老年护理院痴呆老年人口腔护理的循证实践

Evidence-based clinical practice on the oral hygiene care for adults with dementia in aged nursinghomes

目的总结关于老年护理院痴呆老年人口腔护理的循证证据。方法以关键词“口腔护理、痴呆、老年护理院”对美国国立指南数据库、Cochrane循证医学数据库、澳大利亚JBI循证护理学数据库等进行检索。仅对检索出的临床实践指南、系统评价、最佳证据的研究结果进行总结。结果主要获得相关临床实践指南1篇，系统评价1篇，最佳证据1篇。结论评估工具推荐采用《简要口腔健康评估表》；应对照护人员进行口腔筛查的培训。推荐的照护策略有：使用含氟或葡萄糖酸氯己定的口腔清洁剂，限制蔗糖的摄入，使用正确的方法清洁义齿，使用唾液刺激物或替代品，执行与痴呆老年人的沟通和行为管理策略等。

Objective To develop an evidence-based guideline on the oral hygiene care for adults with dementia in aged nursing homes. Methods Using the keywords ＂oral hygiene, dementia, aged nurs- ing homes＂ to search in the databases including National guideline clearinghouse, Cochrane library, and Joanna Briggs institute, etc. Only the clinical guideline, systematical review and best practice were includ- ed. Results One clinical practice guideline, one systematic review, and one best practice were found mainly. Conclusions The scale of brief oral health status is recommended, and nurses should be trained for oral screening. Recommendations include regular using toothpaste with fluoride and mouthwash with chlorhexidine gluconate, reducing intake and frequency of sugar consumption, regular cleaning the dentures, using salvia substitutes or stimulus, and carrying out the behavior management and communication strate- gies for dementia patients.