Abstract
BackgroundThe 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, Humanitude™, was associated with an improvement in empathy for people with dementia among oral health care professionals.MethodsThis research was a pre-post prospective study. A total of 45 dentists and dental hygienists participated in a 7-h 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 1 month after the training (primary outcome). Each participant listed 3 patients with poor oral health due to the refusal of usual oral care or dental treatment from his or her clinical practice. 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 1 month after the training (secondary outcome).ResultsThe 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 with dementia who resisted usual oral care or dental treatment, as assessed by the OHAT, were significantly improved compared with those before the training.ConclusionsThe multimodal comprehensive care methodology training was associated with an improvement in oral health professionals’ empathy for patients with dementia. These findings suggest that randomized controlled trials with large sample sizes will be needed.Trial registrationUMIN 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
Highlights
The prevalence of oral diseases in people with dementia has increased, and patients with dementia have worse oral health than people without dementia
We examined a secondary outcome, i.e., oral health in patients with dementia, using the Oral Health Assessment Tool (OHAT) [17]
The information of the 132 patients who refused oral care or dental treatment listed by the participants was obtained
Summary
The prevalence of oral diseases in people with dementia has increased, and patients with dementia have worse oral health than people without dementia. In the provision of oral care, these patients often exhibit care-resistant behaviours. A study was conducted to assess whether a multimodal comprehensive care methodology training programme, HumanitudeTM, was associated with an improvement in empathy for people with dementia among oral health care professionals. Oral health care-resistant behaviour is a fear-evoked response to a caregiver’s unintentionally threatening behaviour during oral care. A previous study described the neurobiological principles of threat perception and fear response during oral care in patients with dementia [6]. Another reported the effectiveness of strategies based on the neurobiology of threat perception in preventing and reducing care-resistant behaviours during oral care [7]
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