Background: Regular inspection of the oral cavity is required for prevention, early diagnosis and risk reduction of oral- and general health-related problems. Assessments to inspect the oral cavity have been designed for non-dental healthcare professionals, like nurses. The purpose of this systematic review was to evaluate the content and the measurement properties of oral health assessments for use by non-dental healthcare professionals in assessing older peoples’ oral health, in order to provide recommendations for practice, policy, and research. Methods: A systematic search in PubMed, EMBASE.com, and Cinahl (via Ebsco) has been performed. Search terms referring to ‘oral health assessments’, ‘non-dental healthcare professionals’ and ‘older people (60+)’ were used. Two reviewers individually performed title/abstract, and full-text screening for eligibility. The included studies have investigated at least one measurement property (validity/reliability) and were evaluated on their methodological quality using “The Consensus-based Standards for the selection of health Measurement Instruments” (COSMIN) checklist. The measurement properties were then scored using quality criteria (positive/negative/indeterminate). Results: Out of 879 hits, 18 studies were included in this review. Five studies showed good methodological quality on at least one measurement property and 14 studies showed poor methodological quality on some of their measurement properties. None of the studies assessed all measurement properties of the COSMIN. In total eight oral health assessments were found: the Revised Oral Assessment Guide (ROAG); the Minimum Data Set (MDS), with oral health component; the Oral Health Assessment Tool (OHAT); The Holistic Reliable Oral Assessment Tool (THROAT); Dental Hygiene Registration (DHR); Mucosal Plaque Score (MPS); The Brief Oral Health Screening Examination (BOHSE) and the Oral Assessment Sheet (OAS). Most frequently assessed items were: lips, mucosa membrane, tongue, gums, teeth, denture, saliva, and oral hygiene. Conclusion: Taken into account the scarce evidence of the proposed assessments, the OHAT and ROAG are most complete in their included oral health items and are of best methodological quality in combination with positive quality criteria on their measurement properties. Non-dental healthcare professionals, policymakers and researchers should be aware of the methodological limitations of the available oral health assessments and realize that the quality of the measurement properties remains uncertain.
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Background: Geriatric rehabilitation positively influences health outcomes in older adults after acute events. Integrating mobile health (mHealth) technologies with geriatric rehabilitation may further improve outcomes by increasing therapy time and independence, potentially enhancing functional recovery. Previous reviews have highlighted positive outcomes but also the need for further investigation of populations receiving geriatric rehabilitation. Objective: Our main objective was to assess the effects of mHealth applications on the health status of older adults after acute events. A secondary objective was to examine the structure and process elements reported in these studies. Methods: Systematic review, including studies from 2010 to January 2024. Studies were eligible if they involved older adults’ post-acute care and used mHealth interventions, measured health outcomes and compared intervention and control groups. The adjusted Donabedian Structure-Process-Outcome (SPO) framework was used to present reported intervention processes and structures. Results: After initial and secondary screenings of the literature, a total of nine studies reporting 26 health outcomes were included. mHealth interventions ranged from mobile apps to wearables to web platforms. While most outcomes showed improvement in both the intervention and control groups, a majority favored the intervention groups. Reporting of integration into daily practice was minimal. Conclusion: While mHealth shows positive effects on health status in geriatric rehabilitation, the variability in outcomes and methodologies among studies, along with a generally high risk of bias, suggest cautious interpretation. Standardized measurement approaches and co-created interventions are needed to enhance successful uptake into blended care and keep geriatric rehabilitation accessible and affordable.
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Abstract Objective: To describe changes in the health service delivery process experienced by professionals, patients and informal caregivers during implementation of a national programme to improve quality of care of geriatric rehabilitation by improving integration of health service delivery processes. Study setting: Sixteen skilled nursing facilities. Study design: Prospective study, comparing three consecutive cohorts. Data collection: Professionals (elderly care physicians, physiotherapists and nursing staff) rated four domains of health service delivery at admission and at discharge of 1075 patients. In addition, these patients [median age 79 (Interquartile range 71–85) years, 63% females] and their informal caregivers rated their experiences on these domains 4 weeks after discharge. Principal findings: During the three consecutive cohorts, professionals reported improvement on the domain team cooperation, including assessment for intensive treatment and information transfer among professionals. Fewer improvements were reported within the domains alignment with patients’ needs, care coordination and care quality. Between the cohorts, according to patients (n = 521) and informal caregivers (n = 319) there were no changes in the four domains of health service delivery. Conclusion: This national programme resulted in small improvements in team cooperation as reported by the professionals. No effects were found on patients’ and informal caregivers’ perceptions of health service delivery.
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In het PRIMa mond CARE project wordt onderzocht in hoeverre de mondgezondheid bijdraagt aan de voorspelling van kwetsbaarheid bij thuiswondende ouderen.Doel Het doel van het PRIMa mond CARE project is te onderzoeken in hoeverre mondgezondheid bijdraagt aan de voorspelling van kwetsbaarheid bij thuiswonende ouderen. Resultaten Voor het onderzoek zijn 1202 ouderen geïncludeerd, waarvan 45% mannen. De gemiddelde leeftijd van de participanten was 73 jaar. De eerste resultaten laten verbanden zien tussen kwetsbaarheid en onderstaande gezondheidsfactoren: • het bezoeken van de tandarts voor een spoedconsult; • het ervaren van ongemakken in de mond; • het aanpassen van de voeding als gevolg van ongemakken in de mond en • het dragen van een gebitsprothese. De volgende artikelen over dit onderzoek zijn inmiddels gepubliceerd: 'Probing problems and priorities in oral health among community dwelling elderly in the Netherlands' in het International Journal of Health Sciences and Research. In het International Journal of Health Services is het artikel 'Needs in Sevice Provision for Older People: An comparison Between Greater Manchester (United Kingdom) and Utrecht (the Netherlands)' gepubliceerd. Recentelijk verscheen ‘’Measurement properties of oral health assessments for non-dental professionals in older people: a systematic review’’ in het BMC Geriatrics. Looptijd 01 november 2016 - 01 juli 2020 Aanpak De huisarts brengt met een softwareprogramma genaamd ‘’U-PRIM’’ de groep potentieel kwetsbare ouderen in kaart. De mensen uit deze screening komen in fase twee: U-CARE. Zij ontvangen een vragenlijst: de Groningen Frailty Indicator. Met de uitkomsten van de vragenlijsten worden de domeinen van kwetsbaarheid gedefinieerd. Deze mensen krijgen huisbezoek van een praktijkverpleegkundige die een zorgplan op maat maakt. De verpleegkundige screent tijdens dit bezoek de oudere ook op mondgezondheidsproblemen, naast de algemene gezondheidscontrole. Daarnaast zijn de gegevens uit het tandartsenbestand gekoppeld aan de gegevens van de huisarts. Ook zijn twee vragen over mondgezondheid toegevoegd aan de Groningen Frailty Indicator. Aan de deelnemers van het onderzoek is toestemming gevraagd om de tandartsgegevens op te vragen bij de tandarts en deze te koppelen aan de huisartsgegevens. Daarnaast zijn alle gegevens anoniem verwerkt.
