doi: 10.1111/j.1741‐2358.2011.00562.x Attitudes to and knowledge about oral health care among nursing home personnel – an area in need of improvementBackground:  In 1999, a dental reform became law in Sweden that regulated both dental care to dependent individuals and training in oral health care for nursing home personnel. Substantial resources have been channelled into these efforts, but the outcome of these efforts has not been evaluated. The aim of this study was to explore attitudes to and knowledge about oral health care among nursing home personnel more than 5 years after the law was adopted, that being 2005.Methods:  A total of 454 individuals employed at nursing homes answered a questionnaire of 16 multiple‐choice items concerning attitudes to and knowledge about oral health care.Results:  Eighty‐nine per cent considered oral health care to be an important part of good nursing. The answers indicated problems, however, when it came to its implementation and knowledge, and 35% stated that they had had no formal education in oral health care.Conclusions:  Despite generally positive oral health care attitudes, it is important that oral health care education is available to and made of interest for all nursing home personnel, especially in light of the increase in number of natural teeth and frequency of crowns and bridges among dependent elderly.

In order to obtain a better understanding of barriers to the implementation of clinical decision-support systems (CDSSs) in primary health care, we explored general practitioners' (GPs) handling of a CDSS during the implementation process. An Internet-based application for the management of chronic heart failure was used that was an adaptation of established clinical guidelines for computer use. The whole implementation process was followed closely, using a combination of different methods for data collection: repeated interviews with the five participating GPs, observations of patient visits, patient interviews, and detection of usage. We analysed the data using qualitative content analysis. The results showed that GPs' attitudes and characteristics constituted different profiles that seemed to be associated with the degree of acceptance of the CDSS. Those profiles were related to conceptions about the GPs' professional role and their attitudes towards the computer's function in disease management and in decision-making. Some additional barriers were insufficient level of computer skills and time constraints in everyday work. These findings can help us identify groups of GPs with definable needs during the implementation of a CDSS and make it easier to meet those needs with individually tailored interventions.

Objectives: The proportion of older people in the population is increasing rapidly. Along with this comes an increase in the number of people requiring assistance in daily living, including oral care. Swedish law stipulates that care personnel who work with older people should be offered oral health education every year. The aim of this study was to investigate oral health care beliefs among such personnel.Methods: A questionnaire study was conducted among 2167 personnel providing care to older people at special accommodation sites and in home care. Data were collected using the Nursing Dental Coping Beliefs Scale. Descriptive statistics were calculated and logistic regression analysis was performed.Results: Personnel working in home care had lower odds of having an internal locus of control than those working in special accommodation, and personnel with less than 10 years of working experience had lower odds than their more experienced counterparts. Men had higher odds of having an external locus of control than women.Conclusions: It seems important to ensure that home care personnel and less experienced personnel attend oral care educational sessions, and to encourage male staff to focus on oral care work.

Objectives. To describe the oral health-related quality-of-life in homebound elderly dependent on moderate and substantial supportive care for daily living. Materials and methods. A total of 302 selected persons in three counties in Sweden over 65 years of age and in need of daily support from society participated in the study. Half of the participants had moderate needs of support, defined as supportive care of 15–50 h per month and half had substantial needs of supportive care, i.e. 3-times a day with a night overview. An oral examination was performed and structured questions were asked about general health and living conditions, medication, oral care routines and quality-of-life, using the instrument GOHAI (Geriatric Oral Health Assessment Instrument). Results. Cardiovascular disease was common and an average of seven prescription drugs was used. More than half of the participants had dentures. The strongest correlation with GOHAI was the total number of teeth. There was a significant difference between individuals with moderate and substantial needs according to GOHAI, irrespective of gender. More elderly people with substantial needs of support had low GOHAI values. Decayed teeth, DT/T, root remnants and dry mouth were negatively correlated to GOHAI among individuals with substantial needs. Conclusions. This study found that elderly homebound individuals with substantial needs of supportive care had a lower quality-of-life than elderly homebound individuals with moderate needs of supportive care, although both medical and odontological variables were similar in the groups.