A Human-Centered Design Approach to Develop Oral Health Nursing Interventions in Patients with a Psychotic Disorder

Abstract

In mental health, oral health is often given little attention. Mental health nurses (MHNs) are professionally the appropriate target group to support maintaining and increasing oral health. We aimed to develop and validate personas that reflect the attitudes and needs of MHNs regarding oral health in patients with a psychotic disorder. We used a human-centered design with contextual interviews (n = 10) to address the key issues of the problems and needs of MHNs working with patients with a psychotic disorder. We analyzed the data thematically and reflected on insights into unique personas, which were then validated by conducting semi-structured interviews (n = 19) and member checking. Four personas were found based on attitudes and perspectives, barriers, needs, suggestions for interventions, and site conditions regarding practicing oral care in this patient group. Our findings were as follows: the attitudes and perspectives differed from not feeling any responsibility to a holistic obligation, including oral health; suggestions for interventions for MHNs ranged from interventions focusing on improving skills and knowledge to using practical tools; most MHNs recognized themselves within a persona that had a holistic obligation that included oral health; in addition, the MHNs indicated that they considered the issue of oral health in this patient group important, but, in practice, took little responsibility for that role. These findings suggest that a toolkit with interventions for MHNs that are tailored to the personas that emerged from our research should be developed by MHNs in co-creation with designers. The differences between the perceived role and MHNs’ practice in oral health highlighted the need for role clarification and professional leadership of MHNs regarding oral health, which should be considered when developing interventions.

Life years lost for users of specialized mental healthcare

“…To start with, regular somatic screenings of patients with mental health problems should be imbedded in regular care. Herewith, health issues such as metabolic syndrome or poor oral health can be identified 43,44 . Then, appropriate treatment of the identified health issues should be offered by health services.…”

“…A strong collaboration between relevant health services such as general practitioners and institutions is crucial to follow up these health issues and to provide the best fitting treatment. Based on what is known from literature, improved collaboration between relevant health services and institutions 45 may improve identification of health issues such as metabolic syndrome or poor oral health, 43,44 and enable pathways for the treatment of such health‐related issues.…”

“…Herewith, health issues such as metabolic syndrome or poor oral health can be identified. 43,44 Then, appropriate treatment of the identified health issues should be offered by health services. A strong collaboration between relevant health services such as general practitioners and institutions is crucial to follow up these health issues and to provide the best fitting treatment.…”

“…Based on what is known from literature, improved collaboration between relevant health services and institutions 45 may improve identification of health issues such as metabolic syndrome or poor oral health, 43,44 and enable pathways for the treatment of such health-related issues.…”

The Development of an Oral Health Nursing Tool in Patients with a Psychotic Disorder: A Human-Centered Design with a Feasibility Test

“…Recent studies [7,23] show that a wide range of interventions must be developed for MHNs to support patients with psychotic disorders in maintaining and improving their oral health. Initially, MHNs must increase their sensitivity and alter their behaviour concerning oral health.…”