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Should oral care be about more than a gut feeling? A qualitative study investigating patients' and healthcare professionals' experiences

Abstract

Aim

To explore patients' and healthcare professionals' (HCPs) experiences of oral care during hospitalisation to identify needs and challenges.

Background

Daily oral care is important to patients' health and well-being, to prevent diseases in the oral cavity, systemic infections and increased morbidity, which subsequently can lead to prolonged hospitalisation and, at worst, increased mortality. Despite this knowledge, oral care is a neglected part of nursing practice. Studies do not clearly identify barriers regarding oral care, as the existing knowledge is inadequate.

Design

A qualitative study exploring participants' experiences to gain new in-depth knowledge of oral care among hospitalised patients.

Methods

A phenomenological-hermeneutic approach was applied. Participant observations were conducted on five hospital wards, combined with individual semi-structured interviews with 16 patients and 15 HCP. Data analysis was based on Ricoeur's theory of narrative and interpretation.

Results

Four themes describing the challenges regarding oral care emerged: Oral care as a gut feeling; oral care fades into the background; even self-reliant patients need help with oral care; and the mouth reflects the life lived.

Conclusions

The identified challenges show there is a need for improvement in the health professional approach to oral care in nursing practice. Focus on increasing HCPs' knowledge, skills and competences can increase their nursing agency and support patients' self-care capacity.

Impact

Investigation of oral care during hospitalisation revealed four main challenges concerning both patients' and HCPs' lack of knowledge and awareness of oral care. Thus, patients and HCPs should be included in developing solutions to improve oral care in nursing practice.

Reporting methods

The COREQ criteria for reporting qualitative research were adhered to.

Patient contribution

A patient representative was involved in the discussion of the proposal, conduct and results of the study.

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