ABSTRACT
Oral care is a hallmark of attentive, high-quality nursing care. Oral care improves a patient's sense of well-being, communication, and nutritional status, and lowers the risk for pneumonia. However, for patients with severe trismus, oral care may seem impossible. Trismus is the inability to open the mouth more than 35 mm and often results from medical therapies for head and neck cancers. This article details a simple approach to oral care that was implemented successfully with five hospice patients with severe trismus.
Subject(s)
Oral Hygiene , Trismus/nursing , Humans , Nutritional Status , Trismus/physiopathologyABSTRACT
OBJECTIVE: To assess nurses' perspectives on character, prevalence and cause of oral diseases among psychiatric patients and also their approach and suggestions in relation to the care of oral problems. MATERIALS AND METHODS: A questionnaire-based cross-sectional survey of all cadres of nurses (n = 136) at the Federal Psychiatric Hospital, Benin City, Nigeria, was conducted between December 2010 and January 2011. RESULTS: Two-thirds (67.6%) of the respondents reported that psychiatric in-patients in comparison with the general population have a higher occurrence of oral and dental problems. Commonly cited reasons for the poor oral health of patients included as follows: sedation for long periods, lack of care by family, psychopathological symptoms, poor access to dentists and lack of oral hygiene advice. The common oral health complaints received by the respondents included toothache, pain from the gums and inability to open the mouth. Majority (91.4%) of respondents claimed to be presently involved with oral care of psychiatric in-patients but oral care delivery is however bedevilled with lot of barriers like uncooperativeness of patients and lack of oral care materials. CONCLUSION: Oral complaints received are frequent and numerate with limited palliative action rendered. Attaching dentists to psychiatric hospitals and regular training of psychiatric nurses on oral care delivery are recommended to comprehensively cater for the oral health problems of psychiatric in-patients.
Subject(s)
Attitude of Health Personnel , Mental Disorders/nursing , Nurses/psychology , Oral Health , Adult , Conscious Sedation , Cross-Sectional Studies , Family Relations , Female , Gingival Diseases/nursing , Health Services Accessibility , Humans , Male , Middle Aged , Mouth Diseases/etiology , Mouth Diseases/nursing , Mouth Diseases/therapy , Nigeria , Nurse-Patient Relations , Oral Hygiene , Patient Care Team , Patient Compliance , Patient Education as Topic , Psychiatric Nursing , Tooth Diseases/etiology , Tooth Diseases/nursing , Tooth Diseases/therapy , Toothache/nursing , Treatment Refusal , Trismus/nursing , Xerostomia/nursingABSTRACT
Our aim was to develop a way of measuring trismus and evaluating it in terms of reliability and validity for use by nurses who care for patients with head and neck cancer. We developed a method from existing resources and tested it for interoperator reliability and validity against a "gold standard". We showed that within the variables outlined, nursing staff could use it after minimal training to identify patients broadly as being "at risk", "low risk", or having "normal mouth opening". Interexaminer reliability was poor. There was a trend towards a group of people having reasonable interexaminer reliability, and this same group showed consistency towards the gold standard. Nurses' accuracy and consistency in using a simple method of assessing trismus depends on more than the method used, and neither validity nor reliability can be assumed. The accurate assessment of trismus for comparison across studies is complex, and future research must define exactly what method was used.
Subject(s)
Nursing Assessment/standards , Trismus/nursing , Feasibility Studies , Head and Neck Neoplasms/nursing , Humans , Observer Variation , Range of Motion, Articular/physiology , Reproducibility of Results , Risk Assessment , Surveys and QuestionnairesABSTRACT
This paper discusses trismus (mandibular hypomobility), addressing its etiologies, relevant anatomy and pathophysiology, with the medical and nursing care of trismic patients commonly seen in the otolaryngology setting. It aims to raise awareness among ORL nurses about the sometimes subtle presentation of trismus and about the important role ORL specialists can play in detecting and treating this debilitating disorder.
