Syftet med denna litteraturstudie var att beskriva vilken utbildning, kunskap och attityd sjuksköterskor har inom munvård samt hur sjuksköterskor kan främja god munvård hos patienter i palliativ vård. En beskrivande litteraturstudie användes som metod där artiklar söktes i Cinahl och Pubmed (Medline). Där hittades tolv artiklar som sedan formade denna studie. Resultatet visade att många sjuksköterskor ansåg att de hade fått bristfällig utbildning i munvård under sin grundutbildning. Eftersom kunskapsnivån hos många sjuksköteskor var otillfredsställande har det framkommit att både personal och patienter inom den palliativa vården gynnas genom utbildning. Det fanns många negativa attityder kring munvård bland sjuksköterskor. Munvård prioriterades inte heller tillräckligt inom den palliativa vården enligt sjuksköterskor. Däremot ansåg de att det bör prioriteras bättre. Olika program och framtagna arbetsredskap har visat sig kunna underlätta arbetet för sjuksköterskor. Även patientutbildning har bidragit till att skapa en bättre munstatus. Slutsatsen av studien är att det finns brister i utbildning, kunskap och attityder inom munvård bland sjuksköteskor. För att ändra på detta vill sjuksköterskor ha mer utbildning och träning. På så vis kan bättre förutsättningar skapas för sjuksköterskan att främja god munvård för patienter i den palliativa vården. / The purpose of this literature study was to describe education, knowledge and attitudes among nurses regarding oral health care and in which way nurses can promote proper mouth care among patients within palliative care. A descriptive design was the method chosen, with articles obtained via Cinahl and Pubmed (Medline). Twelve articles were found that subsequently formed this study. The results showed that many nurses considered having recieved insufficient mouth care training during their education. Since the level of knowledge among many nurses was lacking it has been shown that both staff and patients within palliative care benefit from education. There were many negative attitudes about mouth care among nurses. Moreover, it was not prioritized enough within palliative care according to nurses. However, they felt that it should be. Different programs and developed tools have shown to facilitate nurses' work. Patient education has also contributed to a better mouth status. The conclusion of the study is that there are flaws in education, knowledge and attitudes about mouth care among nurses. To change this nurses want more education and training. Thus better condition can be created for nurses to promote proper mouth care for patients within palliative care.

published_or_final_version / Dentistry / Master / Master of Philosophy

No description available.

Bakgrund: munvård är en grundläggande omvårdnadsåtgärd som bidrar till att förebygga respirator-relaterad lunginflammation, s.k. VAP (”ventilator-associated pneumonia”) och en rad diverse systemiska infektioner. Trots vikten med munvård och förekomsten av PM som beskriver utförande av munhygien på intensivvårdsavdelningar, så tycks det vara en lågprioriterad handling hos intensivvårdspatienter. Syfte: att beskriva sjuksköterskans inställning kring munvård hos patienter som vårdas på intensivvårdsavdelning. Metod: kvantitativ studie med beskrivande design som grundas på statistisk analys av data insamlade utifrån ett enkätformulär. Resultat: denna enkätstudie visar att sjuksköterskor prioriterar munvård högt men samtidigt tycker de att det delvis är en undersköterskeuppgift och delegerar ofta uppgiften. Hinder som t.ex. brist på tid kan förklara denna inställning. De flesta sjuksköterskor kände till att det finns ett styrdokument gällande munvård på deras avdelning. Ett antal sjuksköterskor som inte kände till grundläggande munvårdsåtgärder för förebyggandet av VAP, visar bristfälligt kunskap om ämnet. Utbildningsnivå har konstaterats ha ett samband med sjusköterskans inställning kring munvård, då dessa sjuksköterskor har en högre prioritering kring denna åtgärd. Slutsatser: resultatet visar att sjuksköterskor är olika involverade i munvård hos patienter som är i behov av intensivvård. Förbättrad kunskap om evidensbaserad munvård skulle i positiv riktning ändra sjuksköterskans attityd kring munvård i allmänhet, förbättra kvalitén av vården i synnerhet samt minska sjukhusvistelse. Det skulle även leda till minskad mortalitet och utgifter för sjukvården. / Background: mouth care is a basic nursing activity which contributes to prevent ventilator associated pneumonia (VAP) and a number of different systemic infections. Despite the importance of mouth care and the presence of protocols which describe how to perform mouth hygiene in the intensive care units, there is still low priority in mouth care on the critically ill patient. Aim: to describe nurses attitude on mouth care in patients who takes care of in the intensive care unit. Method: quantitative study with a describing design which is based on the statistical analysis of data collected from a questionnaire. Results: this survey shows that nurses prioritizes mouth care high but at the same time they have the opinion that it is partly a nursing assistants’ task and often delegates it. Barriers like for example lack of time can explain this attitude. It was to the knowledge of most of the nurses that there is a policy on mouth care in their wards. A number of nurses, who did not know basic mouth care for preventing VAP, demonstrate lack of knowledge on the subject. Education level has shown to have a connection with nurses’ attitude about mouth care, when these nurses prioritize higher this action. Conclusions: the results show that nurses are at different levels involved in oral care of patients who are in need of intensive care.  An improved knowledge about evidence based mouth care would change nurses’ attitude in a positive direction in general, improve the quality of health care in particular and reduce hospital stay. It would also lower mortality and the economic strain on health care.

published_or_final_version / Dentistry / Master / Master of Dental Surgery

published_or_final_version / Dentistry / Master / Master of Dental Surgery

published_or_final_version / abstract / Dentistry / Doctoral / Doctor of Philosophy

published_or_final_version / abstract / Dentistry / Doctoral / Doctor of Philosophy

Background: Knowledge translation models to address existing knowledge gaps in different areas of speech-language pathology practice are providing researchers and clinicians the opportunity to improve efficiency and effectiveness of service delivery. As a developing context, public health care in South Africa can scarce afford the luxury of wasting resources and finances on interventions that are inefficient or without proven benefit given the increasing prevalence of chronic burden of disease such as stroke and traumatic related injury, both of which has dysphagia as a symptom. The outcome of the manner, efficiency and consistency of traditional models of dysphagia management currently being implemented in this context were compared to a pre-existing theoretically proven free water protocol for dysphagia management. Method: The primary aim of the current study was to enable knowledge-to-action translation in dysphagia management by determining the feasibility of using a free water protocol for stroke or traumatic brain injured patients presenting with dysphagia in an acute government hospital setting in Gauteng, South Africa. A mouth care training protocol was developed for nurses as a component of the free water protocol. Nurse perceptions on the training and implementation of mouth care were explored. The quantitative aims investigated if there was a difference between traditional and free water management in terms of a) the occurrence of aspiration pneumonia, b) amount of water intake and c) length of hospitalisation. 139 Nurses and 46 patients with dysphagia were participants. A mixed method design was used. The study was conducted in two phases, phase one comprised the ethnography and the nurse training component. Phase two was quantitative and comprised implementation of the free water protocol by the researcher. Thematic content analysis was used for the qualitative data. Quantitative data was analysed using inferential statistics. Results: The mouth care training protocol for nurses was efficient and effective for the current context. Nurses engaged positively with the study by implementing mouth care successfully when necessary for the dysphagic patients. This combined with consistent daily management of dysphagia with patient involvement, facilitated patient compliance, adequate levels of water intake, with no cases of dehydration, and no incidence of aspiration pneumonia at the end of the intervention period. The comparison group in contrast who received the traditional model of dysphagia management showed longer period of hospitalisation and higher consumption of liquids despite recommendations for liquid restricted diets. There were seven cases of aspiration pneumonia at the end of the intervention period in the comparison group. Conclusions & Implications: Despite no statistically significant differences between the study and comparison groups on the specified outcome measures, clinically significant differences were noted. The method employed in the study seemed to facilitate knowledge translation of the free water protocol to a public hospital context in South Africa. The findings of the study suggested that a collaborative partnership between the speech-language pathologist and nurse was attainable and this seemed to have multifaceted mutual benefits to the patient, institution and the respective professions. Improved monitoring of service provision, implementation of protocols based on contextual evidence, importance of knowledge translation in a developing context and an expanded role of the speech-language pathologist responsive to the needs of the context and patient population were some of the implications that arose from the study.

Includes bibliographical references (leaves 127-141)