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Barriers and facilitators to integrate oral health care for older adults in general (basic) care in East Netherlands. Part 1: Normative integration
Author(s) -
Niesten Dominique,
Gerritsen Anneloes E.,
Leve Verena
Publication year - 2021
Publication title -
gerodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 54
eISSN - 1741-2358
pISSN - 0734-0664
DOI - 10.1111/ger.12507
Subject(s) - normative , medicine , nursing , health care , qualitative research , social science , philosophy , epistemology , sociology , economics , economic growth
Objective to synthesise a framework of barriers and facilitators in the normative integration of oral health care (OHC) into general health care for frail older adults at macro (system), meso (organisation and interprofessional integration) and micro (clinical practice) levels. Background Identification of these barriers and facilitators is expected to promote better and more appropriate care. Methods For this qualitative study, comprising 41 participants, representatives of 10 different groups of (professional) care providers, and OHC receivers (home‐dwelling, and nursing home patients) in East Netherlands were interviewed. Transcripts of the in‐depth, topic‐guided interviews were thematically analysed. In a subsequent workshop with 52 stakeholders, results and interpretations were discussed and refined. Results Two main themes were identified: (1) a compartmentalised care culture in which OHC and general health care are seen as two separate realms, and (2) prioritisation, awareness and attitude regarding OHC integration. Subthemes such as low political attention (macro level); unclear responsibilities, hierarchical relations and the lack of vision of organisations (meso level); and poor awareness and low prioritisation by care providers and patients (micro level) were identified as potential barriers. Subthemes such as leadership (meso level), and the supportive personality of individual caregivers and ownership of patients (micro level) were identified as facilitators. Conclusion Barriers and facilitators in normative OHC integration in The Netherlands are interrelated and apparent at macro‐, meso‐ and micro levels. They are mainly related to (a) a compartmentalised care culture, and (b) related low prioritisation, and poor awareness of and attitude towards (integration of) oral health (care).