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postgraduate thesis: Multicentre randomised clinical trials to promote oral health care for stroke survivors during rehabilitation
Title | Multicentre randomised clinical trials to promote oral health care for stroke survivors during rehabilitation |
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Authors | |
Advisors | |
Issue Date | 2018 |
Publisher | The University of Hong Kong (Pokfulam, Hong Kong) |
Citation | AB Malik, N. B.. (2018). Multicentre randomised clinical trials to promote oral health care for stroke survivors during rehabilitation. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. |
Abstract | Objectives: This thesis aimed to evaluate the effectiveness of oral health promotion interventions to improve oral health care for stroke survivors by: i) stroke-care nurses and ii) stroke survivors themselves.
Methods: Two multi-centres trials were conducted. In trail 1, nurses were randomly assigned by centre, to receive a Web-based continual professional development (CPD) programme using computer-aided learning (CAL) based on the ‘Theory of Planned Behaviour’ (TPB) [Theory Web-based CPD-CAL] or a Non-theory Web-based CPD-CAL: test group versus control group. Assessments of ‘intention to’ and ‘performance of’ oral hygiene care were conducted pre-intervention, at 1-month and 6-month post-intervention. In trail 2, stroke survivors were randomly assigned into either (i) test group - ‘Intense Oral Hygiene Care’ [powered toothbrushing and antimicrobial gel (1% chlorhexidine gluconate) daily], or (ii) control group - ‘Conventional Oral Hygiene Care’ (manual toothbrushing and commercially available dentifrice daily). Assessments of dental plaque and oral pathogens (yeast, aerobic and facultative anaerobic Gram-negative bacilli (AGNB) and Staphylococcus aureus were conducted pre-intervention, at 3-month and 6-month post-intervention.
Results: The response rate to trial 1 was 68.2% (373/547). At 1-month, compared to the control group, the test group recipients had significant greater improvements in ‘attitudes’ (P<0.01) and ‘subjective norms’ (P<0.05) to provide oral hygiene care. At 6-month, compared to the control group, the test group recipients had significant greater improvements in ‘intention to’ to provide oral hygiene care (P<0.01); as well as greater improvements in ‘attitudes’ (P<0.01) and ‘subjective norms’ (P<0.001). The response rate to trial 2 was 62.7% (54/86). At 3-month and 6-month, significant reductions in dental plaque levels were evident among the test group (P<0.001) and among the control group (P<0.001). However, no significant differences in dental plaque levels were evident between groups (P>0.05). In terms of oral pathogens, the prevalence of yeast at 6-month was lower in the test group compared to the control group (P<0.05). In the test group significant reductions in the prevalence of the yeast C. albicans was observed over time (P<0.05), but not in the control group (P>0.05). In both groups there were significant reductions in the prevalence and viable counts of AGNB: test (P<0.05) and control (P<0.05) groups; but no significant difference between them (P>0.05). In both groups there were significant reductions in the prevalence of the AGNB species K. pneumoniae: test (P<0.01) and control (P<0.01) groups; but no significant difference between them (P>0.05). Among the test group there was a significant reduction in S. aureus (P<0.01) but not in the control group (P>0.05); and no significant difference was observed between groups (P>0.05).
Conclusion: Trail 1: The test intervention (TPB theory Web-based CPD-CAL) was more effective at improving general ‘intention to’ provide oral hygiene care than the control intervention (Non-theory Web-based CPD-CAL). Trial 2: The ‘Intense Oral Hygiene Care’ intervention and the ‘Conventional Oral Hygiene Care’ intervention were effective in dental plaque control; and of comparable effectiveness. The ‘Intense Oral Hygiene Care’ intervention was more effective than the ‘Conventional Oral Hygiene Care’ intervention in the control of some oral pathogens
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Degree | Doctor of Philosophy |
Subject | Cerebrovascular disease - Patients - Dental care |
Dept/Program | Dentistry |
Persistent Identifier | http://hdl.handle.net/10722/261520 |
DC Field | Value | Language |
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dc.contributor.advisor | McGrath, CPJ | - |
dc.contributor.advisor | Jin, L | - |
dc.contributor.advisor | Lam, OLT | - |
dc.contributor.author | AB Malik, Normaliza Binti | - |
dc.date.accessioned | 2018-09-20T06:44:04Z | - |
dc.date.available | 2018-09-20T06:44:04Z | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | AB Malik, N. B.. (2018). Multicentre randomised clinical trials to promote oral health care for stroke survivors during rehabilitation. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. | - |
dc.identifier.uri | http://hdl.handle.net/10722/261520 | - |
dc.description.abstract | Objectives: This thesis aimed to evaluate the effectiveness of oral health promotion interventions to improve oral health care for stroke survivors by: i) stroke-care nurses and ii) stroke survivors themselves. Methods: Two multi-centres trials were conducted. In trail 1, nurses were randomly assigned by centre, to receive a Web-based continual professional development (CPD) programme using computer-aided learning (CAL) based on the ‘Theory of Planned Behaviour’ (TPB) [Theory Web-based CPD-CAL] or a Non-theory Web-based CPD-CAL: test group versus control group. Assessments of ‘intention to’ and ‘performance of’ oral hygiene care were conducted pre-intervention, at 1-month and 6-month post-intervention. In trail 2, stroke survivors were randomly assigned into either (i) test group - ‘Intense Oral Hygiene Care’ [powered toothbrushing and antimicrobial gel (1% chlorhexidine gluconate) daily], or (ii) control group - ‘Conventional Oral Hygiene Care’ (manual toothbrushing and commercially available dentifrice daily). Assessments of dental plaque and oral pathogens (yeast, aerobic and facultative anaerobic Gram-negative bacilli (AGNB) and Staphylococcus aureus were conducted pre-intervention, at 3-month and 6-month post-intervention. Results: The response rate to trial 1 was 68.2% (373/547). At 1-month, compared to the control group, the test group recipients had significant greater improvements in ‘attitudes’ (P<0.01) and ‘subjective norms’ (P<0.05) to provide oral hygiene care. At 6-month, compared to the control group, the test group recipients had significant greater improvements in ‘intention to’ to provide oral hygiene care (P<0.01); as well as greater improvements in ‘attitudes’ (P<0.01) and ‘subjective norms’ (P<0.001). The response rate to trial 2 was 62.7% (54/86). At 3-month and 6-month, significant reductions in dental plaque levels were evident among the test group (P<0.001) and among the control group (P<0.001). However, no significant differences in dental plaque levels were evident between groups (P>0.05). In terms of oral pathogens, the prevalence of yeast at 6-month was lower in the test group compared to the control group (P<0.05). In the test group significant reductions in the prevalence of the yeast C. albicans was observed over time (P<0.05), but not in the control group (P>0.05). In both groups there were significant reductions in the prevalence and viable counts of AGNB: test (P<0.05) and control (P<0.05) groups; but no significant difference between them (P>0.05). In both groups there were significant reductions in the prevalence of the AGNB species K. pneumoniae: test (P<0.01) and control (P<0.01) groups; but no significant difference between them (P>0.05). Among the test group there was a significant reduction in S. aureus (P<0.01) but not in the control group (P>0.05); and no significant difference was observed between groups (P>0.05). Conclusion: Trail 1: The test intervention (TPB theory Web-based CPD-CAL) was more effective at improving general ‘intention to’ provide oral hygiene care than the control intervention (Non-theory Web-based CPD-CAL). Trial 2: The ‘Intense Oral Hygiene Care’ intervention and the ‘Conventional Oral Hygiene Care’ intervention were effective in dental plaque control; and of comparable effectiveness. The ‘Intense Oral Hygiene Care’ intervention was more effective than the ‘Conventional Oral Hygiene Care’ intervention in the control of some oral pathogens | - |
dc.language | eng | - |
dc.publisher | The University of Hong Kong (Pokfulam, Hong Kong) | - |
dc.relation.ispartof | HKU Theses Online (HKUTO) | - |
dc.rights | The author retains all proprietary rights, (such as patent rights) and the right to use in future works. | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject.lcsh | Cerebrovascular disease - Patients - Dental care | - |
dc.title | Multicentre randomised clinical trials to promote oral health care for stroke survivors during rehabilitation | - |
dc.type | PG_Thesis | - |
dc.description.thesisname | Doctor of Philosophy | - |
dc.description.thesislevel | Doctoral | - |
dc.description.thesisdiscipline | Dentistry | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.5353/th_991044040574103414 | - |
dc.date.hkucongregation | 2018 | - |
dc.identifier.mmsid | 991044040574103414 | - |