Development of an Oral Health Literacy Promotion Model for Caregivers of Dependent Older Adults in Sisaket Province.

Abstract

     This study aimed to develop an oral health literacy promotion model for caregivers of dependent older adults in Sisaket Province, Thailand, and to evaluate the preliminary feasibility outcomes of the developed model through a pilot implementation. The study employed a participatory action research approach based on the conceptual framework of Kemmis and McTaggart, consisting of planning, action, observation, and reflection. The study was conducted over a 12 week period. Stakeholders were purposively selected and included health administrators, dentists, dental public health personnel, nurses, care managers, caregivers, village health volunteers, family representatives, local administrative organization personnel, and community leaders. Twenty-three key informants participated in in-depth interviews, while 69 stakeholders participated in the model development process. Research instruments included semi-structured interview guides, focus group discussion guidelines, workshop records, observation forms, and field notes. Qualitative data were analyzed using thematic content analysis and descriptive synthesis.

     The findings revealed that oral health problems among dependent older adults in Sisaket Province had not received sufficient attention within the long-term care system, despite the important relationship between oral health and mastication, nutritional status, comfort, human dignity, and quality of life. Major limitations included caregivers’ lack of practical skills and confidence in providing oral care in complex situations, the absence of appropriate educational media and support tools, inadequate integration of oral health into individualized care plans, discontinuity of referral and follow-up systems, and insufficient family participation. The pilot implementation among 30 caregivers demonstrated that the mean scores of all outcome variables increased after the intervention. Oral health literacy scores increased from 5.07 to 6.67, oral health attitude scores increased from 3.51 to 3.92, perceived severity scores increased from 2.07 to 2.21, perceived benefits scores increased from 2.35 to 2.50, self-efficacy scores increased from 2.18 to 2.45, social support scores increased from 2.02 to 2.25, and oral health care behavior scores increased from 1.98 to 2.27.