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Assignment of Dental Hygienists Improves Outcomes in Japanese Rehabilitation Wards: A Retrospective Cohort Study

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The journal of nutrition, health & aging

Abstract

Objectives

To clarify the effectiveness of ward-assigned dental hygienists (DHs) on rehabilitation outcomes in rehabilitation wards.

Design

Retrospective cohort study.

Setting

The registry data from the Japanese Rehabilitation Nutrition Database.

Participants

656 patients with hip fracture or stroke admitted to convalescent rehabilitation wards.

Measurements

The main outcome measures were the Functional Independence Measure (FIM), the Food Intake Level Scale (FILS), and the home discharge rate. Patients were divided into two groups based on the ward setting: with an assigned DH (DH group) and without an assigned DH (NDH group). Clinical characteristics and outcomes were compered between the groups. Between-facility differences were adjusted by generalized estimating equation. We performed post-hoc power analysis to confirm that there were enough samples included in this study to detect a significant difference.

Results

Of 656 patients (mean age, 77 years; 57.1% female; 65.5% stroke) from 10 facilities, 454 patients (69.2%) from 4 facilities were in the DH group. FIM score at discharge (107 vs 90, P<0.001), percentage improvement in FILS score from admission to discharge (44.5% vs 22.8%, P<0.001) and home discharge rate (72.5% vs 61.4%, P<0.001) were significantly higher in the DH group than in the NDH group. After multivariate analysis, the FIM score at discharge (P=0.007), FILS score at discharge (P=0.024), and home discharge rate (P=0.007) were significantly higher in the DH group than in the NDH group.

Conclusions

ADL and swallowing function were significantly improved at discharge and the home discharge rate was higher among patients in rehabilitation wards with DHs. Having a ward-assigned DH may lead to better rehabilitation outcomes in rehabilitation wards.

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Acknowledgements

This work is supported by a grant from the Japan Society for the Promotion of Science (grant number: 18K10690). The authors would like to thank Atagawa Hospital, Nagasaki Rehabilitation Hospital, Miharu Hospital, Tsurumaki Onsen Hospital, Haradoi Hospital, Nanko Hospital, Nishi Hiroshima Rehabilitation Hospital, Yasuoka Hospital, Kanazawa Nishi Hospital, Sakurakai Medical Corporation Sakurakai Hospital, Sapporo Nishi-maruyama Hospital, Mihono Hospital, Tamana Regional Health Medical Center, Jikei University Daisan Hospital, Nakanoshima Iwaki Hospital, Nishinomiya Kyoritsu Neurosurgical Hospital, and Minamisoma Municipal General Hospital for providing patients’ data to the JRND.

Author information

Authors and Affiliations

  1. Department of Nutrition, Tsushima Rehabilitation Hospital, Tsushima City, Aichi, Japan

    R. Suzuki

  2. Department of Nursing Care, Nishinomiya Kyoritsu Neurosurgical Hospital, 11-1 Imazu-Yamanaka-cho, Nishinomiya, Hyogo, 663-8211, Japan

    Ayano Nagano

  3. Department of Rehabilitation Medicine, Yokohama City University Medical Center, Yokohama City, Kanagawa, Japan

    H. Wakabayashi

  4. Palliative Care Center, Aichi Medical University, Nagakute City, Aichi, Japan

    K. Maeda

  5. Department of Clinical Nutrition and Food Service, Nagasaki Rehabilitation Hospital, Nagasaki City, Nagasaki, Japan

    S. Nishioka

  6. Takahashi Dental Clinic, Tsuno, Kochi, Japan

    M. Takahashi

  7. Department of rehabilitation Medicine, Teikyo University School of Medicine University Hospital Mizonokuchi, Kanagawa, Japan

    R. Momosaki

Authors
  1. R. Suzuki
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  2. Ayano Nagano
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Corresponding author

Correspondence to Ayano Nagano.

Ethics declarations

Disclosure statement: Hidetaka Wakabayashi received a grant from the Japan Society for the promotion of Science (grant number: 19H03979) outside the submitted work. Keisuke Maeda received a grant from the Japan Society for the promotion of Science (grant number: 18K11142) outside the submitted work. Other authors have no conflicts of interests.

Ethical standards: This study was approved by the ethics committee at the Jikei University School of Medicine (approval number 27–150 [8035]). This study has been performed in accordance with the ethical standards established in the 1964 Declaration of Helsinki and later amendments.

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Suzuki, R., Nagano, A., Wakabayashi, H. et al. Assignment of Dental Hygienists Improves Outcomes in Japanese Rehabilitation Wards: A Retrospective Cohort Study. J Nutr Health Aging 24, 28–36 (2020). https://doi.org/10.1007/s12603-019-1284-9

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  • DOI: https://doi.org/10.1007/s12603-019-1284-9

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