Barriers to and Facilitators of Oral Health Among Persons Living With Mental Illness: A Qualitative Study

Wright, Wanda; Averett, Paige; Benjamin, Janet; Nowlin, Jonathan P; Lee, Joseph G. L.; Anand, Vivek

doi:10.1176/appi.ps.201900535

Cited by 8 publications

(4 citation statements)

References 31 publications

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“…This is in contrast with the study that indicated that nurses need to assess oral health in somatic screening in order to improve oral health-related quality of life in patients diagnosed with a psychotic disorder. 29 In addition, the study conducted by Wright and associates 30 stated that lack of routine oral health examination and treatment in mental health care facilities has been reported as a problem both by persons living with mental illness and psychiatric nurses.…”

Section: Discussionmentioning

confidence: 99%

Nurses’ practice of metabolic monitoring for patients on antipsychotics in Lesotho

Matete,

Rathobei

2024

South African Journal of Psychiatry

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Background: Severe mental illness is associated with higher physical health morbidities and reduced life expectancy, with an estimated 14.3% of global deaths attributed to mental disorders. Antipsychotic medications (APs) used in treatment contribute to physical health issues, including metabolic and cardiovascular effects.Aim: The aim of this study was to assess nurses’ practices regarding metabolic monitoring for patients prescribed antipsychotic medications at Mohlomi Hospital in Lesotho.Setting: The study was conducted at Mohlomi Hospital, the primary psychiatric facility in Lesotho.Methods: Using a cross-sectional design, 44 nurses from Mohlomi Hospital participated in the study. A structured questionnaire assessed nurses’ metabolic monitoring practices.Results: Most of the respondents were female (n = 30, 75%), and minority were male (n = 10, 25%). The academic qualifications of respondents were distributed as follows: 40% (16) held a nursing assistant certificate and 22.5% (9) held an advanced nursing diploma, among others. The average age of all respondents was 39.05 (s.d. 8.9), with an average of 8 years of experience in psychiatry (s.d. 7.6). The overall rate of nurses’ practices of metabolic monitoring for patients taking antipsychotic medications showed variability, with a mean score of 2.83 (s.d. 0.524). However, only 20% performed ECG tests, 22.5% measured blood pressure, 27.5% tested for glucose abnormalities and 17.5% conducted lipid profile testing.Conclusion: Results revealed a significant gap in the practice of metabolic monitoring among nurses with various aspects of metabolic monitoring, not being adequately monitored.Contribution: The study’s findings shall inform policy and guidelines for monitoring patients on antipsychotic medications while guiding future research.

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Section: Discussionmentioning

confidence: 99%

Nurses’ practice of metabolic monitoring for patients on antipsychotics in Lesotho

Matete,

Rathobei

2024

South African Journal of Psychiatry

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“…Similar results were reported by a study conducted in the USA regarding barriers and facilitators for oral health among persons living with mental illness, in which the authors qualitatively explored the views of patients with mental illness, psychiatrists and dentists. The study reported dentists’ chair side manner, community support and interprofessional communication as important professional- and system-level facilitators for supporting the dental needs of patients with SMI [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Study Exploring the Barriers and Facilitators for Maintaining Oral Health and Using Dental Service in People with Severe Mental Illness: Perspectives from Service Users and Service Providers

Mishu

Faisal

Macnamara

et al. 2022

IJERPH

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People with severe mental illness suffer from a high burden of oral diseases, which can negatively impact their physical and mental well-being. Despite the high burden, they are less likely to engage in oral health care including accessing dental services. We aimed to identify both the service users’ and service providers’ perspective on the barriers and facilitators for maintaining oral health and dental service use in people with severe mental illness. Qualitative exploration was undertaken using dyadic or one-to-one in-depth interviews with service users in the UK with a diagnosis of schizophrenia, schizoaffective disorder or bipolar disorder. Service providers, including mental health and dental health professionals, and informal carers (people identified as family or friend who are not paid carers) were also interviewed. Thematic analysis of the data revealed three main cross-cutting themes at the personal, inter-personal and systems level: amelioration of the problem, using a tailored approach and provision of comprehensive support. The main barriers identified were impact of mental ill-health, lack of patient involvement and tailored approach, and accessibility and availability of dental services including lack of integration of services. The main facilitators identified were service providers’ effective communication skills and further support through the involvement of carers. The findings suggest that the integration of dental and mental health services to provide tailored support for overall health and well-being, including the oral health of the patient, can better support people with severe mental illness regarding their oral health needs.

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“…The presence of a psychiatric diagnosis has also been shown to negatively affect dental hygiene routines and dental visits ( 7 ). Additionally, psychiatric disorders may have an impact on the financial situation of the patient due to unemployment and sick leave, hence providing a reduced dental visit pattern ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

“…Patients with reduced mental health, particularly severe mental illness, are at greater risk of developing oral health problems due to a specter of potential risk factors such as high consumption of sugary substances, poor oral hygiene, self-neglect, dehydration, vitamin deficiency and concomitant misuse of substances such as tobacco and alcohol ( 5 , 9 , 11 ). The lack of routine oral health examination and treatment in mental health care facilities, has been reported as a problem both by persons living with mental illnesses and by psychiatrists themselves ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Exploring oral health indicators, oral health-related quality of life and nutritional aspects in 23 medicated patients from a short-term psychiatric ward

Frigaard

Hynne

Randsborg

et al. 2023

Front. Public Health

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BackgroundPatients suffering from psychiatric disorders face many difficulties due to their condition, medications and lifestyle. Oral health and nutrition may be affected, further complicating their lives. Our aim was to provide in-depth information on oral health and nutritional factors in a small group of patients in short-term psychiatric ward.MethodsTwenty-three patients (mean age 36, average medications five) were recruited during short-term hospitalization in a psychiatric ward. Inclusion criteria: anxiety, psychosis and/or depression, and use of at least one antidepressant or anxiolytic/antipsychotic drug with xerostomia as a known side effect. Subjective oral dryness was evaluated using the Shortened Xerostomia Inventory (SXI). Oral examination included Clinical Oral Dryness Score (CODS), secretion of unstimulated (UWS) and stimulated whole saliva (SWS), and evaluation of dental, gingival, and periodontal status. Self-reported complaints of oral disorders were recorded. The Oral Health Impact Profile-14 (OHIP-14) was used to explore oral health-related quality of life. Nutritional status was assessed using the Patient-Generated Subjective Global Assessment Short Form (PG-SGA-SF), and diet quality was assessed using the Mediterranean diet score (KIDMED).ResultsCompared to healthy controls, the patients had significantly higher SXI scores and CODS, and SWS secretion was lower. Complaints of dysgeusia and halitosis were significantly more frequent among patients. Gingivitis was more common in patients. OHIP-14 scores were much higher in the patients, and they reported significantly poorer oral and general health. Most patients lacked a regular meal pattern. Very low diet quality was observed in five patients, while improvements were needed in twelve. “Dry mouth” and “No appetite, just did not feel like eating” were the most common symptoms preventing patients from eating enough. The PG-SGA-SF symptoms component score showed a strong negative correlation with self-reported oral health, and a strong positive correlation with OHIP-14.ConclusionThis relatively small group of patients in short-term psychiatric ward had both reduced oral health and poor oral health-related quality of life. Furthermore, their nutritional intake was affected by their oral health problems. Although larger groups need to be studied, these findings indicate that oral health and nutrition should be evaluated and adjusted in these patients to improve their overall care.

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Barriers to and Facilitators of Oral Health Among Persons Living With Mental Illness: A Qualitative Study

Cited by 8 publications

References 31 publications

Nurses’ practice of metabolic monitoring for patients on antipsychotics in Lesotho

Nurses’ practice of metabolic monitoring for patients on antipsychotics in Lesotho

A Qualitative Study Exploring the Barriers and Facilitators for Maintaining Oral Health and Using Dental Service in People with Severe Mental Illness: Perspectives from Service Users and Service Providers

Exploring oral health indicators, oral health-related quality of life and nutritional aspects in 23 medicated patients from a short-term psychiatric ward

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