Barriers against Provision of Oral Healthcare Services to the Elderly: Views of Dentists and Managers of Elderly Care Centers
Journal of Dental School,
Vol. 39 No. 2 (2021),
13 April 2022
,
Page 42-47
https://doi.org/10.22037/jds.v39i2.35836
Abstract
Objectives The proportion of older people is increasing faster than other age groups. Evidence shows that older people receive less oral health services than what they need. The purpose of this study was to investigate the barriers against the provision of oral healthcare services to the elderly from the perspective of dentists and managers of elderly care centers (ECCs) in Tehran.
Methods This qualitative study was conducted using semi-structured interviews. The study population included managers of ECCs and dentists who work in the field of geriatric dentistry in Tehran. Participants were selected by purposive and convenience sampling. Interviews were continued until saturation of the information in both groups. The interviews included about 10 predetermined questions regarding different aspects of providing dental care services to the elderly. The Graneheim and Lundman’s qualitative approach was used for content analysis of the interviews.
Results The data reached saturation after conducting interviews with nine managers of the ECCs and seven dentists. Finally, five main themes were extracted by the content analysis including "problems related to accessing care", "problems related to disability", "financial problems", "problems related to dentists" and "problems related to policy-making”.
Conclusion Several barriers exist related to service recipients, service providers, and policy-makers against the provision of oral healthcare services to the elderly. Removing these barriers requires cooperation between the education, health, and treatment sectors of the Ministry of Health, the Welfare Organization, and professional dental organizations.
- Delivery of Health Care
- Dental Care for Aged
- Qualitative Research
How to Cite
References
2. Ahmadi A, Sahaf R, Rashedi V, Akbari Kamrani AA, Shati M, Delbari A. Relationship between oral health and demographic characteristics in retired elderly people in Iran. 2019.
3. Issrani R, Ammanagi R, Keluskar V. Geriatric dentistry–meet the need. Gerodontology. 2012;29(2):e1-e5.
4. Gershen J. Geriatric dentistry and prevention: research and public policy. Advances in dental research. 1991;5(1):69-73.
5. Hilton S, Sheppard JJ, Hemsley B. Feasibility of implementing oral health guidelines in residential care settings: views of nursing staff and residential care workers. Applied nursing research. 2016;30:194-203.
6. Montini T, Tseng T-Y, Patel H, Shelley D. Barriers to dental services for older adults. American journal of health behavior. 2014;38(5):781-8.
7. Willumsen T, Karlsen L, Næss R, Bjørntvedt S. Are the barriers to good oral hygiene in nursing homes within the nurses or the patients? Gerodontology. 2012;29(2):e748-e55.
8. Gil-Montoya JA, de Mello ALF, Barrios R, Gonzalez-Moles MA, Bravo M. Oral health in the elderly patient and its impact on general well-being: a nonsystematic review. Clinical interventions in aging. 2015;10:461.
9. Griffin SO, Barker LK, Griffin PM, Cleveland JL, Kohn W. Oral health needs among adults in the United States with chronic diseases. The journal of the American dental Association. 2009;140(10):1266-74.
10. Borreani E, Jones K, Wright D, Scambler S, Gallagher JE. Improving access to dental care for older people. Dental update. 2010;37(5):297-302.
11. Khoshnevisan M, Ghasemianpour M, Samadzadeh H, Baez R. Oral Health Status and Healthcare System in I.R. Iran. Journal of Contemporary Medical Sciences. 2018;4(3).
12. Patterson Norrie T, Villarosa AR, Kong AC, Clark S, Macdonald S, Srinivas R, et al. Oral health in residential aged care: Perceptions of nurses and management staff. Nursing open. 2020;7(2):536-46.
13. Hoben M, Clarke A, Huynh KT, Kobagi N, Kent A, Hu H, et al. Barriers and facilitators in providing oral care to nursing home residents, from the perspective of care aides: A systematic review and meta-analysis. International journal of nursing studies. 2017;73:34-51.
14. Bharti R, Chandra A, Tikku AP, Arya D, Gupta R. Oral care needs, barriers and challenges among elderly in India. The Journal of the Indian Prosthodontic Society. 2015;15(1):17.
15. Bots-VantSpijker P, Bruers J, Bots C, De Visschere L, Schols J. Dentists’ opinions on knowledge, attitudes and barriers in providing oral health care to older people living independently in the Netherlands and Flanders (Belgium). BDJ open. 2017;3(1):1-8.
16. Bots‐VantSpijker PC, Vanobbergen JN, Schols JM, Schaub RM, Bots CP, de Baat C. Barriers of delivering oral health care to older people experienced by dentists: a systematic literature review. Community dentistry and oral epidemiology. 2014;42(2):113-21.
17. Carson SJ, Edwards M. Barriers to providing dental care for older people. Evidence-based dentistry. 2014;15(1):14-5.
18. Hopcraft M, Morgan M, Satur J, Wright F. Dental service provision in Victorian residential aged care facilities. Australian dental journal. 2008;53(3):239-45.
19. Chung JP, Dent M, Mojon P, Budtz‐Jørgensen E. Dental care of elderly in nursing homes: perceptions of managers, nurses, and physicians. Special care in dentistry. 2000;20(1):12-7.
20. Helgeson M, Glassman P. Oral health delivery systems for older adults and people with disabilities. Special Care in Dentistry. 2013;33(4):177-89.
21. Kohli R, Nelson S, Ulrich S, Finch T, Hall K, Schwarz E. Dental care practices and oral health training for professional caregivers in long-term care facilities: An interdisciplinary approach to address oral health disparities. Geriatric Nursing. 2017;38(4):296-301.
22. Louise Barriball K, While A. Collecting Data using a semi‐structured interview: a discussion paper. Journal of advanced nursing. 1994;19(2):328-35.
23. May KA. Interview techniques in qualitative research: Concerns and challenges. Qualitative nursing research: A contemporary dialogue. 1991:188-201.
24. Opdenakker R, editor Advantages and disadvantages of four interview techniques in qualitative research. Forum qualitative sozialforschung/forum: Qualitative social research; 2006.
25. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today. 2004;24(2):105-12.
26. Lindgren B-M, Lundman B, Graneheim UH. Abstraction and interpretation during the qualitative content analysis process. International Journal of Nursing Studies. 2020:103632.
27. Gaszynska E, Szatko F, Godala M, Gaszynski T. Oral health status, dental treatment needs, and barriers to dental care of elderly care home residents in Lodz, Poland. Clinical interventions in aging. 2014;9:1637.
28. Choufani A, Folliguet M, El-Osta N, Rammal S, Doumit M. Oral health status and care of institutionalized elderly individuals in Lebanon. Indian Journal of Dental Research. 2020;31(4):507.
29. Singh H, Maharaj RG, Naidu R. Oral health among the elderly in 7 Latin American and Caribbean cities, 1999-2000: a cross-sectional study. BMC Oral Health. 2015;15(1):1-14.
30. Borrell LN, Northridge ME, Miller DB, Golembeski CA, Spielman SE, Sclar ED, et al. Oral health and health care for older adults: a spatial approach for addressing disparities and planning services. Special Care in Dentistry. 2006;26(6):252-6.
31. Davis DL, Reisine S. Barriers to dental care for older minority adults. Special Care in Dentistry. 2015;35(4):182-9.
32. Vujicic M, Buchmueller T, Klein R. Dental care presents the highest level of financial barriers, compared to other types of health care services. Health affairs. 2016;35(12):2176-82.
- Abstract Viewed: 198 times
- PDF Downloaded: 94 times