Fersiynau electronig



  • Annie Hendry
  • Sarah Baker
    University of Sheffield
  • Gerry McKenna
    Queen's University, Belfast
  • Georgios Tsakos
    University College London
  • Ivor Chestnutt
    School of Healthcare Sciences, Cardiff University
  • Craig Smith
    University of Manchester
  • Vicki Jones
    Aneurin Beval University Health Board
  • Ciaran O'Neill
    Queen's University, Belfast
  • Alison Jenkins
  • Rachel Evans
  • Saif Sayeed Syed
    University College London
  • Afshan Mirza
    University College London
  • Michelle Harvey
    Queen's University, Belfast
  • Anup Karki
    Public Health Wales
  • Kirstie Moons
    Health Education and Improvement Wales
  • Fiona Sandom
    Health Education and Improvement Wales
  • Michael Donaldson
    Health & Social Care Board, Northern Ireland
  • Caroline Lappin
    Community Dental Services, South Eastern Trust, Belfast
  • Karen Shepherd
    Patient and public involvement representative
  • Paul Brocklehurst
    Public Health Wales
SENIOR (uSing rolE-substitutioN In care homes to improve oRal health) is a randomised controlled trial designed to determine whether role substitution could improve oral health for this population. A parallel process evaluation was undertaken to understand context. This paper reports on the first phase of the process evaluation.

The oral health and quality-of-life of older adults residing in care homes is poorer than those in the community. Oral health care provision is often unavailable and a concern and challenge for managers. The use of Dental Therapists and Dental Nurses rather than dentists could potentially meet these needs.

Materials and Methods
Semi-structured interviews were conducted with 21 key stakeholders who either worked or had experience of dependent care settings. Questions were theoretically informed by the: Promoting Action on Research Implementation in Health Services (PAHRIS) framework. The focus was on contextual factors that could influence adoption in practice and the pathway-to-impact. Interviews were fully transcribed and analysed thematically.

Three themes (receptive context, culture, and leadership) and 11 codes were generated. Data show the complexity of the setting and contextual factors that may work as barriers and facilitators to intervention delivery. Managers are aware of the issues regarding oral health and seek to provide best care, but face many challenges including staff turnover, time pressures, competing needs, access to services, and financial constraints. Dental professionals recognise the need for improvement and view role substitution as a viable alternative to current practice.

Although role substitution could potentially meet the needs of this population, an in-depth understanding of contextual factors appeared important in understanding intervention delivery and implementation.
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Tudalennau (o-i)1-12
StatwsE-gyhoeddi cyn argraffu - 27 Maw 2024
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