ประสิทธิผลในการใช้การสัมภาษณ์เพื่อเสริมสร้างแรงจูงใจผู้ดูแลในการดูแลสุขภาพช่องปากของผู้สูงอายุติดเตียง

Abstract

Aim: The purposes of this study were to compare the effectiveness on promoting oral health care for bedridden elderly people between applying motivational interviewing (MI) and conventional dental health education (CDE), and to understand the reasons and conditions towards the changes in oral health care for those elders. Materials and Methods: The design of this study was a mixed method based on an explanatory sequential design comprising a randomized controlled trial with single blinded method and supported by an in-depth interview. Sixty-two elders and family caregivers in Krabi Province were randomly assigned to an intervention or a control group. In the 3 months' follow- up 28 and 26 participants remained in the intervention and control-groups, respectively. Ten informants were selected by intensity sampling technique for qualitative data collection. Results: At baseline, there were no significant differences between the intervention and control groups on levels of plaque index, oral health behavior care for elders as well as general characteristics of elders and caregivers except elder's diet types, number of permanent teeth, caregivers' education and age (p<0.05). At 3 months' follow-up, there were no significant differences of level of plaque index between groups, but dental plaque index of each group was decreased compared with their baselines. In addition, the proportion of appropriate oral health care for the elders in the intervention group was significantly different from the control group (p<0.05). Furthermore, level of positive attitudes towards oral health care, perceived susceptibility on oral health were also increased at 3 months' follow-up in an intervention-group. The qualitative study suggested that a hands-on experience was a key factor to improve tooth cleaning skills. Applying MI was able to support the internal motives and raise awareness of caregivers to provide oral hygiene care suitable for bedridden elderly people's context. However, using MI may not solve the problems from the external conditions such as improper physical environment.