Perceptions of nurses towards oral health in palliative care: A qualitative study

Kong, Ariana C; George, Ajesh; Villarosa, Amy R.; Agar, Meera; Harlum, Janeane; Wiltshire, Jennifer; Srinivas, Ravi; Parker, Deborah

doi:10.1016/j.colegn.2020.04.001

Cited by 9 publications

(14 citation statements)

References 19 publications

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“…Despite the RNs united view that oral health is an important part of the patient’s overall health near the end of life, the theme “Oral health is easily overlooked in palliative care” revealed that the perceived importance is not always visible through the RNs’ caring acts. The RNs’ reflections showed that oral health is easily forgotten, missed or lost among their scattered assignments, in line with previous research showing negligence with respect to oral health [ 37 , 38 ]. The present study indicates that the neglect of oral health in these patients is mainly related to the multifaceted nature of the responsibilities of the nursing profession in this field, as opposed to other studies which have pointed out lack of time as a major cause [ 37 – 39 ].…”

Section: Discussionsupporting

confidence: 86%

“…The RNs’ reflections showed that oral health is easily forgotten, missed or lost among their scattered assignments, in line with previous research showing negligence with respect to oral health [ 37 , 38 ]. The present study indicates that the neglect of oral health in these patients is mainly related to the multifaceted nature of the responsibilities of the nursing profession in this field, as opposed to other studies which have pointed out lack of time as a major cause [ 37 – 39 ]. Could the stated argument “lack of time”, as found in previous research, been used as an evasion, a method to avoid confronting the neglect of oral health?…”

Section: Discussionsupporting

confidence: 86%

“…For oral care in palliative settings and end-of-life care to take place and attract more attention, it seems reasonable to suggest an increased focus on oral health within healthcare education curricula, at both basic and higher levels, and on a continuing basis in the work place, in line with previous suggestions [ 38 ]. The RNs in the present study also called for memos and guidelines concerning oral health in palliative care since they are conspicuous by their absence, as noted earlier [ 16 , 37 ]. If these measures were undertaken, healthcare staff would possibly have more knowledge, increased awareness as well as tools to handle oral health problems.…”

Section: Discussionmentioning

confidence: 74%

“…This is the moment when their full responsibility seems to dawn on the RNs, leading to actions being taken. Although this has been confirmed by others [ 38 ], research has also indicated there is a risk that oral care continues to be disregarded, even near the end of life [ 37 ].…”

Section: Discussionmentioning

confidence: 81%

“…The RNs also raised that it is important to have proper knowledge concerning oral health for the subject to be addressed. The lack of both awareness of, and education about, oral health within palliative care has previously been targeted in research [ 16 , 37 , 38 , 44 ], and described as resulting in health professionals turning “a blind eye on oral care issues” [ 16 ]. In an intervention for RNs in the form of a two-day education on end-of-life the participants ranked knowledge about oral health as one of the most important gains [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

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Oral health plays second fiddle in palliative care: an interview study with registered nurses in home healthcare

Gustafsson

Skogsberg²,

Rejnö

2021

BMC Palliat Care

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Background Oral health is crucial to the experience of well-being, and symptoms from the mouth are common at the end of life. Palliative care aims to identify and treat symptoms early to avoid unnecessary suffering and is thus an important part of nursing in home healthcare. The aim of this study was to illustrate the professional reflections of registered nurses about oral health amongst patients in palliative care, who are being cared for in a home healthcare setting. Results The results showed oral health in end-of-life care, to be an area marked by responsibility and ethical considerations. This was seen in all four partly overlapping themes that emerged through the analysis: Oral health is easily overlooked in palliative care, Oral health is everybody’s but in reality nobody’s responsibility, Patient integrity can be an obstacle for oral health, and Focus on oral health is urgently needed. The mouth is often not included as part of the daily basic care routine, by the registered nurses and the home healthcare staff, until the patient is near end of life. Moreover, neither does the patient tell about symptoms from the mouth. The interpreted whole indicates that the registered nurses had a bad conscience about not doing what they are actually responsible for and ought to do. Conclusion The oral health of patients at the end of life risks being forgotten or falling between the cracks, due to the nurses’ scattered tasks and unclear delimitations between their, and other professionals’ responsibilities. The responsibilities of registered nurses are also ethically demanding, since their intent to respect the patient’s integrity could mean that in some cases the patients does not allow them to help with oral health. To reduce the risk that oral health is overlooked, clearer demarcation and guidelines on the division of responsibilities are required. Routines that clearly implement early and recurring oral health assessments in home healthcare as well as continuing education updates on oral health and oral care are also needed.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Oral health plays second fiddle in palliative care: an interview study with registered nurses in home healthcare

Gustafsson

Skogsberg²,

Rejnö

2021

BMC Palliat Care

View full text Add to dashboard Cite

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Relieving Perception of Thirst and Xerostomia in Patients with Palliative and End-of-life Care Needs: A Rapid Review

Chakraborty

Thorpe

O'Loughlin

et al. 2023

Journal of Pain and Symptom Management

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Oral hygiene care and the management of oral symptoms in patients with cancer in palliative care: a mixed methods systematic review protocol

Serra,

de Oliveira,

Roque

et al. 2023

JBI Evidence Synthesis

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Objective: The objective of this review is to examine the effectiveness of oral hygiene care in the management of oral symptoms of cancer patients under specialist palliative care and the patients’ experience of such symptoms and care. Introduction: Oral symptoms, such as xerostomia, mouth pain or dysgeusia, are highly prevalent in specialist palliative care cancer patients and have a negative effect on their quality of life. Oral hygiene care can manage oral symptoms and could be improved with a more systematized approach, adequate guidelines, and training to properly integrate oral hygiene care into the care provided in specialist palliative care. Inclusion criteria: This review will consider quantitative, qualitative, and mixed methods studies on the effectiveness and experience of oral hygiene care intended to manage oral symptoms of adult cancer patients aged 18 years or older, diagnosed with any type of cancer, under specialist palliative care. Methods: The search will be conducted in MEDLINE (PubMed), CINAHL (EBSCO), Cochrane Central Register of Controlled Trials, Dentistry and Oral Sciences Source (EBSCO), and MedicLatina (EBSCO). Sources of unpublished studies and gray literature to be searched will include Networked Digital Library of Theses and Dissertations and Repositórios Científicos de Acesso Aberto de Portugal. Studies in English, Portuguese, and Spanish from 2000 to the present will be considered. Methodological quality will be assessed and data will be extracted. Synthesis and integration will follow the JBI segregated approach for mixed methods reviews. Review registration: PROSPERO CRD42023400554

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Perceptions of nurses towards oral health in palliative care: A qualitative study

Cited by 9 publications

References 19 publications

Oral health plays second fiddle in palliative care: an interview study with registered nurses in home healthcare

Oral health plays second fiddle in palliative care: an interview study with registered nurses in home healthcare

Relieving Perception of Thirst and Xerostomia in Patients with Palliative and End-of-life Care Needs: A Rapid Review

Oral hygiene care and the management of oral symptoms in patients with cancer in palliative care: a mixed methods systematic review protocol

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