The development and psychometric properties of oral health assessment instruments used by non-dental professionals for nursing home residents: a systematic review

Abstract

Background Globally, oral health status of the geriatric population residing in nursing homes is poor. The integration of non-dental professionals is vital to monitor oral health, early identification and triaging of oral health problems, and timely referral to dental professionals. The aims of this systematic review were to provide a summary on the development and characteristics of oral health assessment instruments currently used by non-dental professionals for nursing home residents, and to perform a critical appraisal of their psychometric properties. Methods This review was conducted as per the PRISMA guidelines. CINHAL (EBSCO), Medline (Ovid), and EMBASE (Ovid) were searched systematically. Two reviewers independently screened the title, abstract, and full text of the studies as per the eligibility criteria. Studies describing oral health assessment instruments used to assess oral health of nursing home residents by non-dental professionals were included. Using a methodological framework, each instrument was evaluated for purpose, content, and psychometric properties related to validity, reliability, feasibility, generalisability, and responsiveness. Additionally, the reporting quality assessment of each included study was performed according to the SURGE guidelines. Results Out of the 819 screened articles, 10 studies were included in this review. The 10 identified instruments integrated 2 to 12 categories to assess oral health, which was scored on a 2 to 5-point scale. However, the measurement content varied widely, and none were able to comprehensively measure all aspects of oral health. Three measurement approaches were identified: performance- based assessment, direct inspection of the oral health status, and interview measures. Only eight instruments provided quality assessment on the basis of validity, reliability, feasibility and generalisability, whereas three instruments- Brief Oral Health Status Examination, Dental Hygiene Registration, and Oral Health Assessment Tool reported good methodological quality on at least one assessment criteria. Conclusions None of the instruments identified in this review provided a comprehensive assessment of oral health, while three instruments appeared to be valid and reliable. Nonetheless, continuous development of instruments is essential to embrace the complete spectrum of oral health and address the psychometric gaps.

Development of the Turkish version of the oral health assessment tool: Methodological study

“…The forms used to collect data were prepared by the researchers in accordance with the relevant literature. 8,14,15,18,22 The data were collected via face-to-face interviews with the participants that included an oral examination. The participants were given information about the research prior to data collection.…”

“…Ensuring that elderly individuals attach due importance to these problems and evaluating the oral health of elderly individuals in cooperation with nurses can help minimize the adverse effects. 14,15 WHO states that oral healthcare systems are an indispensable part of primary healthcare services and that they should be strengthened in a manner that does not pose a financial burden on the individuals. 4 Public health nurses play a critical role in preventive healthcare services and are effective in determining how these services are received.…”

“…16 In the literature, there is a need for tools to be used by nurses for evaluating oral and dental health in the elderly, which can be included as a part of the comprehensive patient evaluation process. 15 In Turkey, the Geriatric Oral Health Assessment Index (GOHAI) is available to assess oral health. 17 This tool was developed and adapted based on self-report and was validated in the Turkish language.…”

A systematic review of measurement instruments for oral health assessment of older adults in long‐term care facilities by nondental professionals

“…Three previous systematic reviews analysed instruments for assessing the oral health of institutionalised 9 and noninstitutionalised 8,10 older adults by nondentist professionals. Of those, only one review evaluated the measurement properties of the instruments using a validated assessment tool, such as the Consensus‐based Standards to select health Measurement Instruments (COSMIN) and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).…”

“…[1][2][3][4][5] The use of valid and reliable instruments is essential for identifying oral health problems, allowing daily oral health care planning, and timely referral to dental services when necessary, 3,[5][6][7][8][9] although there is evidence that some may have methodological flaws. 8,9 Three previous systematic reviews analysed instruments for assessing the oral health of institutionalised 9 and noninstitutionalised 8,10 older adults by nondentist professionals. Of those, only one review evaluated the measurement properties of the instruments using a validated assessment tool, such as the Consensus-based Standards to select health Measurement Instruments (COSMIN) and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).…”