Oral health care in older people in long-term care facilities: An updated systematic review and meta-analyses of implementation strategies
Introduction: Oral health care of older people in long-term care facilities is insufficient, stressing the need for clear evidence-based implementation strategies to improve oral care. In 2013, a systematic review was performed and new evidence was published. This study aimed to gain insights into i...
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Elsevier
2025-06-01
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| Series: | International Journal of Nursing Studies Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666142X24001164 |
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| author | Lina F. Weening-Verbree Anouk Douma Cees P. van der Schans Getty J. Huisman-de Waal Annemarie A. Schuller Sytse U. Zuidema Wim P. Krijnen Johannes S.M. Hobbelen |
| author_facet | Lina F. Weening-Verbree Anouk Douma Cees P. van der Schans Getty J. Huisman-de Waal Annemarie A. Schuller Sytse U. Zuidema Wim P. Krijnen Johannes S.M. Hobbelen |
| author_sort | Lina F. Weening-Verbree |
| collection | DOAJ |
| description | Introduction: Oral health care of older people in long-term care facilities is insufficient, stressing the need for clear evidence-based implementation strategies to improve oral care. In 2013, a systematic review was performed and new evidence was published. This study aimed to gain insights into implementation strategies used to promote or improve oral health care for older people in long-term care facilities, explore their effectiveness and uncover strategy content in behavioral change techniques, and report the differences between the current results and those of the 2013 study. Methods: A systematic review of the literature according to PRISMA guidelines and meta-analyses of implementation strategies were performed. Cochrane Library, PubMed, and CINAHL databases were searched for papers published between 2011 and 2023. Strategies were identified using the Coding Manual for Behavioral Change Techniques. Meta-analyses of oral health outcomes (“plaque” and “denture plaque”) were performed with random-effects models using R language for statistical computing. Results: 16 studies were included in the current results; 20 studies were included in the 2013 findings. More high-quality studies (67 %) were included in this review than in 2013 (47 %). Dental care professionals were involved in 14 of the 16 studies. Fourteen of the 16 studies used and/ or combined five or more different implementation strategies: knowledge, intention, awareness, self-efficacy, attitude, and facilitation of behavior. Implementation positively affected the knowledge and attitudes of the nursing staff; however, the oral health of older people did not necessarily improve. In the 2013 review, more studies indicated combined oral health measurements were effective (71 %) than in the current review (20 %–33 %). Meta-analysis of four studies on dental plaque (0—3 scale) showed a significant, statistically small mean difference of -.21 (CI -.36; -.07, Cohen's d -.29) between the control and treatment group. Meta-analysis of three studies on denture plaque (0—4 scale), showed a significant, statistically large mean difference of -.76 (CI -1.48; -.05, Cohen's d -.88). Conclusions: In this review, more implementation strategies and combinations were used to implement oral care in long-term care. Implementation strategies positively affected the knowledge and attitudes of nursing staff; however, the oral health of older people did not necessarily improve. Meta-analyses on plaque showed that oral care implementations are effective; for denture plaque, the effect size was large and thus may have more clinical value than for dental plaque. |
| format | Article |
| id | doaj-art-0e42b03838e3427eb813f49ed957e056 |
| institution | Kabale University |
| issn | 2666-142X |
| language | English |
| publishDate | 2025-06-01 |
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| series | International Journal of Nursing Studies Advances |
| spelling | doaj-art-0e42b03838e3427eb813f49ed957e0562025-01-06T04:08:59ZengElsevierInternational Journal of Nursing Studies Advances2666-142X2025-06-018100289Oral health care in older people in long-term care facilities: An updated systematic review and meta-analyses of implementation strategiesLina F. Weening-Verbree0Anouk Douma1Cees P. van der Schans2Getty J. Huisman-de Waal3Annemarie A. Schuller4Sytse U. Zuidema5Wim P. Krijnen6Johannes S.M. Hobbelen7Research Group Healthy Ageing, Allied Health Care and Nursing and FAITH Research, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714, CA, Groningen, The Netherlands; Center for Dentistry and Oral Hygiene, University Medical Center Groningen A, Deusinglaan 1 FB 21, 9713, AV, Groningen, The Netherlands; Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714, CA, Groningen, The Netherlands; Corresponding author.Center for Dentistry and Oral Hygiene, University Medical Center Groningen A, Deusinglaan 1 FB 21, 9713, AV, Groningen, The Netherlands; Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714, CA, Groningen, The NetherlandsResearch Group Healthy Ageing, Allied Health Care and Nursing and FAITH Research, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714, CA, Groningen, The Netherlands; Department Health Psychology, University Medical Centre Groningen, Groningen, The Netherlands; Department Rehabilitation Medicine, University Medical Centre Groningen, Groningen, The NetherlandsDepartment of IQ Healthcare, Radboud University Nijmegen Medical Center, Kapittelweg 54, 6525, EP, Nijmegen, The NetherlandsCenter for Dentistry and Oral Hygiene, University Medical Center Groningen A, Deusinglaan 1 FB 21, 9713, AV, Groningen, The Netherlands; TNO the Netherlands Organisation for applied scientific research, Sylviusweg 71, 2333, BE Leiden, The NetherlandsDepartment of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, P.O. Box 196 FA21, 9700, AD, Groningen, The NetherlandsResearch Group Healthy Ageing, Allied Health Care and Nursing and FAITH Research, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714, CA, Groningen, The Netherlands; Faculty of Science and Engineering, University of Groningen, Groningen, the NetherlandsResearch Group Healthy Ageing, Allied Health Care and Nursing and FAITH Research, Hanze University of Applied Sciences, Petrus Driessenstraat 3, 9714, CA, Groningen, The Netherlands; Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, P.O. Box 196 FA21, 9700, AD, Groningen, The NetherlandsIntroduction: Oral health care of older people in long-term care facilities is insufficient, stressing the need for clear evidence-based implementation strategies to improve oral care. In 2013, a systematic review was performed and new evidence was published. This study aimed to gain insights into implementation strategies used to promote or improve oral health care for older people in long-term care facilities, explore their effectiveness and uncover strategy content in behavioral change techniques, and report the differences between the current results and those of the 2013 study. Methods: A systematic review of the literature according to PRISMA guidelines and meta-analyses of implementation strategies were performed. Cochrane Library, PubMed, and CINAHL databases were searched for papers published between 2011 and 2023. Strategies were identified using the Coding Manual for Behavioral Change Techniques. Meta-analyses of oral health outcomes (“plaque” and “denture plaque”) were performed with random-effects models using R language for statistical computing. Results: 16 studies were included in the current results; 20 studies were included in the 2013 findings. More high-quality studies (67 %) were included in this review than in 2013 (47 %). Dental care professionals were involved in 14 of the 16 studies. Fourteen of the 16 studies used and/ or combined five or more different implementation strategies: knowledge, intention, awareness, self-efficacy, attitude, and facilitation of behavior. Implementation positively affected the knowledge and attitudes of the nursing staff; however, the oral health of older people did not necessarily improve. In the 2013 review, more studies indicated combined oral health measurements were effective (71 %) than in the current review (20 %–33 %). Meta-analysis of four studies on dental plaque (0—3 scale) showed a significant, statistically small mean difference of -.21 (CI -.36; -.07, Cohen's d -.29) between the control and treatment group. Meta-analysis of three studies on denture plaque (0—4 scale), showed a significant, statistically large mean difference of -.76 (CI -1.48; -.05, Cohen's d -.88). Conclusions: In this review, more implementation strategies and combinations were used to implement oral care in long-term care. Implementation strategies positively affected the knowledge and attitudes of nursing staff; however, the oral health of older people did not necessarily improve. Meta-analyses on plaque showed that oral care implementations are effective; for denture plaque, the effect size was large and thus may have more clinical value than for dental plaque.http://www.sciencedirect.com/science/article/pii/S2666142X24001164ImplementationNursing staffMeta-analysesOral healthOlder peopleSystematic review |
| spellingShingle | Lina F. Weening-Verbree Anouk Douma Cees P. van der Schans Getty J. Huisman-de Waal Annemarie A. Schuller Sytse U. Zuidema Wim P. Krijnen Johannes S.M. Hobbelen Oral health care in older people in long-term care facilities: An updated systematic review and meta-analyses of implementation strategies International Journal of Nursing Studies Advances Implementation Nursing staff Meta-analyses Oral health Older people Systematic review |
| title | Oral health care in older people in long-term care facilities: An updated systematic review and meta-analyses of implementation strategies |
| title_full | Oral health care in older people in long-term care facilities: An updated systematic review and meta-analyses of implementation strategies |
| title_fullStr | Oral health care in older people in long-term care facilities: An updated systematic review and meta-analyses of implementation strategies |
| title_full_unstemmed | Oral health care in older people in long-term care facilities: An updated systematic review and meta-analyses of implementation strategies |
| title_short | Oral health care in older people in long-term care facilities: An updated systematic review and meta-analyses of implementation strategies |
| title_sort | oral health care in older people in long term care facilities an updated systematic review and meta analyses of implementation strategies |
| topic | Implementation Nursing staff Meta-analyses Oral health Older people Systematic review |
| url | http://www.sciencedirect.com/science/article/pii/S2666142X24001164 |
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