Measuring Self-Efficacy and Attitudes for Providing Mouth Care in Nursing Homes |
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| Affiliation: | 1. The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC;2. School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC;3. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC;4. Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC;1. Department of Emergency Medicine, Changi General Hospital, Singapore;2. Department of Geriatric Medicine, Changi General Hospital, Singapore;3. Advanced Diploma Nursing (Emergency Medicine), Nanyang Polytechnic, Singapore;4. Clinical Services, Changi General Hospital, Singapore;5. Health Services Research, Changi General Hospital, Singapore;6. Saint Andrew''s Community Hospital, Singapore;1. Department of Internal Medicine, Division of Endocrinology and Metabolism, Eastern Virginia Medical School, Norfolk, VA;2. Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA;3. School of Health Professions, Eastern Virginia Medical School, Norfolk, VA;4. School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA;5. Human Movement Sciences Department, Old Dominion University, Norfolk, VA;6. Department of Internal Medicine, National Taiwan University Hospital, Yun Lin Branch, Taiwan;7. Department of Psychology, Old Dominion University, Norfolk, VA;1. Videbimus Clinic Research Center, Tokyo, Japan;2. Department of Primary Care and Population Health, University College London, London, United Kingdom;3. Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan;4. Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Tsukuba, Japan |
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| Abstract: | ObjectivesMouth care is increasingly recognized as an important component of care in nursing homes (NHs), yet is known to be deficient. To promote quality improvement and inform research efforts, it is necessary to have valid measures of staff self-efficacy and attitudes to provide mouth care.DesignA self-administered questionnaire completed by NH staff, information about the NH obtained from the administrator, and oral hygiene assessments of NH residents.Setting and ParticipantsA total of 434 staff in 14 NHs in North Carolina who were participating in a cluster randomized pragmatic trial of Mouth Care Without a Battle (MCWB).MethodsStaff in MCWB homes completed the questionnaire at baseline; staff in control homes completed it at 2-year follow-up. The 35-item questionnaire used new items and those from previous measures, many of which were modified for the NH setting. Factorial, construct, and criterion validity were assessed.ResultsExploratory factor analysis identified a 3-factor 11-item self-efficacy scale (promoting oral hygiene, providing mouth care, obtaining cooperation) named “Self-Efficacy for Providing Mouth Care” (SE-PMC), and a 2-factor 11-item attitudes scale (care of residents' teeth, care of own teeth), named Attitudes for Providing Mouth Care (A-PMC). Scores varied significantly across NHs and differentiated them based on profit status, age, and, for the A-PMC, NH size. Scores also differentiated among staff based on age and, for the SE-PMC, years of experience. In NHs where staff scored more highly, residents featured better oral hygiene (P < .001).Conclusions and ImplicationsThe SE-PMC and A-PMC are valid, parsimonious, and useful measures for quality improvement and research to improve mouth care in NHs that can be used jointly or individually. Preliminary evidence suggests that these scales may be associated with resident-level plaque and gingival hygiene, making them useful tools to assess promotion of mouth care. |
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| Keywords: | Mouth care nursing homes measurement quality improvement |
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