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How do foster carers manage the oral health of children in foster care? A qualitative study
Author(s) -
Muirhead Vanessa,
Subramanian SriKavi,
Wright Desmond,
Wong Ferranti S. L.
Publication year - 2017
Publication title -
community dentistry and oral epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.061
H-Index - 101
eISSN - 1600-0528
pISSN - 0301-5661
DOI - 10.1111/cdoe.12316
Subject(s) - nonprobability sampling , thematic analysis , foster care , medicine , focus group , qualitative research , context (archaeology) , health care , nursing , oral health , family medicine , population , sociology , paleontology , social science , environmental health , economics , biology , economic growth , anthropology
Objectives This qualitative study explored how the foster family environment influenced children's oral health. It also aimed to better understand foster carers’ oral health knowledge, attitudes and experiences of managing foster children's oral health behaviours and oral health care. Methods An interpretative phenomenological analysis ( IPA ) study design was used to recruit a purposive sample of foster carers in Tower Hamlets, United Kingdom, from a range of backgrounds (maximum variation sampling). Participants were aged 21 years and older and provided full‐time foster care for children for a minimum of 1 year. The foster carers took part in focus groups that were audio‐recorded and transcribed verbatim. Data analysis followed a five‐step IPA process, which included reading the transcripts, note taking, identifying emerging themes, connecting related themes and writing up the final themes. Iterative data gathering and analysis continued to reach thematic saturation. Results Three focus groups were conducted, involving a total of 12 foster carers. Eight of the 12 participants had fostered children for more than 10 years and they were currently fostering 22 children aged five to 18 years old. Four themes emerged from within the context of the supportive and nurturing foster family environment that described how foster carers’ responded to and managed the oral health of their foster children. Foster carers had adopted an oral health caregiving role, “in loco parentis” responding to the poor oral health of their vulnerable foster children. They were hypervigilant about establishing and monitoring children's oral health routines and taking their children to see a dentist; these were seen as an integral part of being good foster carers. They were knowledgeable about the causes of children's oral ill health, gained from their own dental experiences and from looking after their own children. Foster carers had experienced tensions while adopting this oral health caregiving role with dentists who had refused to see younger children. Foster carers had also experienced tensions with teenage foster children who questioned their parental authority and legitimate right to set rules about smoking and healthy eating. Conclusions This is the first study to explore foster carers’ oral health perspectives and the foster family environment within the oral health context. It highlights the unrecognized and important role that foster carers have in improving the oral health of vulnerable children. Further research is needed to explore the relationship between foster carers and dentists and to support the development of health and social care interventions to improve foster children's oral health.