ABSTRACT
Background and purpose: Oral health affects systemic health and the importance of maintaining good oral health is acknowledged. The high prevalence of oral diseases is associated with low health literacy (HL). Therefore, the purpose of this study was to investigate whether comprehensive HL in community-dwelling older adults is associated with objective oral hygiene and oral health-related quality of life (OHRQoL). Methods: Participants aged ≥65 years completed a self-administered questionnaire. On the same day, data collected with the oral health assessment tool were used to assess participants' objective oral status. The questionnaire included the general oral health assessment index to measure OHRQoL and the short version of the European Health Literacy Survey Questionnaire to assess comprehensive HL. Data were analyzed by univariate and multiple logistic regression. Results: In total, 145 people consented to participate in this study, of whom 118 (81.4%) responded effectively. Of the 118 participants, 18% recorded a rating of "unhealthy" for oral cleanliness in objective oral hygiene. Multiple logistic regression analysis identified comprehensive HL as a related factor for both oral cleanliness and OHRQoL (odds ratio = 5.00 and 3.33, p < 0.01 and p < 0.05, respectively). Implications for Practice: These findings indicate that comprehensive HL changes clinical outcomes. Because older adults often have comorbidities as well as oral health problems, it is important for nurses to assess HL during follow-up for comorbidities and take the opportunity to provide personalized oral health guidance and improve OHRQoL.
ABSTRACT
OBJECTIVE: This study aimed to investigate the incidence of postoperative pneumonia (PP) and surgical site infection (SSI) in head and neck cancer (HNC) patients and clarify the relationship between oral care and postoperative infection. METHODS: We conducted a retrospective observation survey based on the medical records of 209 HNC surgery patients managed at a University Hospital in 2016-2018. The incidence of PP and SSI were assessed in patients who underwent operations of the nose and paranasal sinuses to the larynx. Factors associated with PP and SSI in a univariate analysis were included in a multiple logistic regression analysis. A Cox proportional hazards model was used analyze the incidence of PP according to time after surgery. The present study was approved by the ethical review board of our Institute. RESULTS: The rates of PP and SSI in our study population were 20.5% and 23.0%. Operative time (P < 0.01), blood loss (P = 0.004), tracheostomy (P < 0.01), reconstruction (P < 0.01), and preoperative plaque control record (PCR) (P < 0.01) were significantly associated with PP. The PCR depicted the oral hygiene based on the percentage of plaque attached to the tooth neck. A multiple logistic regression analysis indicated that the incidence of PP was significantly higher in patients with PCR values of ≥50% after preoperative oral care (OR=10.174, 95% CI 2.14-48.32, P = 0.004). Tracheostomy (P < 0.01), reconstruction (P = 0.044), a lower preoperative albumin level (P = 0.019), and a lower preoperative hemoglobin level (P < 0.01) were significantly associated with SSI. CONCLUSIONS: The incidence of PP among patients who received oral care was high in those patients with high PCR values, indicating the importance of increasing compliance to preoperative oral care.