Método: Se realizó un estudio descriptivo transversal, mediante la aplicación de una encuesta a 44 pacientes de dichos consultorios donde se analizaron las variables: satisfacción en la relación interpersonal, satisfacción sobre calidad de atención, escala de valoración sobre la atención odontológica y tiempo ideal de espera en consulta, luego de recibir su tratamiento odontológico. Resultados: El 89 % de los encuestados percibió una relación con el odontólogo amigable y favorable. En la satisfacción con la calidad de la atención un 41 % consideró que sí ha creado un vínculo interpersonal con su odontólogo, un 59 % no lo cree así. En cuanto a la evaluación de la atención odontológica el 64 % le otorgó el máximo de 10 puntos. El 25 % de los pacientes concordó en que el tiempo ideal de espera en consulta debía ser de 20 minutos y otro porcentaje, alto, de 48 %, consideró que el ideal fuera de 30 minutos. Conclusiones: Más de la mitad de los pacientes indican que se sienten satisfechos con el tratamiento que les brindó el odontólogo.
Introduction: Professional ethics allows for characterization of the human behavior from an affirmative or negative perspective in which the ethical and social values make possible a more effective relationship among dentists and their professional environment. Objective: To identify the level of satisfaction in patients treated in both dental offices, "Centro Odontológico Integral" manages by Dr. Guillermo Méndez and "Design Dental" manages by Dr. Freddy Santillán, in Santo Domingo de los Tsáchilas, Ecuador. Method: a cross-sectional descriptive study was carried out with the use of a questionnaire to 44 patients of these dental offices; the variables analyzed were as follow: interpersonal relationship satisfaction, patient satisfaction with quality of care, evaluation scale on dental care and ideal waiting time in the office after receiving dental treatment. Results: The 89% of respondents perceived a friendly and favorable relationship with dentists. Concerning patients' satisfaction on quality of care, 41% considered that they had created an interpersonal relationship with their dentist, but the other 59% expressed the opposite. As for the evaluation of dental care, 64% gave it a maximum of 10 points. Twenty-five percent of the patients agreed that the ideal waiting time for consultation should be 20 minutes and another high percentage, 48%, considered that the ideal waiting time should be 30 minutes. Conclusions: More than half of patients reported that they were satisfied with the treatment provided by dentists.
Introdução: A ética profissional permite qualificar os atos humanos sob uma perspectiva afirmativa ou negativa, onde os valores éticos e sociais permitem relações efetivas no ambiente profissional. Objetivo: Identificar o nível de satisfação do paciente desde a perspectiva dos valores éticos da relação dentista-paciente dos consultórios "Centro Odontológico Integral" do Dr. Guillermo Méndez e "Design Dental" do Dr. Freddy Santillán, Santo Domingo de Tsáchilas, Equador. Método: Realizou-se um estudo transversal descritivo, através da aplicação de um questionário a 44 pacientes das referidas clínicas onde foram analisadas as variáveis: satisfação no relacionamento interpessoal, satisfação com a qualidade do atendimento, escala de avaliação do atendimento odontológico e ideal tempo de espera na consulta, após receber seu tratamento odontológico. Resultados: 89% dos entrevistados perceberam uma relação amigável e favorável com o dentista. Quanto à satisfação com a qualidade do atendimento, 41% consideraram ter criado vínculo interpessoal com seu dentista, 59% não. Quanto à avaliação da assistência odontológica, 64% atribuíram nota máxima de 10 pontos. 25% dos pacientes concordaram que o tempo ideal de espera na consulta deveria ser de 20 minutos e outro alto percentual, 48%, considerou que o ideal seria de 30 minutos. Conclusões: Mais de metade dos pacientes indica que se sente satisfeito com o tratamento prestado pelo médico dentista.
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Objective:To explore the risk factors of oral fungal infection in patients with severe hepatitis, and the prevention role of nystatin oral care combined with precision health education on oral fungal infection.Methods:A total of 150 patients with severe hepatitis who were hospitalized for diagnosis and treatment in the First Affiliated Hospital of Zhengzhou University from February 2018 to February 2020 were selected as the research objects. According to the random number table method, they were divided into the observation group (given nystatin oral care combined with precision health education intervention) and the control group (given routine oral care combined with precision health education intervention), 75 cases in each group. The incidence of oral fungal infections in the two groups after the intervention were compared.Results:The fungal infection rate in the observation group at 1 week, 2 weeks and 4 weeks after intervention were 2.67% (2/75), 4.00% (3/75), 8.00% (6/75), which were significantly lower than 12.00% (9/75), 18.67% (14/75), 25.33% (19/75) in the control group ( χ2=4.81, 8.03, 8.11, all P<0.05). Four weeks after the intervention, among the 6 patients with fungal infection in the observation group, there were 5 cases of oral leukoplakia and foreign body sensation in the pharynx, and 1 patient with oral leukoplakia; among the 19 patients with fungal infection in the control group, all had oral mucosal leukoplakia. There were 17 cases of leukoplakia and pharyngeal foreign body sensation, and 2 cases of oral leukoplakia. Conclusions:Nystatin oral care combined with precision health education is of great significance in patients with severe hepatitis, and can effectively reduce the incidence of oral fungal infections.
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Objective:To explore the function of temperature difference stimulation oral nursing for the patients with mild to moderate dysphagia after oral cancer operation.Methods:A total of 64 patients with mild to moderate dysphagia after oral cancer surgery admitted to our hospital from January 2019 to June 2021 were selected as the research subjects by convenient sampling method, and divided into control group ( n=32) and observation group ( n=32) according to random number table method. The grouping method was random number table method. The control group was treated with traditional ice-water stimulation rehabilitation training, and the observation group was treated with temperature difference stimulation oral care. The degree of dysphagia, nutritional status, postoperative complications and quality of life were analyzed and compared between the two groups. Results:After the intervention, the degree of dysphagia in the observation group (water swallow test) fromⅠto Ⅳ degree were 2, 11, 13 and 6 cases, while in the control group were 9, 17, 4 and 2 cases, the difference was significant ( Z=-3.41, P<0.05). After the intervention, the serum albumin of the observation group was (38.74 ± 4.87) g/L, which was significantly higher than that of the control group (35.81 ± 5.14) g/L. there was significant difference between the two groups ( t=2.34, P<0.05). After the intervention, the self scores of chewing, swallowing, anxiety, emotion and quality of life in the Chinese version of the University of Washington quality of life scale in the observation group were 70.28 ± 10.39, 68.20 ± 9.43, 72.39 ± 12.28, 65.30 ± 15.33 and 78.05 ± 9.47, which were significantly higher than those in the control group 64.29 ± 9.26, 61.42 ± 12.38, 64.50 ± 10.43, 58.08 ± 11.62 and 72.92 ± 10.40, The difference was statistically significant ( t values were 2.06-2.77, all P<0.05). Conclusions:Oral nursing with temperature difference stimulation can effectively improve the swallowing disorder of patients after oral cancer surgery, reduce the incidence of aspiration and malnutrition, and improve the quality of life of patients.
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Objective:To explore the effect of improving oral care based on cluster management in ventilator-associated pneumonia (VAP).Methods:Totally 126 VAP patients from February 2019 to February 2020 in our hospital were selected. The patients admitted from February 2019 to August 2019 were the control group, and the patients from September 2019 to February 2020 were the observation group, 63 cases in each group. The control group was treated with cluster nursing, and the observation group was treated with cluster nursing with improved oral care. The EICU hospitalization time, mechanical ventilation time, plaque index, pathogen infection, oral cleaning score, oral bleeding ulcer and aspiration were compared between the two groups.Results:After nursing, the EICU hospitalization time and mechanical ventilation time in the observation group were (18.34±4.15), (8.56±2.14) days, which were shorter than (23.56±4.82), (12.04±3.10) days in the control group ( t value was -6.514, -7.333, P<0.05). During the nursing process, the incidence of bleeding ulcer and aspiration in the observation group were 12.70% (8/63), 6.35% (4/63), which were lower than 30.16% (19/63), 20.63% (13/63) in the control group ( χ 2 values were 5.704, 5.508, P<0.05). After nursing, the plaque index of the two groups was lower than that before nursing ( t values were 12.516, 6.654, P<0.05), and the plaque index of the observation group was lower than that of the control group ( t value was -6.860, P<0.05). During the nursing process, the incidence of pathogenic bacteria infection in the observation group was 28.57% (18/63), which was lower than 49.21% (31/63) in the control group ( χ 2 value was 5.644, P<0.05). After nursing, the oral cleaning score of the two groups was lower than that before nursing ( t values were 11.118, 6.240, P<0.05), and the score of the observation group was (14.38±3.60) points, which was lower than (18.20±4.11) points of the control group ( t value was -5.549, P<0.05). Conclusion:Auricular pressure therapy can effectively improve the constipation symptoms, shorten the time required to take effect for the main symptoms, and improve the quality of life of schizophrenic patients.
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@#Acute lymphoblastic leukemia is the most common type of leukemia in children. In recent years, the treatment and prognosis of acute lymphoblastic leukemia in children have improved significantly. However, acute lymphoblastic leukemia itself and treatment measures can lead to a variety of adverse oral complications and affect further treatment. These complications have a significant effect on patients and affect further treatment. To improve the quality of life of children, this article reviews the oral health status and oral health management of children with acute lymphoblastic leukemia for clinical reference. The literature review shows that the oral health management measures for children with acute lymphoblastic leukemia mainly include oral health education, active prevention of oral diseases, timely oral treatment before the start of antitumor treatment, elimination of potential sources of infection after blood examination and risk assessment, treatment of oral mucosal problems during therapy, oral emergency during antitumor therapy should be carried out under the guidance of hematologists and regular oral inspection and oral care. However, current studies have found that there is still a lack of effective prevention and treatment measures for oral mucositis. As a common oral disease in children with acute lymphoblastic leukemia, the prevention and treatment of oral mucositis remain to be further studied.
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Resumen Objetivo: analizar las creencias relacionadas al cuidado de la salud oral en cuidadores de adultos mayores institucionalizados de la ciudad de Antofagasta, Chile, 2019. Material y Métodos: Estudio cuantitativo, observacional, descriptivo, transversal. Se entrevistó a 49 cuidadores con el cuestionario DCBS-sp, para determinar sus creencias relacionadas al cuidado de la salud oral. Para análisis estadístico se utilizó STATA 14 ®. Resultados: El 36,73% tiene capacitación en salud oral y el 97,96%, percibe la necesidad de capacitarse. Cuidadores con capacitación tienen significativamente más puntajes promedio favorables a la salud bucal en las dimensiones locus control interno y autoeficacia. Conclusiones: Cuidadores tienen baja capacitación para el cuidado de la salud bucal, existiendo creencias desfavorables al cuidado de la salud bucal de las personas mayores institucionalizados. Es necesario diseñar intervenciones de educación para la salud bucal en este grupo que permitan mejorar las creencias relacionadas al cuidado de la salud oral.
Resumo Objetivo: analisar as crenças relacionadas à atenção à saúde bucal em cuidadores de idosos institucionalizados na cidade de Antofagasta, Chile, 2019. Materiais e Métodos: Estudo quantitativo, observacional, descritivo, transversal. 49 cuidadores foram entrevistados com o questionário DCBS-sp para determinar suas crenças relacionadas aos cuidados com a saúde bucal. Para análise estatística, foi utilizado o STATA 14 ®. Resultados: 36,73% possuem treinamento em saúde bucal e 97,96% percebem a necessidade de treinamento. Cuidadores treinados apresentam escores médios significativamente mais elevados favoráveis ââà saúde bucal nas dimensões de controle do locus interno e autoeficácia. Conclusões: Os cuidadores apresentam baixa formação para os cuidados com a saúde bucal, há crenças desfavoráveis ââem relação aos cuidados com a saúde bucal de idosos institucionalizados. É necessário desenhar intervenções de educação em saúde bucal nesse grupo para melhorar as crenças relacionadas aos cuidados com a saúde bucal.
Abstract Objective: to analyze oral health care related beliefs among caregivers of the institutionalized elderly in Antofagasta, Chile, 2019. Material and methods: A quantitative, observational, descriptive, cross-sectional study was conducted. Forty-nine caregivers were interviewed with the DCBS-sp questionnaire to determine their oral health care beliefs. STATA 14® was used to conduct the statistical analysis. Results: Of the caregivers interviewed, 36.73% have oral health training, and 97.96% feel they need training. Trained caregivers have significantly better average oral health scores on internal locus of control and self -efficacy. Conclusions Caregivers have insufficient oral health training, and there are unfavorable beliefs about the oral health care of the institutionalized elderly. It is necessary to design oral health educational interventions to allow this group of professionals to improve their oral health care related beliefs.
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Background: Oral health awareness and oral care are crucial aspects of oncology nursing practice. However, very few studies concentrate on the oral care of cancer patients undergoing cancer treatment and nursing practice in the Indian subcontinent scenario/situation. Most of the published studies have been conducted in the Western and European countries. Aims: This study aimed to determine the nurses' practice and barriers regarding oral care in cancer patients undergoing chemotherapy and radiation therapy. Materials and Methods: A cross-sectional descriptive survey was conducted among 158 staff nurses working in oncology-related areas from four different hospitals of Dakshina Kannada district and Udupi district of Karnataka state, India. Statistical Analysis: Descriptive and inferential statistics was used by using SPSS 16 version. Results: More than half of respondents [54 (34.2%)] did not perform oral care as a part of routine duties. Maintenance of various records, lack of manpower, and lack of standard operating procedures were major barriers in providing oral care. Documentation audit revealed that nurses recorded oral care in the chart only when order was present in the care sheet, but oral problem assessment was not recorded at all. In all four hospitals surveyed, there was no protocol specifically designed for oral care of cancer patients. Conclusion: Nurses expressed that oral care in cancer patients was one of the most ignored aspect in oncology nursing. Our result highlights the need to develop evidence-based oral care intervention protocol and motivate staff nurses to attend continuing nursing educations regularly to keep themselves abreast of the latest trends in order to render comprehensive care to the patients.
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Background: Oral health is recognized as an integral component of general health, and poor oral health is reflected in general health and quality of life (QoL). India has seen a profound shift in the elderly population and is currently home to 103.9 million elders. General Oral Health Assessment Index (GOHAI) is a self-reported oral health assessment index used in elderly population and has been tested in multiple countries. Objective: The study aimed to assess the oral health-related QoL (OHRQoL) using GOHAI and various factors affecting it, among elderly patients visiting special Sunday geriatric clinics at Delhi public hospitals. Methods: A cross-sectional study was conducted among four purposively selected special geriatric public clinics in Delhi, India, and a convenience sample of 145 elderly patients was obtained. OHRQoL was measured using a prevalidated instrument (GOHAI) along with other variables (sociodemographic factors, self-perceived oral health, utilization of medical/dental services, dental problems in the past 12 months, and prosthetic status/need). Statistical analysis was done using Statistical Package for the Social Sciences software version 21, and descriptive results were obtained. Results: The sample consisted of 66 males (45.5%) and 79 females (55.5%), and around 58% (n = 84) of the participants were illiterate. Around 39% (n = 57) of the elderly had never visited a dentist and 48% (n = 69) were financially dependent (no income) on others. The mean GOHAI score for the population was 26.69 + 4.44 (median = 25, interquartile range = 23�). GOHAI score was compared for age, oral hygiene practices, dental problems in the past 12 months, self-reported oral health, and prosthetic need, and a statistically significant difference was observed. Conclusions: The current study assessed GOHAI score and highlighted important determinants of OHRQoL in elderly population visiting the special clinics in Delhi. Thus, OHRQoL should be considered as a surrogate measure to clinical oral examination.
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BACKGROUND: The purpose of this study was to determine the degree of oral care, perceived halitosis, halitosis, interpersonal relationships and oral health-related quality of life and to examine the relationships among these variables.METHODS: The participants were 94 elderly people. The questionnaire included questions on oral care, perceived halitosis, interpersonal relationships, and oral health-related quality of life. Halitosis was measured using odor breath tester.RESULTS: A total of 63.8% of the elderly did not receive regular oral care. The halitosis score was 1.59, thus indicating moderate halitosis. The current perceived halitosis figure was 1.54, participants responded that they feel slight. There was no significant correlation between halitosis and perceived halitosis. Furthermore, there was no significant difference in halitosis and perceived halitosis according to the oral care. Perceived halitosis was negatively correlated with oral health-related quality of life. Interpersonal relationships were correlated with oral health-related quality of life.CONCLUSIONS: It is necessary to actively promote the need for oral care among the elderly. Moreover, older people need regular oral care to prevent halitosis and improve their oral health-related quality of life.
Subject(s)
Aged , Humans , Breath Tests , Halitosis , Odorants , Oral Hygiene , Quality of LifeABSTRACT
Ventilator-associated pneumonia(VAP) is more likely to occur in patients with mechanical ventilation due to the decrease of oral self-purification ability, weakening of mucosal defense ability and translocation of oropharyngeal colonies. Oral care can reduce plaque and mucosal inflammation, improve oral function, promote oral health and effectively prevent VAP. This article reviewed the current situation of oral care for mechanical ventilation patients at home and abroad. Based on the best evidence, the evaluation of oral function, the choice of oral care solution and appliances were summarized. We suggested further improving the training system and unifying the evaluation, inspection standard and operation procedure, so as to develop the optimum oral care scheme.
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Objective@#To understand the real experience of oral hygiene care of perioperative oral cancer patients.@*Methods@#Qualitative descriptive research was adopted. Semi-structure in depth interviews were conducted among 17 postoperative oral cancer patients. NVivo 11 was used to manage and sort out the original data, data was analyzed with the content analysis of Colaizzi.@*Results@#Six themes regarding oral hygiene care was extracted, including the diversity of methods of oral hygiene and the care provider, patients have limited knowledge about oral hygiene care and the relative education is lacking, the change of function, structure and the degree of comfort of mouth impact the oral hygiene care, patients′ feedback on oral hygiene care is complicated, patients′ oral care related emotional experience is rich, oral hygiene care experience of elderly and non-elderly patients with oral cancer has few difference.@*Conclusions@#The oral hygiene care of perioperative oral cancer patients needs to be further standardized, the instruction of patients′ oral hygiene care needs to be enhanced, more attention should be paid to the popularization of disease knowledge, so as to optimize patients care and do a good job in disease prevention.
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Objective To understand the real experience of oral hygiene care of perioperative oral cancer patients. Methods Qualitative descriptive research was adopted. Semi- structure in depth interviews were conducted among 17 postoperative oral cancer patients. NVivo 11 was used to manage and sort out the original data, data was analyzed with the content analysis of Colaizzi. Results Six themes regarding oral hygiene care was extracted, including the diversity of methods of oral hygiene and the care provider, patients have limited knowledge about oral hygiene care and the relative education is lacking, the change of function, structure and the degree of comfort of mouth impact the oral hygiene care, patients′feedback on oral hygiene care is complicated, patients′oral care related emotional experience is rich, oral hygiene care experience of elderly and non-elderly patients with oral cancer has few difference. Conclusions The oral hygiene care of perioperative oral cancer patients needs to be further standardized, the instruction of patients′oral hygiene care needs to be enhanced, more attention should be paid to the popularization of disease knowledge, so as to optimize patients care and do a good job in disease prevention.
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OBJECTIVES: There is currently little research on dental hygienists' interest and need related to oral care. To perform elderly oral care effectively, dental hygienists must understand the features of aging in the elderly. The purpose of this study is to investigate how dental hygienists' interest affects oral care for the elderly.METHODS: 232 dental hygienists completed a self-reported questionnaire from March to April 2019. The questionnaires consisted of general characteristics of the subjects (6 items), elderly patient experience (11 items), and questions regarding aging (7 items). This study analyzed collected data by frequency analysis, ANOVA, Pearson correlation analysis, and multiple regression analysis.RESULTS: Correlation analysis between concern, need, and participation in elderly oral care showed a significant amount of correlation among all variables. We found that gender (P=0.022), education level (P=0.029), workplace type (P=0.002), and the proportion of future elderly patients were statistically significant (P=0.001) factors affecting the level of concern.CONCLUSIONS: The results of this study suggest that experience in treating and caring for the elderly are essential factors for raising the interest and understanding of oral health care for elderly patients. Therefore, we should consider the development of various programs to raise interest in oral health for the elderly.
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Aged , Humans , Aging , Dental Hygienists , Education , Oral HealthABSTRACT
Objective: To explore the clinical effect of a kind of assistant cleaner for oral care of severe patients who couldn't eat through mouth. Methods: 80 patients who couldn't eat through mouth were divided into observation group (n=40 cases) and control group (n=40 cases). The oral cavity of patients of observation group were cleaned by using self-made assistant cleaner before oral care, and then cotton ball with physiological saline (NS) were used to scrub their oral cavity. While the patients of control group were directly scrubbed by using cotton ball with NS. The operation time and oral clean situation of the two groups were observed and recorded. Results: The preparing time before oral care of observation group was significantly longer than that of control group (t=4.282, P<0.05), while the operation time of oral care and total time of observation group was significantly shorter than that of control group (t=31.3, P<0.05). The method of observation group could more effectively clean oral peculiar smell, eliminate massive furred tongue and reduce residual sputum scab than that of control group. And it could significantly reduced complication of oral cavity than that of control group (t=32.111, P<0.05). Conclusion: The application of assistant cleaner before oral care not only can effectively improve oral hygiene condition for severe patients, but also can shorten the time of oral care of nurses for these patients and reduce the operation time of stoop. Therefore, it is a new method with advantage of saving time and saving labour.
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Objective To determine the effectiveness of an oral care protocol on prevention and treatment of chemotherapy-induced oral mucositis in patients with hematological neoplasms. Methods Totally 106 patients with hematological neoplasms undergoing therapies from March to October 2017 were enrolled. Patients who were included from March to June 2017 constituted the control group, others from July to October constituted the intervention group. Patients in control group received the regular care, while patients in intervention group received a 3-week period oral care protocol. The oral health status of the patients was recorded and compared between the two groups. Results On the 7th,14th, 21th day after chemotherapy, the oral mucositis level of I degree,Ⅱdegree,Ⅲdegree andⅣdegree of the intervention group were 11, 13, 17, 1 cases, 28, 16, 0, 0 cases, 9, 3, 0, 0 cases, which were lower than the control group whose degrees were 24, 18, 10, 2 cases, 21, 13, 12, 0 cases, 13, 9, 8, 0 cases, respectively. The difference between the two groups was statistically significant (Z=-2.177,-2.504,-2.113, P<0.05). On the 3th, 7th, 14th and 21th day after chemotherapy, the oral pain scores reported by patients in the intervention group were 2.00(2.50), 3.00(2.75), 2.50(2.00), 0.00 (1.00), which were lower than the control group whose scores, in contrast, were 3.00(4.00), 5.00(3.25), 5.50 (4.00), 2.00(3.25). The difference between the two groups was statistically significant (Z=-2.587,-3.326,-4.925,-3.217, P <0.05). The positive rate of microbial examination in the intervention group was 14.6％(7/48), which was lower than 36.2％(21/58) in the control group. The difference between the two groups was statistically significant(χ2=6.318, P<0.05). Conclusions The oral care protocol established and implemented based on evidence could effectively decrease the incidence of chemotherapy-induced oral mucositis, ease oral pain and reduce inflammation for patients with hematological neoplasms.
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Objective To study the clinical effect of chlorhexidine acetate solution for oral care in patients with endotracheal intubation. Methods From February 2017 to August 2017, 160 patients with tracheal intubation in our department were divided into the observation group (80 cases) and the control group (80 cases) by random number table method. The observation group was treated with chlorhexidine acetate solution, and the control group used the compound Borax solution for oral care. The oral condition score, the positive rate of oral bacterial culture, the incidence rate of ventilator-associated pneumonia were compared between two groups. Results In the observation group, the oral condition score and the positive rate of oral bacterial culture were 10.29 ± 2.04 and 16.25% (13/80) on the 3rd day after theoral care. In the control group, the oral condition score and the positive rate of oral bacterial culture were 12.79 ± 1.97 and 31.25%(25/80) on the 3rd day after the oral care. There were statistically significant differences between the two groups (t=-7.895, P<0.01; χ2=4.970, P<0.05). The incidence and occurrence time of ventilator-associated pneumonia in the observation group were 7.50% (6/80), (9.33±1.37) d. The incidence and occurrence time of ventilator-associated pneumonia in the control group were 18.75% (15/80), (5.87 ± 1.06) d. The difference between the two groups was statistically significant (χ2=4.440, P<0.05; t=6.248, P<0.01). Conclusions The chlorhexidine acetate flushing oral care can significantly improve dental status, reduce the positive rate of oral bacterial culture and the incidence of ventilator-associated pneumonia, and prolong the occurrence time of ventilator-associated pneumonia in patients with endotracheal intubation.
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O cuidado oral em pacientes intubados internados em Unidade de Terapia Intensiva é uma atividade da Enfermagem que se constitui num conjunto de competências fundamentadas em evidências científicas. A saúde oral refere-se ao ótimo estado da cavidade oral e o bom funcionamento de suas estruturas, obtido por meio da higiene oral adequada, estratégia crucial de prevenção para excluir o risco de problemas bucais e promover o conforto físico e psicológico dos pacientes. A higiene oral inadequada traz vulnerabilidade a cavidade oral potencializando focos de infecções propícias à pneumonia nosocomial. Objetiva identificar e analisar na literatura as melhores evidências disponíveis referentes ao produto, dispositivo e frequência do cuidado oral para prevenção de pneumonia associada à ventilação mecânica em pacientes intubados e em ventilação mecânica internados em Unidade de Terapia Intensiva. Trata-se de uma revisão integrativa da literatura, na qual foi realizada buscas de estudos primários nas bases de dados eletrônicas PubMed, EMBASE e CINAHL, utilizando descritores controlados e os respectivos vocabulários destas bases de dados: MeSh, EMTREE e TÍTULOS. Das 184 referências identificadas, 52 foram selecionados após leitura de título e resumo para serem lidos na íntegra, 18 constituíram a amostra final. A extração e análise dos dados foram realizadas por dois revisores independentes. As publicações dos 18 estudos ocorreram no período de 2009 a 2017. O controle do biofilme e prevenção de lesões na cavidade oral constituem ações importantes para a obtenção da boa saúde oral. Para esse controle, são necessárias intervenções que promovam a remoção mecânica e/ou farmacológica do mesmo. Essas intervenções constituem a combinação de produtos, dispositivos e frequência do cuidado oral. As melhores evidências indicaram a combinação dos seguintes produtos, dispositivos e frequência: creme dental Biotene® combinado com a escovação dentária e também Biotene® enxaguante bucal, para promover a hidratação da cavidade oral, reduzindo a xerostomia; clorexidina 0,12%, melhor evidência como antisséptico; lubrificantes a base de água e hidrossolúveis para mucosa oral e lábios; escova de dentes elétrica de cabeça pequena e cerdas macias, como melhor evidência de dispositivo, porém seu custo pode ser um fator que pode impedir sua larga utilização, em sua indisponibilidade, as evidências apontam para a escova de dentes pediátrica com cerdas macias; raspadores de língua para a remoção do biofilme local; frequência a cada oito horas. Citadas as escalas de avaliação da cavidade oral, sustentando a verificação da saúde oral e como fator determinante da frequência da intervenção, respeitando assim a individualidade do paciente. Recomenda-se implementar o uso de escalas de avaliação da saúde oral para a determinação segura da frequência da intervenção; sugere-se novos estudos que abordem esta temática para comparar as escalas de avaliação da cavidade oral, os produtos, dispositivos e frequência; capacitar os profissionais para que a assistência seja realizada com qualidade e segurança, mitigando eventos adversos aos pacientes
Oral care in intubated patients admitted to an Intensive Care Unit is a nursing activity that is a set of competencies based on scientific evidence. Oral health refers to the excellent state of the oral cavity and the proper functioning of its structures, obtained through proper oral hygiene, a crucial prevention strategy to exclude the risk of oral problems and to promote the physical and psychological comfort of patients. Inadequate oral hygiene brings vulnerability to the oral cavity potentiating foci of infections conducive to nosocomial pneumonia. Aims to identify and analyze, in the literature, the best available evidence regarding the product, device and frequency of oral care for the prevention of pneumonia associated with mechanical ventilation in intubated patients and mechanical ventilation admitted to the Intensive Care Unit. It is an integrative review of the literature, in which searches of primary studies in the electronic databases PubMed, EMBASE and CINAHL were carried out using controlled descriptors and the respective vocabularies of these databases: MeSh, EMTREE and TITLES. Of the 184 references identified, 52 were selected after reading the title and abstract to be read in their entirety, 18 constituted the final sample. Data extraction and analysis were carried out by two independent reviewers. The publications of the 18 studies occurred between 2009 and 2017. Biofilm control and prevention of oral cavity lesions are important actions to achieve good oral health. For this control, interventions that promote the mechanical and / or pharmacological removal of the same are necessary. These interventions are the combination of products, devices and frequency of oral care.The best evidences indicated the combination of the following products, devices and frequency: Biotene® toothpaste combined with toothbrushing and also Biotene® mouthwash, to promote hydration of the oral cavity, reducing xerostomia; chlorhexidine 0.12%, better evidence as an antiseptic; water-based and water-soluble lubricants for oral mucosa and lips; small electric toothbrush and soft bristles, as best evidence of device, however its cost may be a factor that may prevent its wide use, in its unavailability, the evidence points to the pediatric toothbrush with soft bristles; tongue scrapers for local biofilm removal; every eight hours. Cited scales of assessment of the oral cavity, supported the verification of oral health and as a determinant factor of the frequency of intervention, thus respecting the individuality of the patient. It is recommended that the use of oral health assessment scales for the safe determination of the frequency of intervention be implemented; new studies that address this theme are suggest to compare oral cavity evaluation scales, products, devices and frequency; to enable professionals to carry out quality and safe care, mitigating adverse events to patients
Subject(s)
Humans , Respiration, Artificial , Chlorhexidine , Rapid Sequence Induction and Intubation , Intensive Care UnitsABSTRACT
@#The treatment of oral cancer patients mainly involves surgery in combination with radiotherapy and chemotherapy. This paper reviews the clinical features of perioperative patients with oral cancer, including oral flora imbalance, oral complications after radiotherapy and chemotherapy, the presence of oral incisions (and flaps), special dietary needs, and airway management. In connection with the above characteristics, this article analyzes the necessity of three aspects of oral care to improve the patient’s comfort and prevent pulmonary and surgical site infections, with the goal of providing a reference for oral care research on patients undergoing oral cancer surgery and laying a foundation for the construction of comprehensive oral care programs during the perioperative period for patients with oral cancer.
ABSTRACT
Objective To investigate the effects of oral care using hydrogen peroxide and sodium bicarbonate to prevent neonatal ventilator associated pneumonia(VAP). Methods Totally 209 neonates were recruited and divided into the experimental group with 104 cases and the control group with 105 cases by using random number table method. Based on conventional mechanical ventilation nursing,the experimental group received oral care using 1.5%hydrogen peroxide combined with 2.5% sodium bicarbonate,Q8H,while the control group received oral care using only 2.5% sodium bicarbonate,Q8H. Positive results of bacteria detection in tracheal sputum culture,the incidence rate of VAP,mechanical ventilation time,hospitalization time and hospitalization costs were compared between two groups. Results After 48 hours of mechanical ventilation,the difference in positive results of bacteria detection in tracheal sputum culture between two groups was statistically significant(P0.05) when the duration of the mechanical ventilation was 48 hours. While after 48 hours of the mechanical ventilation,the difference of the incidence rate of VAP between two groups was statistically significant(P0.05). Conclusion The combined usage of hydrogen peroxide and sodium bicarbonate for oral care can effectively eliminate neonatal oral bacteria colonization and prevent neonatal VAP,so as to reduce the time of mechanical ventilation and hospitaliza-tion, and decrease hospitalization costs.
ABSTRACT
Objective To discuss the intervention effect of four oral care model on compliance of atomizing inhalation and mouth and throat complications in outpatient infants and young children patients. Methods A total of 480 cases of children patients using budesonide inhalation for the treatment of respiratory tract infection were divided into the observation group(n=260)and the control group (n=220) according to the time sequence. The control group received conventional nursing, the observation group used quaternity oral care model in nursing care. The compliance and occurrence of complications in the mouth and throat were observed between the two groups. Results In the observation group with nebulae inhalation compliance was 79.2% (206/260), evidently higher than that in the control group the compliance of 58.6%(129/220) (χ2=23.97,P0.05). The incidence of thrushes was 3.64%(8/220) in the control group, and none occurred in the observation group, which showed significant difference (χ2=9.62, P<0.01). Conclusions Using quaternity oral care model in corticosteroid nebulae inhalation patientscan increase compliance and decreasecomplications of oral and throat of outpatient children.