| Summary: | 碩士 === 國立臺北護理健康大學 === 長期照護研究所 === 99 === As the consequence of an aging society, dementia has become an issue highly concerned by health institutes all over the world. Patients suffering from dementia gradually lose their cognitive functions, and this even causes negative impact on their ability to take care of their own health. A frequently seen problem is that of the patients’ oral hygiene, which, if failed to maintain, can not only cause health problems related to the mouth, but may even expose the patient to systematic infections, which can be deadly . While the body and cognitive function impairment seen in institute dementia residents remains a common phenomenon, nursing assistants are usually required to help perform the oral hygiene tasks. Nevertheless, it seems that the proficiency and training of institute nursing assistants in oral hygiene care remain insufficient, which is worsen by heavy tasks, time pressure or rejection by residents – bite from residents in such cases may also hinder the willingness of nursing assistants in performing oral care, consequently causes potential threat to the oral hygiene of the dementia residents. In 2003, WHO has already called attention to oral health issues, whereas the Department of Health (DOH) also echoed by issuing “Oral Health Act” and “Oral Health for People with Disabilities Five-Year Plan” in 2005 and 2008 respectively; in which DOH called for strengthened oral health care to senior citizens and the disabled as well as better oral hygiene proficiency of the nursing assistants; the urgent need of dementia residents’ oral health care is hence highlighted. Therefore, this research aims to probe the current situation how oral health care is performed by institute nursing assistants for dementia residents, while also analyzing other related factors and behaviors.
A cross-sectional study is applied for the study purposes. Data collection is done through a questionnaire survey which aims at native nursing assistants taking care of dementia residents in five long-term caring institutes in the north district equipped with special dementia care, and 109 effective samples in total are acquired. The research questionnaire include: the scale of knowledge of oral hygiene, oral hygiene attitude scale, oral hygiene behavior scale, dementia behavior problem scale and so on.
The study results show that nursing behaviors which institutional nursing assistants perform to maintain dementia residents’ oral hygiene tends to medium-good level (Mean = 61.63; SD = 8.33), whereas oral hygiene nursing knowledge remains good (Mean = 8; SD = 1.6), and oral hygiene nursing attitude tends to medium-high level (Mean = 30.53; SD = 4.26). Among factors which influence oral hygiene behaviors, the more positively nursing assistants will perform if the less troubled they are by dementia residents’ behavior, the more sufficient time they spend on performing oral nursing care, and the more positive oral nursing attitude they maintain. In addition, the predictors for oral hygiene care behaviors model of institute nursing assistants are: the attitude of oral hygiene care and the degree of the troubled behaviors caused by dementia resident.
From the result of this research, the following suggestions can be made: while reaction methods to dementia resident behavior can be further strengthened in the in-service education of nursing assistants in the future, positive attitude of nursing assistants can also be reinforced through different work experience sharing. Moreover, knowledge to environment setup prior to oral hygiene care should be enhanced. Nursing assistants should be reminded to help dementia residents to the washroom. It is recommend that while executing oral nursing care, nursing assistants can play the same theme music and perform neck-shoulder massage for dementia residents, which may help to reduce problem behaviors by stabilizing the emotion of dementia residents, hence to promote the higher quality of oral hygiene care.
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