Abstract
Background: The prevalence of oral diseases in people with dementia has increased, and patients with dementia have worse oral health than people without dementia. However, in the provision of oral care, these patients often exhibit care-resistant behaviours. Empathy is important for health care professionals who provide dental care for people with dementia. A study was conducted to assess whether a multimodal comprehensive care methodology training programme: HumanitudeTM is associated with an improvement in empathy for people with dementia among oral health care professionals.Methods: This research was a pre-post prospective study. A total of 45 dentists and dental hygienists participated in a 7-hour multimodal comprehensive care methodology training programme. Participants’ empathy for their patients was evaluated with the Jefferson Scale of Physician Empathy-Health Professionals Version (JSPE-HP) before the training and one month after the training (primary outcome). Each participant listed 3 patients from his or her clinical practice for whom he or she felt difficulty to provide oral care due to dementia. The oral health of the 3 care-resistant patients listed by each participant was evaluated by the Oral Health Assessment Tool (OHAT) before the training and one month after the training (secondary outcome).Results: The post-training response rate was 87% (21 dentists and 18 dental hygienists). From pre-training to post-training, the multimodal comprehensive care methodology training significantly increased the mean empathy score (from 113.97 to 122.95, P<0.05, effect size=0.9). Regardless of gender, profession and years of clinical experience, all post-training subgroup scores were higher than the pre-training subgroup scores. The tongue, natural teeth, and oral hygiene scores of patients, as assessed by the OHAT, were significantly improved compared with those before the training.Conclusions: Multimodal comprehensive care methodology training was associated with an improvement in oral health professionals’ empathy for patients with dementia and an improvement in the oral health of their patients. These findings suggest that randomized controlled trials with large sample sizes will be needed.Trial registration: UMIN Clinical Trials Registry (UMIN-CTR), UMIN000041687. Registered 4 September 2020 – Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047586
Oral health care after the National Policy on Oral Health - "Smiling Brazil": a case study