期刊
GERODONTOLOGY
卷 34, 期 2, 页码 232-239出版社
WILEY
DOI: 10.1111/ger.12255
关键词
caregiver; long-term care facility; nurse; oral health screening tool; referral to a dentist
资金
- 8020 Promotion Foundation [13-3-07]
Objective: To develop and evaluate, with a dentist as gold standard, an oral health screening tool, the Oral Health Screening Tool for Nursing Personnel (OHSTNP), that assists long-term care facility nursing staff without preliminary training in identifying resident need for dentist referral. Methods: Using an OHSTNP adapted from previous screening tools (Chalmers, J Gerontol Nurs, 2004, 30, 5; Tsukada, J Jpn Soc Dent Hyg, 2012, 7, 43), one of four nurses, one of eight caregivers and a dentist with 15years' experience screened the oral health/function of 57 long-term care facility residents. The OHSTNP included a question on the need and reasons for dentist referral. Tool reliability and validity were evaluated by determining inter-rater agreement (Cohen's kappa), sensitivity, specificity and accuracy. Results: For dentist-nurse and dentist-caregiver pairs, kappa was statistically significant and sensitivity was high (>= 0.67, nurses; >= 0.71, caregivers) for natural teeth, dentures and oral function-related categories. Specificity for all categories was >= 0.69. Screening by nurses and caregivers for need for referral had low sensitivity (0.05, 0.23), accuracy (0.25, 0.39) and kappa (-0.01, 0.08). However, if nursing staff had been instructed to request a dentist referral in case of alterations in natural teeth/dentures or severe alterations in any other category, the estimated values increased to a sensitivity of 0.86 and 0.91, an accuracy of 0.75 and 0.82 and a kappa of 0.26 and 0.47. Conclusions: OHSTNP was reliable and valid for screening natural teeth, denture conditions and oral functions. Supplementary guidelines improved estimates of OHSTNP sensitivity, accuracy and reliability for nurse/caregiver assessment of resident need for dentist referral.
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