The purpose of this study was to investigate perceived comfort levels, behaviors, and barriers reported by group home caregivers who provide oral hygiene measures to consumers with special health care needs (SHCN) who physically resist the care. A 24-item survey was sent to 884 caregivers employed at six care facilities in Iowa. Bivariate analyses and logistic regression models were used to analyze the data (alpha = 0.05). The overall response rate was 52%. An analysis of the data indicated that caregivers who felt more comfortable providing oral hygiene for consumers who physically resisted the care experienced a higher frequency of consumers not opening their mouths (p = 0.0003), pushing the caregiver away (p = 0.0002), moving their heads uncontrollably (p = 0.0004), spitting at (p = 0.0099), hitting and/or kicking the caregiver (p = 0.0011). Furthermore, these caregivers provided weekly direct care for a greater number of consumers (p = 0.0044), received oral care training from their current facility (p = 0.0424), brushed the teeth of uncooperative consumers at least 75% of the time (p < 0.0001), and felt "somewhat comfortable to very comfortable" flossing their teeth (p < 0.0001). The caregivers' comfort level in providing oral hygiene measures to those consumers with SHCN who physically resist the care appears to be significantly associated with their training and experience working with this population.
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