Abstract

Stroke often results in physical disability and functional impairment, which may severely limit patients' ability to care for personal hygiene, including oral care. This study aimed to identify the challenges faced by informal caregivers in managing the oral health of stroke patients. This study conducted semi-structured individual interviews with eight home-based caregivers of stroke patients recruited from a community-based clinic facility of a public university in Malaysia. The interviews took 30-45 minutes to complete and were transcribed verbatim. Transcripts were analyzed thematically using a phenomenological approach. Relevant themes that emerged were variations in oral hygiene care, caregivers’ concerns in providing oral care, dental clinic utilization, and caregivers’ perceived educational and training needs. This study highlights the challenges faced by caregivers in managing the oral health of stroke patients. Improving access to dental services for stroke patients and tailoring educational programs to suit the specific learning needs of caregivers, as identified in this study, may result in improved health outcomes for stroke patients.

References

1. Donkor ES. Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke Res Treat. 2018; 3238165. DOI: 10.1155/2018/3238165.

2. Yousufuddin M, Young N. Aging and Ischemic Stroke. Aging. 2019; 11 (9): 2542–2544. DOI: 10.18632/aging.101931.

3. Tan KS, Venketasubramanian N. Stroke burden in Malaysia. Cerebrovasc Dis Extra. 2022; 12 (2): 58–62. DOI: 10.1159/000524271.

4. Son M, Jo S, Lee JS, et al. Association between Oral Health and Incidence of Pneumonia: A Population-Based Cohort Study from Korea. Sci Rep. 2020; 10: 9576. DOI: 10.1038/s41598-020-66312-2.

5. Moldvai J, Orsós M, Herczeg E, et al. Oral Health Status and Its Associated Factors Among Post-Stroke Inpatients: A Cross-Sectional Study in Hungary. BMC Oral Health. 2022; 22: 234. DOI: 10.1186/s12903-022-02259-2.

6. Aziz AFA, Nordin NAM, Ali MF, et al. The Integrated Care Pathway for Post Stroke Patients (iCaPPS): A Shared Care Approach between Stakeholders in Areas with Limited Access to Specialist Stroke Care Services. BMC Health Serv Res. 2017; 17: 35. DOI: 10.1186/s12913-016-1963-8.

7. Balwanth S, Singh S. Caregivers' Knowledge, Attitudes, and Oral Health Practices at Long-Term Care Facilities in KwaZulu-Natal. Health SA. 2023; 28: a2147. DOI: 10.4102/hsag.v28i0.2147.

8. Gurgel-Juarez N, Egan M, Wiseman M, et al. Technology for Maintaining Oral Care After Stroke: Considerations for Patient-Centered Practice. Disabil Rehabil Assist Technol. 2022; 17 (8): 916-926. DOI: 10.1080/17483107.2020.1822450.

9. Broderick JP, Adeoye O, Elm J. Evolution of the Modified Rankin Scale and Its Use in Future Stroke Trials. Stroke. 2017; 48 (7): 2007–2012. DOI: 10.1161/STROKEAHA.117.017866.

10. Wilson JL, Hareendran A, Grant M, et al. Improving The Assessment of Outcomes in Stroke: Use of A Structured Interview to Assign Grades on The Modified Rankin Scale. Stroke. 2002; 33 (9): 2243-2246. DOI: 10.1161/01.str.0000027437.22450.bd.

11. Braun V, Clarke V. Using Thematic Analysis in Psychology. Qual Res Psychol. 2006; 3 (2): 77–101. DOI: 10.1191/1478088706qp063oa.

12. Kim HT, Park JB, Lee WC, et al. Differences in The Oral Health Status and Oral Hygiene Practices According to The Extent of Post‐Stroke Sequelae. J Oral Rehabil. 2018; 45 (6): 476–484. DOI: 10.1111/joor.12634.

13. Eriyani T, Shalahuddin I, Pebrianti S, et al. Impact of Oral Hygiene Interventions on Stroke Patients: Rapid Review. J Ilmu Kesehat. 2023; 8 (4): 1574–1584. DOI: 10.30604/jika.v8i4.2378.

14. Dai R, Lam OLT, Lo ECM, et al. A Randomized Clinical Trial of Oral Hygiene Care Programmes During Stroke Rehabilitation. J Dent. 2017; 61: 48–54. DOI: 10.1016/j.jdent.2017.04.001.

15. Xu T, O’loughlin K, Clemson L, et al. Therapists’ Perspectives on Adapting the Stepping on Falls Prevention Programme for Community-Dwelling Stroke Survivors in Singapore. Disabil Rehabil. 2019; 41 (21): 2528–2537. DOI: 10.1080/09638288.2018.1471168.

16. Yoo YJ, Kim JW, Kim JS, et al. Corticospinal Tract Integrity and Long-Term Hand Function Prognosis in Patients with Stroke. Front Neurol. 2019; 10: 374. DOI: 10.3389/fneur.2019.00374.

17. Moggio L, de Sire A, Marotta N, et al. Exoskeleton Versus End-Effector Robot-Assisted Therapy for Finger-Hand Motor Recovery in Stroke Survivors: Systematic Review and Meta-Analysis. Top Stroke Rehabil. 2022; 29 (8): 539-550. DOI: 10.1080/10749357.2021.1967657.

18. Bhadauria US, Purohit B, Priya H. Access to Dental Care in Individuals with Disability: A Systematic Review. Evid Based Dent. 2024; 25: 111. DOI: 10.1038/s41432-024-00970-3.

19. Kuo YW, Yen M, Fetzer S, et al. Effect of Family Caregiver Oral Care Training on Stroke Survivor Oral and Respiratory Health in Taiwan: A Randomised Controlled Trial. Community Dent Health. 2015; 32 (3): 137-142. DOI: 10.1922/CDH_3572Kuo06.

20. Chen HJ, Chen JL, Chen CY, et al. Effect of an Oral Health Programme on Oral Health, Oral Intake, and Nutrition in Patients with Stroke and Dysphagia in Taiwan: A Randomised Controlled Trial. Int J Environ Res Public Health. 2019; 16 (12): 2228. DOI:10.3390/ijerph16122228.

21. Ghazali SB, Abdullah KL, Abd Aziz AB, et al. Burden of Caregivers of The Elderly with Chronic Illnesses and Their Associated Factors in an Urban Setting in Malaysia. Malays J Med Sci. 2015; 15 (1): 1–9.

22. Sidek NN, Kamalakannan S, Tengku Ismail TA, et al. Experiences and needs of the caregivers of stroke survivors in Malaysia—A phenomenological exploration. Front Neurol. 2022; 13: 996620. DOI: 10.3389/fneur.2022.996620.

23. Wan-Fei K, Hassan ST, Sann LM, et al. Depression, Anxiety and Quality of Life in Stroke Survivors and Their Family Caregivers: A Pilot Study Using an Actor/Partner Interdependence Model. Electron Physician. 2017; 9 (8): 4924–4933. DOI: 10.19082/4924.

24. Zawawi NS, Aziz NA, Fisher R, et al. The Unmet Needs of Stroke Survivors and Stroke Caregivers: A Systematic Narrative Review. J Stroke Cerebrovasc Dis. 2020; 29 (8): 104875. DOI: 10.1016/j.jstrokecerebrovasdis.2020.104875.

25. Omar O, Aziz AF, Ali MF, et al. Caregiver Depression Among Home-Bound Stroke Patients in an Urban Community. Cureus. 2021; 13 (9): e17948. DOI: 10.7759/cureus.17948.

26. Lobo EH, Frølich A, Abdelrazek M, et al. Information, Involvement, Self-Care and Support—The Needs of Caregivers of People with Stroke: A Grounded Theory Approach. Plos One. 2023; 18 (1): e0281198. DOI: 10.1371/journal.pone.0281198.

27. Haji Mukhti MI, Ibrahim MI, Tengku Ismail TA, et al. Family Caregivers’ Experiences and Coping Strategies in Managing Stroke Patients during the COVID-19 Pandemic: A Qualitative Exploration Study. Int J Environ Res Public Health. 2022; 19 (2): 942. DOI: 10.3390/ijerph19020942.

28. Keyworth C, Epton T, Goldthorpe J, et al. Acceptability, reliability, and validity of a brief measure of capabilities, opportunities, and motivations ("COM-B"). Br J Health Psychol. 2020; 25 (3): 474-501. DOI: 10.1111/bjhp.12417.

Download

Share

COinS