Turkiye Klinikleri Journal of Nursing Sciences

.: REVIEW
İnme Geçiren Hastalarda Ağız Hijyeni Uygulamalarının Etkisi: Sistematik Derleme
The Effect of Oral Hygiene Practices in Patients with Stroke: Systematic Review
Simge KALAVa, Arife ALTIN ÇETİNb, Hicran BEKTAŞa
aAkdeniz Üniversitesi Hemşirelik Fakültesi, İç Hastalıkları Hemşireliği ABD, Antalya, TÜRKİYE
bAkdeniz Üniversitesi Hastanesi, Antalya, TÜRKİYE
Turkiye Klinikleri J Nurs Sci. 2020;12(3):430-42
doi: 10.5336/nurses.2020-74729
Article Language: TR
Full Text
ÖZET
 İnme sonrası dönemde, çeşitli nedenlerle ağız hijyeni bozulabilmektedir. Kötü ağız hijyeni sonucunda orofarengeal disfajiye bağlı olarak pnömoni gelişebilmektedir. Bu sistematik derlemenin amacı, inme geçiren hastalarda ağız hijyeni uygulamaların etkisinin incelenmesidir. Literatür tarama aşamasında, PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) akış şeması kullanılmıştır. Taramalar yapılırken yıl sınırlaması yapılmamıştır. 'EBSCOhost/CINAHL Complete, PubMed, Scopus, Ovid MEDLINE, Web of Science ve Cochrane Library' veri tabanlarındaki İngilizce çalışmalar taranmış ve 10 randomize kontrollü çalışma sistematik derlemeye dâhil edilmiştir. Çalışmalarda, çoğunlukla ağız hijyeni bakım programlarının uygulandığı saptanmıştır. Bu programlar dâhilinde uygulamalı ağız hijyeni eğitimleri yapıldığı, eğitimler kapsamında ağız hijyeni önerileri verildiği, elektrikli diş fırçası ile gerçekleştirilen profesyonel diş fırçalama eğitimi sunulduğu, diş arayüz fırçası ve dil temizleyicileri kullanımı sağlandığı, günde 2 kez %0,2'lik klorheksidin glukonat ile ağız çalkalama ve günde 1 kez %1'lik klorheksidinli jel ile dişleri fırçalama gibi girişimler gerçekleştirildiği belirlenmiştir. Uygulanan girişimlerin plak düzeyini ve pnömoni gelişimini azaltma, hastanın yaşam kalitesini iyileştirme, bakım veren aile üyelerinin ağız bakımı bilgisi ve öz yeterliliğini geliştirme ve hemşirelerin ağız bakımı sağlama konusundaki tutum, öznel norm ve bilgi düzeylerini artırma gibi olumlu etkileri olduğu saptanmıştır. İnme geçiren hastalara yönelik gerçekleştirilen ağız hijyeni uygulamalarının, ağız sağlığının geliştirilmesinde etkili olduğu söylenebilir. İnme geçiren hastaların ve yakınlarının ağız sağlığı ile ilgili bilgi ve beceri düzeylerinin geliştirilmesine yönelik bakım programlarının uygulanması ve yaygınlaştırılması önerilebilir.

Anahtar Kelimeler: İnme; ağız sağlığı; ağız hijyeni; randomize kontrollü çalışma
ABSTRACT
 Oral hygiene may be impaired due to several reasons after stroke. As a result of poor oral hygiene, pneumonia may develop due to oropharyngeal dysphagia. The aim of this systematic review is to investigate the effect of oral hygiene practices on stroke patients. PRISMA-P (Preferred Reporting Items for Systematic review and Meta-Analysis Protocols) flow chart was used in the literature review phase. No year limitation was made during the scanning and English studies in EBSCOhost/CINAHL Complete, PubMed, Scopus, Ovid MEDLINE, Web of Science, and Cochrane Library databases were searched. Ten randomized controlled trials were included in the systematic review. It was found that mostly oral hygiene care programs were applied in the studies. Within these programs, practical oral hygiene trainings were held, oral hygiene recommendations were given within the scope of the trainings, and professional toothbrushing training with an electric toothbrush was offered. In addition, it has been determined that using of tooth interface brushes and tongue cleaners are provided, and attempts such as rinsing mouth with 0.2% chlorhexidine gluconate twice a day and brushing teeth with 1% chlorhexidine gel once a day were performed. It has been determined that the applied interventions have positive effects such as decreasing plaque level and pneumonia development, improving the patient's quality of life, improving oral care knowledge and self-efficacy of the caregivers, and increasing nurses' attitude towards providing oral care, subjective norms and knowledge levels. It can be said that oral hygiene practices that are specific to stroke patients are effective in improving oral health. It may be recommended to apply and expand care programs to improve the level of knowledge and skills related to oral health of stroke patients and their relatives.

Keywords: Stroke; oral health; oral hygiene; randomized controlled trial
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