Oral-care provided by stroke-carers: exploring the therory of planned behaviour

Abstract

OBJECTIVES: To identify factors that contribute to predicting healthcare providers’ intention and behaviour related to oral care for patients with stroke according to the Theory of Planned Behaviour (TPB). METHODS: A national cross-sectional study was conducted at hospitals with rehabilitation physician services in Malaysia. All nurses from medical and rehabilitation wards were invited to participate. Data were collected using self-administered structured questionnaires covering the domains of TPB : oral health knowledge, current oral health behaviour, attitudes, subjective norms (SN), perceived behavioural control (PBC) and generalised intention (GI). Variations in oral care practices for stroke survivors with respect to the domains of TPB were explored in bivariate and regression analysis. RESULTS: Among the 806 returned questionnaire, 95% (n=768) were complete. The recommended practice for toothbrushing at least twice daily was associated with nurses’ attitudes (OR=1.15, 95%CI=1.04,1.27, P<0.05); PBC (OR=0.85, 95%CI=0.78, 0.94, P<0.05) and GI (OR=1.16, 95%CI=1.07,1.23, P<0.001), whereas the recommended practice for mouthwash at least daily was associated with nurses’ oral health knowledge (OR=1.18, 95%CI=1.05,1.32, P<0.05) and GI (OR=1.13, 95% CI=1.04,1.22, P<0.05). With regards to the practice of assisting patients with oral care, it was associated with nurses’ oral health knowledge (OR=1.24, 95%CI=1.04,1.48, P<0.05); attitudes (OR=1.20, 95%CI=1.03,1.40, P<0.05) and SN (OR=1.34, 95% CI=1.14,1.57, P<0.001). In addition, variations in oral care practices were also associated with nurse-demographics. CONCLUSIONS: Variations in recommendations and practices of oral care among those hospitalised for stroke in Malaysia existed. Such variations were associated with specific domains/aspects of the TPB – attitudes, subjective norms, perceived behavioural control and generalised intention.