title: The integration of oral health care into day-to-day care in nursing homes: a qualitative study.
abstract: OBJECTIVE
  This qualitative study explored barriers and enabling factors to the implementation of an oral hygiene protocol in nursing homes.
  
  
  BACKGROUND
  Oral health care in nursing homes in Flanders (Belgium) is inadequate.
  
  
  METHODS
  Qualitative data were obtained from nurses employed in 13 nursing homes involved in two randomised controlled trials in Flanders-Belgium. Data were collected by focus group and face-to-face interviews during April 2005 and December 2009. All transcripts were analysed with support of NVivo 8 (Version 2008). Transcripts were intuitively analysed in a two-step method.
  
  
  RESULTS
  Most revealed barriers were consistent with previous findings in the literature. Newly reported barriers were respect for residents' self-determination, experience based oral health care by nurses, residents' oral health status and nurses' inability to notice residents' oral health status. Demand-driven oral health care was found to be a strong enabling factor.
  
  
  CONCLUSIONS
  The integration of oral health care into day-to-day care seems to be a major problem due to a multitude of barriers. In future implementation innovations in oral health care an a priori assessment of influencing factors is recommended.
authors.affiliation: Community Dentistry and Oral Public Health, Dental School, Ghent University, Ghent, Belgium.|BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium, Nijmegen, The Netherlands.
authors.forename: Luc
authors.initials: L
authors.lastname: De Visschere
authors.affiliation: Department of Oral Function and Prosthetic Dentistry, Radboud University Nijmegen Medical Centre, The Netherlands.|BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium, Nijmegen, The Netherlands.
authors.forename: Cees
authors.initials: C
authors.lastname: de Baat
authors.affiliation: Community Dentistry and Oral Public Health, Dental School, Ghent University, Ghent, Belgium.
authors.forename: Lize
authors.initials: L
authors.lastname: De Meyer
authors.affiliation: University of Applied Sciences, Utrecht, The Netherlands.|The Opbouw Foundation Birkhoven Zorggoed Soesterweg 533, Amersfoort, The Netherlands.|BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium, Nijmegen, The Netherlands.
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: van der Putten
authors.affiliation: Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Bart
authors.initials: B
authors.lastname: Peeters
authors.affiliation: Department of Oral Public Health Faculty of Odontology, Malmö University, Malmo, Sweden.
authors.forename: Bjorn
authors.initials: B
authors.lastname: Söderfelt
authors.affiliation: Community Dentistry and Oral Public Health, Dental School, Ghent University, Ghent, Belgium.|BENECOMO, Flemish-Netherlands Geriatric Oral Research Group, Ghent, Belgium, Nijmegen, The Netherlands.
authors.forename: Jacques
authors.initials: J
authors.lastname: Vanobbergen
mesh_terms: D000328:Adult; D001530:Belgium; D016321:Dental Care for Aged / Q000379:methods* / Q000451:nursing* / Q000592:standards; D005851:Geriatric Nursing / Q000379:methods* / Q000592:standards; D019983:Guideline Adherence; D006801:Humans; D008875:Middle Aged; D009735:Nursing Homes; D009909:Oral Health; D009910:Oral Hygiene / Q000451:nursing*; D036301:Qualitative Research; D016032:Randomized Controlled Trials as Topic; D055815:Young Adult
keywords: barriers and enabling factors; nursing homes; oral health care