title: A home-based training programme improves family caregivers' oral care practices with stroke survivors: a randomized controlled trial.
abstract: OBJECTIVE
  Stroke survivors experience poor oral health when discharged from the hospital to the community. The aim of this study was to evaluate the effectiveness of a home-based oral care training programme on knowledge, attitude, self-efficacy and practice behaviour of family caregivers.
  
  
  METHODS
  A randomized controlled trial was conducted. The experimental group consisted of 48 family caregivers who received the home-based oral care training programme, and the control group consisted of 46 family caregivers who received routine oral care education. The outcomes were measured by the Knowledge of Oral Care, Attitude towards Oral Care, Self-Efficacy of Oral Care and Behaviour of Oral Care before the training programme, and at one and two months afterwards. The data were analysed using mixed model anova to determine differences in the outcomes between the two groups.
  
  
  RESULTS
  The findings demonstrated that the intervention group had more knowledge (t = 8.80, P < 0. 001), greater self-efficacy (t = 3.53, P < 0.01) and better oral care behaviour (t = 11.93, P < 0.001) than the control group at one and two months, with statistically significant differences in oral care knowledge, self-efficacy and behaviour outcome over time. The attitude of the intervention group towards oral care practice was generally positive (mean of baseline and two month = 12.9 and 14.7), but no significant difference in attitude change between the control and intervention groups (t = 1.56, P = 0.12). The treatment interaction effect was significant for the family caregivers' behaviour of oral care at one and two months of the intervention for both groups.
  
  
  CONCLUSIONS
  Our individualized home-based oral care education can achieve significant improvements in oral care knowledge and self-efficacy among family caregivers of stroke survivors, and it can sufficiently empower them to modify their oral care practices in a home-based healthcare environment.
authors.affiliation: Department of Nursing, Asia University, Taichung, Taiwan.
authors.forename: Y-W
authors.initials: YW
authors.lastname: Kuo
authors.affiliation: Department of Nursing and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: M
authors.initials: M
authors.lastname: Yen
authors.affiliation: Department of Nursing, College of Health and Human Services, University of New Hampshire, Durham, NH, USA.
authors.forename: S
authors.initials: S
authors.lastname: Fetzer
authors.affiliation: School of Nursing, National Defense, Medical Center, Taipei, Taiwan.
authors.forename: L-C
authors.initials: LC
authors.lastname: Chiang
authors.affiliation: School of Nursing and Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Y-Il
authors.initials: YI
authors.lastname: Shyu
authors.affiliation: College of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan.|Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: T-H
authors.initials: TH
authors.lastname: Lee
authors.affiliation: Department of Occupational and Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: H-I
authors.initials: HI
authors.lastname: Ma
mesh_terms: D000368:Aged; D017028:Caregivers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D010353:Patient Education as Topic; D020377:Self Efficacy; D020521:Stroke / Q000451:nursing*; D017741:Survivors
keywords: daily oral care practice; family caregiver; home-based health care; oral hygiene; stroke survivors