Intra- and interobserver reliability of nurses and dentists in the assessment and screening of oral conditions of institutionalized older adults

Larissa Gregório Silva, Jessica Thomaz, A. L. S. F. Mello, Betina Fantuzzi, Sissiane Margreiter, D. Figueiredo
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Abstract

Abstract Introduction older persons in Long-Term Care (LTC) facilities have functional impairments and a higher disease prevalence. Nurses’ comprehensive assessment of older persons’ health is highlighted, including using tools for screening dental treatment needs. Objective to report the intra- and inter-observer reliability of older adults’ oral health assessment in LTC facilities by video. Material and method descriptive study, in three LTC facilities, in the Florianópolis region, Southern Brazil. Data were collected according to Oral Health Assessment Tool (OHAT), which presents 8 categories (“lips, tongue, gums/tissues, saliva, natural teeth, dentures, dental hygiene, and toothache”), and the scores 0=healthy, 1=presence of changes (could be a need for care), 2=unhealthy (need for dental service); final score from 0 to 16. In each LTC facility, a Nurse assessed oral conditions and made a video of each older adult using a smartphone. The dentist performed the oral health assessment through the videos. Estimated Kappa test, p<0.05. Result the sample was 34 older adults, 71% were female. Interobserver reliability between Nurses 1 and 2 and Dentist for “lips” and “natural teeth” was classified as poor and excellent/very good for toothache and denture conditions. The nurse’s intraobserver reliability was classified as weak for the “natural teeth” assessment. Conclusion the OHAT showed reliability for assessing denture conditions and pain. However, nurses’ training for recognizing oral conditions that require dental care is suggested, as well as the management of this action by the dentist and LTC facilities.
护士和牙医在机构老年人口腔状况评估和筛查中的观察者内部和观察者之间的可靠性
长期护理(LTC)设施中的老年人具有功能障碍和较高的疾病患病率。强调护士对老年人健康的全面评估,包括使用工具筛选牙科治疗需求。目的探讨LTC老年人口腔健康视频评估的内部和内部信度。材料和方法描述性研究,在三个LTC设施,在Florianópolis地区,巴西南部。数据是根据口腔健康评估工具(OHAT)收集的,其中包括8个类别(“嘴唇、舌头、牙龈/组织、唾液、天然牙齿、假牙、牙齿卫生和牙痛”),得分为0=健康,1=存在变化(可能需要护理),2=不健康(需要牙科服务);最终比分从0到16。在每个LTC设施中,一名护士评估了口腔状况,并用智能手机为每位老年人拍摄了视频。牙医通过视频进行了口腔健康评估。估计Kappa检验,p<0.05。结果样本为34名老年人,其中71%为女性。护士1和护士2与牙医对“嘴唇”和“天然牙齿”的观察者间信度分为差和优/极好。在“自然牙”评估中,护士的观察者内信度被归类为弱。结论OHAT是评估义齿状况和疼痛的可靠方法。然而,建议对护士进行识别需要牙科护理的口腔状况的培训,以及牙医和LTC机构对这一行动的管理。
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