Evidence map›Paper›PMID 33385333›Full record

ArticleJournal of the American Medical Directors Association2021

Mouth Care in Assisted Living: Potential Areas for Improvement.

Christine E Kistler, Jessica Scott, Kimberly Ward, Robin Zeigler, Louise Sullivan, Sarah E Tomlinson, Christopher J Wretman, Sheryl Zimmerman

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Medical Directors Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Mouth Care Without a Battle: Change in Assisted Living Staff Self-Efficacy and Attitudes.Journal of the American Medical Directors Association · 2025
    Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Christine E KistlerThe Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: Christine_Kistler@med.unc.edu.
Jessica ScottDivision of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA.
Kimberly WardThe Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Robin ZeiglerDivision of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA.
Louise SullivanCollege of Nursing, Salve Regina University, Newport, RI, USA.
Sarah E TomlinsonDivision of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC, USA.
Christopher J WretmanThe Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Sheryl ZimmermanThe Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
University of North Carolina at Chapel Hill · USNC Department of Health and Human Services · USSalve Regina University · US

Funding

Adapting an Evidence-Based Program that Improves Oral Hygiene and Health for Assisted Living Residents with DementiaR01AG061966 · NIA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ZIMMERMAN, SHERYL · 2018 to 2022
$2.6M
NIA NIH HHS R01 AG061966
6 · The paper itself

Abstract

backgroundPoor oral care may lead to systemic disease, and there is evidence that assisted living (AL) residents lack quality oral care; in AL, poor care may be due to staff knowledge and attitudes, as well as organizational barriers to providing care.

objectivesDetermine AL staff knowledge and attitudes regarding mouth care and barriers to changing care.

designSelf-administered repeated-measures questionnaires completed before and after oral care training. SETTING AND

participantsA total of 2012 direct care staff and administrators from 180 AL communities.

methodsNine knowledge questions and 8 attitude and practice intention questions, and open-ended questions regarding training and obstacles to providing oral care.

resultsOverall, 2012 participants completed pretraining questionnaires, and 1977 completed posttraining questionnaires. Baseline knowledge was high, but staff were not uniformly aware of the systemic-oral link whereby mouth care affects pneumonia and diabetes. Almost all staff reported learning a new technique (96%), including for residents who resist care (95%). Suggested areas to improve mouth care included having more hands-on experience. The primary perceived obstacles to care centered around residents who resist care and a lack of time. CONCLUSIONS AND IMPLICATIONS: Based on reports of having benefitted from training, AL staff overwhelmingly noted that new knowledge was helpful, suggesting the benefit of skills-based training, especially in dementia care. Mouth care in AL has been sorely understudied, and merits additional attention.

Indexed as

Delivery of Health CareMouthAttitudeHumansQuality of Health CareSurveys and Questionnairesassisted living communitieseducational traininginterventionmouth careOral care

Identifiers

PMID33385333
PMCPMC8180494
OpenAlexW3116499190

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.