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Testing an oral assessment guide during chemotherapy treatmen in a Swedish care setting: a pilot study
Kristianstad University, Department of Health Sciences.ORCID iD: 0000-0003-0269-730X
Centre for Caring Sciences, Lund University. (Integrativ vård och hälsobefrämjande arbete)
Centre for Caring Sciences, Lund University.
Kristianstad University, Department of Health Sciences.ORCID iD: 0000-0003-0992-2362
1999 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 8, no 2, p. 150-158Article in journal (Refereed) Published
Abstract [en]

Oral complications are common in patients with haematological malignancies who undergo chemotherapy treatment. A pilot study including 16 haematological patients was carried out to evaluate the oral status using an Oral Assessment Guide (OAG) and to test the reliability of the OAG. The oral assessments were made daily by registered nurses at a Department of Internal Medicine in Sweden. Once a week a dental hygienist made the oral assessments independent of the registered nurses in order to provide data for calculations of inter-rater reliability. All patients had varying degrees of alterations in the oral cavity, especially in the mucous membranes, teeth/dentures and gums. The inter-rater agreement between the nurses and the dental hygienist was good for saliva and swallow, and moderate for voice and gums. Assessments to detect alterations in the oral cavity afford the opportunity for early and individualized interventions and may decrease the risk of oral infections. It is necessary to train the nurses to ensure high levels of reliability in the oral assessments. The OAG seems to be a reliable and clinical useful tool for assessing the oral cavity status and determining changes.

Place, publisher, year, edition, pages
1999. Vol. 8, no 2, p. 150-158
Keywords [en]
acute leukaemia, chemotherapy, Hodgkin's disease, myeloma, non-Hodgkin's lymphoma, nursing care, oral assessment guide, oral health
National Category
Dentistry
Identifiers
URN: urn:nbn:se:hkr:diva-5237DOI: 10.1046/j.1365-2702.1999.00237.xISI: 000082095800005PubMedID: 10401348OAI: oai:DiVA.org:hkr-5237DiVA, id: diva2:275429
Available from: 2009-11-05 Created: 2009-11-05 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Evaluation of oral health status using an oral assessment guide in geriatric rehabilitation patients and in patients with haematological malignancies
Open this publication in new window or tab >>Evaluation of oral health status using an oral assessment guide in geriatric rehabilitation patients and in patients with haematological malignancies
2002 (English)Licentiate thesis, comprehensive summary (Other academic)
Place, publisher, year, edition, pages
Malmö: Malmö högskola, 2002. p. 62
Series
Malmö University odontological dissertations, ISSN 1650-6065
National Category
Dentistry
Identifiers
urn:nbn:se:hkr:diva-5292 (URN)91-631-2600-1 (ISBN)
Presentation
(English)
Opponent
Supervisors
Available from: 2009-12-10 Created: 2009-11-11 Last updated: 2014-06-17Bibliographically approved
2. Assessments of oral health status in frail patients in hospital
Open this publication in new window or tab >>Assessments of oral health status in frail patients in hospital
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aims of this thesis were to evaluate the usefulness of an oral assess¬ment guide and to determine the oral health status among frail patients in hospital settings. A further aim was to analyze possible factors that may be associated with oral health status, with special focus on the relationship between oral health and nutritional status among elderly rehabilitation patients. The Oral Assessment Guide (OAG) was used in patients with haematological malignancies undergoing chemotherapy. In further studies a Revised Oral Assessment Guide (ROAG) was used among geriatric rehabilitation patients. The inter-rater reliability of the OAG between registered nurses at the ward and a dental hygienist (DH) was good, as well as between a registered nurse and a DH using ROAG. Problems in the oral cavity were detected in all patients with haematological malignancies undergoing chemotherapy. Problems related to mucous membranes, teeth and/or dentures were most frequent. Oral health problems were also a frequent finding among the geriatric rehabilitation patients. The frequency of oral health problems was significantly lower at discharge compared to admission. Oral health problems were more often found among patients that stayed for longer periods at the hospital, were more dependent on help with daily activities and suffered for dysphagia, than among the healthier patients. Oral health problems were more common among the patients being at risk of undernourishment, suspected to be or severely undernourished (UN), than among the well-nourished patients. Problems in oral health status were significantly associated with the occurrence of respiratory diseases, living in special accommodation, being UN and being a woman. The highest Odds Ratio (OR) was found in problems with gums in relation to the occurrence of respiratory diseases (OR 8.9; 95 % CI 2.8-27.8). OAG as well as ROAG were found to be useful for assessing oral health status in frail patients at hospital. Oral health problems were a frequent finding among the patients. The use of an oral assessment tool on a routine basis may facilitate the detection of problems which otherwise can be hidden, and can serve as a guide for initiating individualised oral health procedures.

Place, publisher, year, edition, pages
Malmö: Malmö högskola, 2004. p. 68
National Category
Dentistry
Identifiers
urn:nbn:se:hkr:diva-5307 (URN)91-628-6019-4 (ISBN)
Public defence
(English)
Available from: 2009-12-10 Created: 2009-11-13 Last updated: 2014-06-17Bibliographically approved
3. Daily life problems from a nursing perspective in patients with acute leukaemia or highly malignant lymphoma
Open this publication in new window or tab >>Daily life problems from a nursing perspective in patients with acute leukaemia or highly malignant lymphoma
1998 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis aimed at from the patients’ and the spouses’ perspective, investigate impact on daily living of acute leukaemia (AL) or highly malignant lymphoma (HML) when under, and free of treatment and their view of the nursing care received. Open-ended interviews, generic life quality (LGC), and cancer specific life quality (EORTC QLQ-C30) questionnaires, Sense of Coherence Scale (SOC), a study-specific questionnaire and an oral assessment guide (OAG) was used. In all 88 respondents with AL or HML and nine spouses participated in the studies. Results showed respondents to be placed in a state of traumatic crisis. Basic aspects were types of diagnosis, level of SOC and LGC and age, which influenced the way things developed. Severe fatigue, nutritional problems, oral complications and proneness to infections reduced their capacity to handle daily living. Psychosocial and existential strain together with economic strain and having to live in isolation became further limitations. Tangible and emotional support was obtained from the family. Care was evaluated as good but said to “be on request”. Different family types “Couple acting as a unit”, “Couple acting independently and on equal terms” and “Couple acting separately with the spouses subordinate” meant different possibilities for the spouses to be involved, support their sick partner and obtain support for themselves. The long-term consequences could constitute a danger to patients’ continued living, or an adaptation in which a balance was obtained or could mean a “new lease of life”.  The outcome of the entire situation seems to depend on the basic aspects, the patient’s life goals when the disease was contracted the family situation and ability to obtain social support from family, friends and nurses.

Place, publisher, year, edition, pages
Lund: Centre of caring sciences, The medical faculty, Lund Univ., 1998. p. 79
Series
Bulletin from the Centre of Caring Sciences, Lund University, Sweden, ISSN 1403-4034 ; 1
Keywords
Nursing Care, acute leukaemia, quality of life, sense of coherence, family, spouses
National Category
Nursing
Identifiers
urn:nbn:se:hkr:diva-7915 (URN)91-628-3019-8 (ISBN)
Public defence
1998-06-13, Lund, 09:00 (English)
Opponent
Supervisors
Available from: 2011-04-27 Created: 2011-03-24 Last updated: 2021-09-28Bibliographically approved

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