Abstract
The association among certified diabetes educator nurses’ knowledge, attitudes, and practices related to oral management has not been well examined. The aim of this study was to examine the association between knowledge and attitude as variables for nurses’ practice of oral management as certified diabetes educators at medical facilities in Japan. The questionnaires were administered to 300 certified diabetes educator nurses from 1277 medical facilities. The items regarding knowledge, attitude, and practice of oral management were assessed using items from the guidelines, reports, and books on diabetes and periodontal disease, as well as the exhaustive findings of previous studies. More than 70% of the participants did not practice adequate oral management. Logistic regression analysis revealed that all the items were negatively associated with nurses’ confidence in oral management (Factor 1: odds ratio [OR] = 0.55; 95% confidence interval [CI] 0.37–0.83; Factor 2: OR = 0.35; 95% CI 0.18–0.70; Factor 3: OR = 0.38; 95% CI 0.24–0.61; Factor 4: OR = 0.29; 95% CI 0.18–0.49). The practice of oral management coupled with an explanation regarding periodontal disease as a diabetic complication (OR = 2.67; 95% CI 1.01–7.02), and supporting collaboration with multiple medical departments (OR = 2.65; 95% CI 1.24–5.65) were positively associated with nurses’ education. These results suggest that more strategies for nurses’ education are needed to understand the importance of oral management practices and to improve knowledge, attitudes, and confidence in patient oral management.
Similar content being viewed by others
References
FDI World Dental Federation. White paper on prevention and management of periodontal diseases for oral health and general health; 2018. https://www.fdiworlddental.org/sites/default/files/media/resources/gphp-2018-white_paper-en.pdf. Accessed 04 Jan 2019.
Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of severe periodontitis in 1990–2010: a systematic review and meta-regression. J Dent Res. 2014;93:1045–53. https://doi.org/10.1177/0022034514552491.
Dye BA. Global periodontal disease epidemiology. Periodontol. 2000;2012(58):10–25.
Petersen PE, Ogawa H. The global burden of periodontal disease: towards integration with chronic disease prevention and control. Periodontol. 2000;2012(60):15–39. https://doi.org/10.1111/j.1600-0757.2011.00425.x.
Claydon NC. Current concepts in toothbrushing and interdental cleaning. Periodontol. 2000;2008(48):10–22. https://doi.org/10.1111/j.1600-0757.2008.00273.x.
Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of severe tooth loss: a systematic review and meta-analysis. J Dent Res. 2014;93:20–8. https://doi.org/10.1177/0022034514537828.
Ministry of Health, Labour and Welfare. Patient research; 2014. (in Japanese) https://www.mhlw.go.jp/toukei/saikin/hw/kanja/14/. Accessed 25 Nov 2019.
Ministry of Health, Labour and Welfare. Patient research; 2017. (in Japanese) https://www.mhlw.go.jp/toukei/saikin/hw/kanja/17/dl/02.pdf. Accessed 25 Nov 2019.
D’Aiuto F, Gable D, Syed Z, Allen Y, Wanyonyi KL, White S, Gallagher JE. Evidence summary: the relationship between oral diseases and diabetes. Br Dent J. 2017;222:944–8. https://doi.org/10.1038/sj.bdj.2017.544.
Nelson RG, Shlossman M, Budding LM, Pettitt DJ, Saad MF, Genco RJ, Knowler WC. Periodontal disease and NIDDM in Pima Indians. Diabetes Care. 1990;13:836–40. https://doi.org/10.2337//diacare.13.8.836.
Mauri-Obradors E, Estrugo-Devesa A, Jane-Salas E, Vinas M, Lopez-Lopez J. Oral manifestations of diabetes mellitus. A systematic review. Med Oral Patol Oral Cir Bucal. 2017;22:586–94. https://doi.org/10.4317/medoral.21655.
Brennan DS, Spencer AJ, Roberts-Thomson KF. Quality of life and disability weights associated with periodontal disease. J Dent Res. 2007;86:713–7.
Luo H, Wu B. Self-awareness of “gum disease” among US adults. J Public Health Manag Pract. 2017;23:1–7. https://doi.org/10.1097/PHH.0000000000000408.
Poudel P, Griffiths R, Wong VW, Arora A, Flack JR, Khoo CL, George A. Oral health knowledge, attitudes and care practices of people with diabetes: a systematic review. BMC Public Health. 2018;18:1–12. https://doi.org/10.1186/s12889-018-5485-7.
Kishimoto H, Oishi Y, Nagaosa S. From oral care to oral management: the importance of medical-dental collaboration. Japan Medical Journal. Tokyo: Japan Medical Journal; 2009; pp. 54–8. (in Japanese)
Ministry of Health, Labour and Welfare. Survey of medical facilities (static and dynamic). Outline of hospital report; 2019. (in Japanese) https://www.mhlw.go.jp/toukei/saikin/hw/iryosd/19/dl/02sisetu01.pdf. Accessed 3 Sep 2021.
The jaw bone necrosis review committee. Pathophysiology and management of bone resorption inhibitor-related osteonecrosis of the jaw: jaw bone necrosis review committee position paper; 2016. (in Japanese) https://www.jsoms.or.jp/medical/wp-content/uploads/2015/08/position_paper2016.pdf. Accessed 3 Oct 2020.
Kudoh R, Shibayama T, Hidaka K. The role of knowledge and self-efficacy on dental consultation behavior of patients with type 2 diabetes. Jan J Nurs Sci. 2021;18:1–9. https://doi.org/10.1111/jjns.12378.
International Diabetes Federation. Guideline on oral health for people with diabetes. 2009. file:///C:/Users/ftxsm/Downloads/OralHealth_EN_RTP.pdf. Accessed 21 Nov 2018.
American Association of Diabetes Educators. AADE thought leader summit: diabetes and oral health; 2016. https://www.diabeteseducator.org/docs/default-source/default-document-library/aade-diabetes-oral-health-white-paper.pdf?sfrsn=2. Accessed 25 Mar 2020.
Henderson V. Basic principles of nursing care. Genève: International Council of Nurses; 2004.
Pai RR, Ongole R, Banerjee S. Oral care in cancer nursing: practice and barriers. Indian J Dent Res. 2019;30:226–30. https://doi.org/10.4103/ijdr.IJDR_343_17.
Kawaguchi T. Certified diabetes expert nurse and nurse educators in Japan. Diabetes Res Clin Pract. 2007;77:205–7. https://doi.org/10.1016/j.diabres.2007.01.058.
The Certification Board for Diabetes Educators in Japan What is the Certified Diabetes Educator in Japan?; 2020. (in Japanese) https://www.cdej.gr.jp/modules/general/index.php?content_id=1. Accessed 18 Jun 2021.
Shibayama T, Kudoh R, Hidaka K. Factors associated with the practice of periodontal management by diabetes educator nurses for outpatients with diabetes: a nationwide survey in Japan. Prim Care Diabetes. 2021;15:819–24. https://doi.org/10.1016/j.pcd.2021.05.004.
Chung MC, Juang WC, Li YC. Perceptions of shared decision making among health care professionals. J Eval in Clin Pract. 2019;25:1080–7. https://doi.org/10.1111/jep.13249.
Fukuda Y, Yabata Y, Imai H. Health promotion at a glance: theory and practice guidebook. Saitama: National Institute of Public Health; 2008. (in Japanese) https://www.niph.go.jp/soshiki/ekigaku/hitomedewakaru.pdf. Accessed 24 Feb 2019.
Lopes MH, Southerland JH, Buse JB, Malone RM, Wilder RS. Diabetes educators’ knowledge, opinions and behaviors regarding periodontal disease and diabetes. J Dent Hyg. 2012;86:82–90.
Yi Q, Hohashi N. Comparison of perceptions of domestic elder abuse among healthcare workers based on the Knowledge-Attitude-Behavior (KAB) model. PLoS ONE. 2018;13:1–14. https://doi.org/10.1371/journal.pone.0206640.
Baranowski T, Cullen KW, Nicklas T, Thompson D, Baranowski J. Are current health behavioral change models helpful in guiding prevention of weight gain efforts? Obes Res. 2003;11:23–43.
Miller M, Kearney N. Oral care for patients with cancer: a review of the literature. Cancer Nurs. 2001;24:241–54. https://doi.org/10.1097/00002820-200108000-00001.
Ohrn KE, Wahlin YB, Sjödén PO. Oral care in cancer nursing. Eur J Cancer Care. 2000;9:22–9. https://doi.org/10.1046/j.1365-2354.2000.00185.x.
Ab Malik N, Yatim SM, Lam O, Jin L, McGrath C. Oral health care guidelines, training, and resources among stroke care providers. JDR Clin Trans Res. 2017;2:312–9. https://doi.org/10.1177/2380084417693784.
Alja’afreh MA, Mosleh SM, Habashneh SS. Nurses’ perception and attitudes towards oral care practices for mechanically ventilated patients. Saudi Med J. 2018;39:379–85. https://doi.org/10.15537/smj.2018.4.21749.
Kudoh R, Shibayama T. Concept analysis of oral care in nursing practices at hospitals:Using the Rogers evolutionary method. J Dent Hlth. accepted.
Warren J, Levy S, Hand S. The accuracy of tooth loss data collected by nurses. Spec Care Dentist. 1999;19:75–8.
Lee YJ, Noh HJ, Han SY, Jeon HS, Chung WG, Mun SJ. Oral health care provided by nurses for hospitalized patients in Korea. Int J Dent Hyg. 2019;17:336–42.
Japanese Society of Periodontology. Periodontal treatment guidelines for diabetic patients 2014 revision, 2nd ed; 2015. (in Japanese). http://www.perio.jp/publication/upload_file/guideline_diabetes.pdf. Accessed 26 Nov 2019.
Japan Diabetes Society. Diabetes clinical practice guidelines 2019. Tokyo: Nankodo; 2019 (in Japanese).
Coker E, Ploeg J, Kaasalainen S, Fisher A. A concept analysis of oral hygiene care in dependent older adults. J Adv Nurs. 2013;69:2360–71. https://doi.org/10.1111/jan.12107.
Talbot A, Brady M, Furlanetto DL, Frenkel H, Williams BO. Oral care and stroke units. Gerodontology. 2005;22:77–83. https://doi.org/10.1111/j.1741-2358.2005.00049.x.
Kodaira K. The present situation of nursing and the future subjects about diabetic education. J Tokyo Woman’s Med Univ. 2007;2:1–9 (in Japanese).
Acknowledgements
This work was supported by the Japan Society for the Promotion of Science under JSPS KAKENHI (Grant Number 19K10946). The authors declare no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Human rights statement and informed consent
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or substitute for it was obtained from all patients for inclusion in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Kudoh, R., Shibayama, T. & Hidaka, K. Nurses’ knowledge, attitude, and practice regarding oral management for outpatients with type 2 diabetes: a national survey on certified diabetes educators. Diabetol Int 13, 407–420 (2022). https://doi.org/10.1007/s13340-021-00555-w
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13340-021-00555-w