Performance of Non-Dental Professional Caregivers in Oral Health Assessment Using the Oral Health Screener: Caregiver-Dentist Agreement and Inter-Rater Reliability.
Patricia Ann Ivonne Vandenbulcke, Dries De Witte, Emilie Schoebrechts, Jan De Lepeleire, Anja Declercq, Dominique Declerck, Joke Duyck, Johanna de Almeida Mello
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引用次数: 0
Abstract
Objective: To evaluate caregiver-dentist agreement and inter-rater reliability of the Oral Health Screener (OHS) following its optimisation for use in long-term care and to examine the effect of different caregiver OHS training modalities.
Methods: This prospective reliability and agreement study was nested within a 2-year cluster-randomised controlled trial in Flemish nursing homes (Belgium). Professional caregivers and dentists independently assessed residents' oral health using the OHS every 6 months across five timepoints, blinded to each other's assessments. Caregivers received either e-learning only (IG1) or e-learning combined with on-site training (IG2). Agreement was analysed using percent agreement, Cohen's kappa, prevalence-adjusted bias-adjusted kappa (PABAK) and logistic generalised linear mixed models (GLMM).
Results: Fifty-one caregivers from six facilities and eight dentists assessed 193 residents. Within groups, IG1 showed higher agreement with dentists for self-reported items (GLMM 0.46-0.58) than for inspection-based OHS items (GLMM 0.10-0.48), whereas this difference was less pronounced in IG2 (self-reported items: GLMM 0.45-0.95, inspection-based items: GLMM 0.35-0.92). Comparing groups, GLMM analyses indicated overall higher reliability in IG2 for most items, except for chewing difficulty. Exploratory analyses suggested that longitudinal patterns varied across items. Inter-caregiver reliability analyses were exploratory due to the limited number of paired assessments.
Conclusion: Non-dental professional caregivers showed acceptable agreement with dentists when assessing residents' oral health using the OHS. Although agreement varied across items due to prevalence and marginal imbalances, the findings suggest the potential added value of training and support when using the OHS as a first-line screening tool in care-dependent older adults.
期刊介绍：
The ultimate aim of Gerodontology is to improve the quality of life and oral health of older people. The boundaries of most conventional dental specialties must be repeatedly crossed to provide optimal dental care for older people. In addition, management of other health problems impacts on dental care and clinicians need knowledge in these numerous overlapping areas. Bringing together these diverse topics within one journal serves clinicians who are seeking to read and to publish papers across a broad spectrum of specialties. This journal provides the juxtaposition of papers from traditional specialties but which share this patient-centred interest, providing a synergy that serves progress in the subject of gerodontology.
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