PALYATİF BAKIM HASTALARINDA YOĞUN BAKIM AĞIZ BAKIMI FREKANS DEĞERLENDİRME ÖLÇEĞİNİN (ICOCFAS) KULLANILMASI

Öz

Amaç: Yoğun Bakım Ağız Bakımı Frekans Değerlendirme Ölçeği (ICOCFAS)’nin palyatif bakım ünitesinde yatan hastalarda kullanılması amacıyla planlanmıştır. Gereç ve Yöntem: Araştırma tanımlayıcı ve kesitsel nitelikte, palyatif bakım ünitesinde yatan hastalar ile yapılmıştır. Araştırmaya, katılmayı kabul eden 70 hasta dahil edilmiş, veriler tanılama formu ve ICOCFAS kullanılarak aynı araştırmacı tarafından bir hafta ara ile değerlendirilmiştir. İlk değerlendirmede aldığı puana göre ağız bakım sıklığına karar verilmiş olup, son değerlendirmede ile karşılaştırılmıştır. Bulgular: Araştırmaya katılan hastaların yaş ortalaması 64.5, %68,6’sı erkek ve %74,3’ ilköğretim mezunudur. Paranteral beslenen hastalarda her iki ölçümde de ICOCFAS puanı anlamlı derecede daha yüksek bulunmuştur (p<0.001). Bireysel özelliklere göre incelendiğinde grupların çoğunda birinci ve ikinci ölçüm arasında anlamlı fark bulunmuştur (p<0.05). ICOCFAS birinci ve ikinci ölçüm alt parametrelerden alınan ortalama puanlar incelendiğinde dudaklar (p=0.003), dişler (p=0.019), dil (p<0.001) ve oral mukoza (p=0.015) puanlarında anlamlı farklılık olduğu ve ikinci ölçümde puanların daha düşük olduğu belirlenmiştir. Sonuç: ICOCFAS’ın palyatif bakım hastalarının ağız bakım sıklığına karar vermede faydalı olduğu, ağız içinde iyileşmeler olduğu gözlenmiştir.

Anahtar Kelimeler

• palyatif bakım
• ICOCFAS
• ağız bakım sıklığı

USE OF INTENSIVE CARE ORAL CARE FREQUENCY ASSESSMENT SCALE (ICOCFAS) IN PALLIATIVE CARE PATIENTS

Abstract

Aim: Intensive Care Oral Care Frequency Assessment Scale (ICOCFAS) was planned to be used in patients hospitalised in a palliative care unit. Material and Methods: This descriptive and cross-sectional study was conducted with patients hospitalised in a palliative care unit. The study included 70 patients who agreed to participate in the study, and the data were evaluated by the same researcher at one-week intervals using the diagnostic form and ICOCFAS. The frequency of oral care was decided according to the score obtained in the first evaluation and compared with the final evaluation. Results: The mean age of the patients who participated in the study was 64.5 years, 68.6% were male and 74.3% were primary school graduates. ICOCFAS score was found to be significantly higher in both measurements in parenterally fed patients (p<0.001). When analysed according to individual characteristics, a significant difference was found between the first and second measurement in most of the groups (p<0.05). When the mean scores obtained from ICOCFAS sub-parameters in the first and second measurements were analysed, it was determined that there were significant differences in the scores of lips (p=0.003), teeth (p=0.019), tongue (p<0.001) and oral mucosa (p=0.015) and the scores were lower in the second measurement. Conclusion: ICOCFAS was found to be useful in deciding the frequency of oral care for palliative care patients and improvements were observed in the oral cavity.

Keywords

• palliative care
• ICOCFAS
• oral care frequency

References

1. 1. Registered Nurses’ Association of Ontario (RNAO). Oral Health: Supporting Adults Who Require Assistance. 2nd ed. Toronto (ON): RNAO; 2020.
2. 2. World Health Organization. Global Oral Health Status Report: Towards Universal Health Coverage for Oral Health by 2030. Geneva: World Health Organization; 2022.
3. 3. Venkatasalu MR, Murang ZR, Ramasamy DTR, Dhaliwal JS. Oral health problems among palliative and terminally ill patients: An integrated systematic review. BMC Oral Health. 2020;20(1):79.
4. 4. Kvalheim SF, Strand GV. A narrative of oral care in palliative patients. Int J Environ Res Public Health. 2022;19(10):6306.
5. 5. Shubhavinyasa SB. Palliative care in patients with oral cancer. Int J Health Sci Res. 2014;4:259-270.
6. 6. Tebidze N, Jincharadze M, Margvelasvili V. Oral complications of palliative patients with advanced cancer. Transl Clin Med Georgian Med J. 2017;2(2):20-23.
7. 7. Berman A, Snyder S, Frandsen G. Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice. Upper Saddle River, NJ: Pearson; 2021.
8. 8. Potter PA, Perry AG, Stockert PA, Hall A. Fundamentals of Nursing. 10th ed. Elsevier; 2021.

9. 9. DeLaune SC, Ladner PK, McTier L, Tollefson J. Fundamentals of Nursing. 3rd ed. Delmar Cengage Learning; 2024.
10. 10. Saravanan T, Mahendra R, Harish S, Venkatesh A. Role of oral medicine in palliative care. J Res Adv Dent. 2019;10(1):145-150.
11. 11. Çeltek NY, Okan İ. Palyatif bakımda hasta değerlendirmesi ve skalalar. Klin Tıp Aile Hekimliği. 2016;8:6-10.
12. 12. Gustafsson A, Skogsberg J, Rejnö Å. Oral health plays second fiddle in palliative care: an interview study with registered nurses in home healthcare. BMC Palliat Care. 2021;20(1).
13. 13. Doğu Kökcü Ö, Terzi B. Development of an intensive care oral care frequency assessment scale. Nurs Crit Care. 2022;27:667-675.
14. 14. Er O, Ozpinar E, Ozyurek P, Orhan S. Oral care frequency of patients with intensive care needs after surgery: A cross-sectional study. Med Sci Int Med J. 2023;12(3):764.
15. 15. Maeda K, Mori N. Poor oral health and mortality in geriatric patients admitted to an acute hospital: an observational study. BMC Geriatr. 2020;20:26.
16. 16. Takagi S, Maeda K, Shimizu A, et al. Associations between oral health status and short-term functional outcomes in hospitalized patients aged over 65 years with acute ischemic stroke: a retrospective observational study. Clin Oral Investig. 2023;27(12):7635-7642.
17. 17. Czwikla J, Herzberg A, Kapp S, et al. Home care recipients have poorer oral health than nursing home residents: results from two German studies. J Dent. 2021;107:103607.
18. 18. Ames NJ, Sulima P, Yates JM, et al. Effects of systematic oral care in critically ill patients: a multicenter study. Am J Crit Care. 2011;20(5):e103-e114.
19. 19. Winning L, Lundy FT, Blackwood B, et al. Oral health care for the critically ill: a narrative review. Crit Care. 2021;25:353.
20. 20. Bozkurt R, Eşer İ. Assessment of the oral health status of patients admitted to pediatric intensive care units: a cross-sectional study. Dimens Crit Care Nurs. 2024;43(2):53-60.
21. 21. Amran NAH, Rahman HA, Mohamad HAMZBHA, et al. Assessment of oral health problems and oral hygiene practices among palliative care patients using a new tool: a pilot study. Palliat Med Pract. 2022;16(1):49-58.
22. 22. Furuya J, Suzuki H, Hidaka R, et al. Factors affecting the oral health of inpatients with advanced cancer in palliative care. Support Care Cancer. 2022;30(2):1463-1471.
23. 23. Delgado MB, Burns L, Quinn C, Moles DR, Kay EJ. Oral care of palliative care patients – carers' and relatives' experiences: a qualitative study. Br Dent J. 2018;224(11):881-886.
24. 24. Bajgora VM, Begzati A, Thaçi LM. Connectivity between frequency of toothbrushing and dental caries. Int J Biomed. 2022;12(4):617-621.
25. 25. Wu T-Y, Liu H-Y, Wu C-Y, et al. Professional oral care in end-of-life patients with advanced cancers in a hospice ward: improvement of oral conditions. BMC Palliat Care. 2020;19:181.