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Wang J, Anderson R, Perez JS, Estabrooks CA, Berta W, Lanham HJ, Duan Y, Iaconi A, Beeber A. Understanding Adaptive Leadership in the Context of Nursing Homes. J Appl Gerontol 2024:7334648241243312. [PMID: 38566520 DOI: 10.1177/07334648241243312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Rapidly growing populations of older adults rely heavily on formal long-term care services such as those provided in nursing homes. Nursing home staff are confronted with complex challenges. We explored how staff (N = 88), particularly care aides, interpreted challenges and responded to them by taking adaptive leadership roles, and engaging in technical and adaptive work in nursing homes. We conducted analysis of the ethnographic case studies. In long-term care settings, staff face complex challenges in improving resident care due to contextual barriers. These include demanding work conditions and inadequate resources. Additionally, top-down communications, despite being well-intentioned, often lead to misinterpretation and a lack of staff motivation. Nonetheless, we found that certain staff managed to overcome these contextual barriers and effectively execute change initiatives by assuming adaptive leadership roles. Formal leaders have a vital role in empowering staff, including care aides, and facilitating their adaptive leadership behaviors.
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Affiliation(s)
- Jing Wang
- College of Health and Human Services, University of New Hampshire, Durham, NH, USA
| | - Ruth Anderson
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Janelle Santos Perez
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Whitney Berta
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Holly J Lanham
- Joe R. & Teresa Lozano Long School of Medicine, University of Texas Health, San Antonio, TX, USA
| | - Yinfei Duan
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Alba Iaconi
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Anna Beeber
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
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Bryant AL, Hirschey R, Caiola CE, Chan YN, Cho Y, Plassman BL, Wu B, Anderson RA, Bailey DE. Care partners experience of an oral health intervention for individuals with mild cognitive impairment and mild dementia using behavior change technique: A qualitative study. Geriatr Nurs 2024; 56:40-45. [PMID: 38237339 PMCID: PMC10990823 DOI: 10.1016/j.gerinurse.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 02/02/2024]
Abstract
Oral health declines in older adults with cognitive impairment. We aimed to improve oral hygiene outcomes for individuals with mild cognitive impairment (MCI) or mild dementia (MD) by fostering behavior changes among carepartners assisting them. We used qualitative data of verbatim transcripts of coaching sessions with carepartners (n = 17 dyads:10 dyads for MCI, 7 dyads for MD). Directed and emergent coding were used to understand behavior change techniques (BCTs). BCTs were compared with carepartners of participants with MCI and MD. Most frequently used BCTs in both groups: prompts and cues, instruction on how to perform the behavior, review behavioral goal, and problem solving. Different BCTs emerged in study: social support-unspecified of the MCI group and credible source for MD group. Findings clarified active intervention components, common BCTs used by carepartners, and different BCT approaches for both participants. Findings help to elucidate the mechanisms of changes in individuals' behaviors in these interventions.
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Affiliation(s)
- Ashley Leak Bryant
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rachel Hirschey
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Ya-Ning Chan
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Youngmin Cho
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brenda L Plassman
- Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Bei Wu
- New York University Rory Meyers College of Nursing, New York City, New York, USA
| | - Ruth A Anderson
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Ho BV, van der Maarel-Wierink CD, de Vries R, Lobbezoo F. Oral health care services for community-dwelling older people with dementia: A scoping review. Gerodontology 2023; 40:288-298. [PMID: 36440580 DOI: 10.1111/ger.12670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/02/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess whether, and if so, which oral health care services for community-dwelling older people with dementia are available. BACKGROUND Oral health in people with dementia is poor compared with people without dementia. Although multiple oral health care interventions have previously been studied for older people living in nursing homes, little is known about interventions or services for community-dwelling older people with dementia. MATERIALS AND METHODS A literature search was performed in the databases Pubmed, Embase and CINAHL. The following search terms were used: "Dementia", "Oral health", "Dental health services" and "Older person". The term "dental health services" was intended to be an as broad as possible construct because limited search results were expected. RESULTS The search generated 1624 unique references, of which seven studies were eligible for inclusion (four cohort studies, one cross-sectional study, and two qualitative studies). The included studies described two actual oral health care services: a telephone help line on oral health and dementia, and a mobile geriatric dental programme in adult day health centres. A need was found for services and strategies specific to community-dwelling older people with dementia. One identified solution was an intervention with individually tailored daily oral hygiene self-care supported by the informal caregiver. Furthermore, increasing accessibility of oral health care professionals with treatment at other locations than their own practices, better collaboration between health care professionals and preventive oral health care are highly necessary. CONCLUSION There is limited evidence on the availability of oral health care services for community-dwelling older people with dementia, while a need was found for oral health care services that focus on good accessibility, oral hygiene self-care, preventive strategies and collaboration among health care professionals.
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Affiliation(s)
- Bach Van Ho
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Claar D van der Maarel-Wierink
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Peres MA, Peres KG, Chan A, Wu B, Mittinty M. Investigating the causal effect of cognition on the self-reported loss of functional dentition using marginal structural models: The Panel on Health and Ageing of Singaporean Elderly study. J Clin Periodontol 2023; 50:408-417. [PMID: 36384159 DOI: 10.1111/jcpe.13752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 09/02/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
Abstract
AIM To assess the effect of cognition on the loss of functional dentition. MATERIALS AND METHODS We used data from the three waves of the Panel on Health and Ageing of Singaporean Elderly study (n = 4990 at baseline, 774 complete cases analysed) over 6 years (2009-2015). The outcome was the loss of functional dentition (<21 teeth). The exposure was cognitive impairment, while baseline confounders included age, sex, education, and ethnicity. Time-varying confounders included income, living arrangements, smoking, diabetes, depressive symptoms, cardiovascular disease, and body mass index. We used marginal structural mean models with inverse probability treatment weighted. RESULTS The mean age of the participants was 70.2 years at baseline. The proportion of participants with loss of functional dentition increased from 74.6% to 89.9% over 6 years. Women, ethnic Chinese, less educated, smokers, people with diabetes, and individuals with depression had a higher proportion of loss of functional dentition than their counterparts. Loss of functional dentition was 1.8 times higher (odds ratio 1.80; 95% confidence interval 0.88-3.69) among those with cognitive impairment after taking well-known confounders into account. CONCLUSIONS After accounting for the time-varying exposure and confounding evidence, the association between cognition and functional dentition among the elderly in Singapore remains uncertain.
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Affiliation(s)
- Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre, Singapore, Singapore
- Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Karen G Peres
- National Dental Research Institute Singapore, National Dental Centre, Singapore, Singapore
- Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Angelique Chan
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
| | - Bei Wu
- Hartford Institute for Geriatric Nursing, Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Murthy Mittinty
- Faculty of Health and Medical Sciences, School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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Chen L, Cao H, Wu X, Xu X, Ji X, Wang B, Zhang P, Li H. Effects of oral health intervention strategies on cognition and microbiota alterations in patients with mild Alzheimer's disease: A randomized controlled trial. Geriatr Nurs 2022; 48:103-110. [PMID: 36155316 DOI: 10.1016/j.gerinurse.2022.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 12/14/2022]
Abstract
We explored the effects of an oral health intervention on the oral microbiome and cognitive function of patients with mild Alzheimer's disease (AD) and determined the influence on disease progression. Sixty-six patients with mild AD were randomly assigned to intervention or control groups and received a 24-week oral health intervention and routine care, respectively. Data were collected at baseline and week 24. 16 S rRNA sequencing was used to analyze oral microbiota. After 24 weeks of oral health intervention, Kayser-Jones Brief Oral Health Status Examination (BOHSE), Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), Nursing Home Adjustment Scale (NHAS), and Alzheimer's Disease Cooperative Study-ADL (ADCS-ADL) scores were different between groups (p < 0.05). Subgingival plaque in patients with AD showed significant differences in the diversity and abundance of oral microbiomes, with a higher abundance of normal oral flora in the intervention group. We found oral health intervention strategies are effective in modifying subgingival microbiota differences and slowing cognitive decline in mild AD patients.
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Affiliation(s)
- Lili Chen
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China; The School of Nursing, Fujian Medical University, Fuzhou, China; Fujian Provincial Hospital, Fuzhou, China.
| | - Huizhen Cao
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China; Fujian Provincial Hospital, Fuzhou, China
| | - Xiaoqi Wu
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xinhua Xu
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xinli Ji
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Bixia Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Ping Zhang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Hong Li
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China; The School of Nursing, Fujian Medical University, Fuzhou, China; Fujian Provincial Hospital, Fuzhou, China.
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Estabrooks C, Song Y, Anderson R, Beeber A, Berta W, Chamberlain S, Cummings G, Duan Y, Hayduk L, Hoben M, Iaconi A, Lanham H, Perez J, Wang J, Norton P. The Influence of Context on Implementation and Improvement: Protocol for a Mixed Methods, Secondary Analyses Study. JMIR Res Protoc 2022; 11:e40611. [PMID: 36107475 PMCID: PMC9523530 DOI: 10.2196/40611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/13/2022] [Accepted: 07/30/2022] [Indexed: 12/05/2022] Open
Abstract
Background Caring for the well-being of older adults is one of the greatest challenges in modern societies. Improving the quality of care and life for older adults and the work lives of their care providers calls for effective knowledge translation of evidence-based best practices. Objective This study’s purpose is to contribute to knowledge translation by better understanding the roles of organizational context (workplace environment) and facilitation (process or role) in implementation and improvement success. Our study has 2 goals: (1) to advance knowledge translation science by further developing and testing the Promoting Action on Research Implementation in Health Services framework (which outlines how implementation relies on the interplay of context, facilitation, and evidence) and (2) to advance research by optimizing implementation success via tailoring of modifiable elements of organizational context and facilitation. Methods This is secondary analyses of 15 years of longitudinal data from the Translating Research in Elder Care (TREC) program’s multiple data sources. This research is ongoing in long-term care (LTC) homes in western Canada. TREC data include the following: 5 waves of survey collection, 2 clinical trials, and regular ongoing outcome data for LTC residents. We will use a sequential exploratory and confirmatory mixed methods design. We will analyze qualitative and quantitative data holdings in an iterative process: (1) comprehensive reanalysis of qualitative data to derive hypotheses, (2) quantitative modeling to test hypotheses, and (3) action cycles to further refine and integrate qualitative and quantitative analyses. The research team includes 4 stakeholder panels: (1) system decision- and policy makers, (2) care home managers, (3) direct care staff, and (4) a citizen engagement group of people living with dementia and family members of LTC residents. A fifth group is our panel of external scientific advisors. Each panel will engage periodically, providing their perspectives on project direction and findings. Results This study is funded by the Canadian Institutes of Health Research. Ethics approval was obtained from the University of Alberta (Pro00096541). The results of the secondary analyses are expected by the end of 2023. Conclusions The project will advance knowledge translation science by deepening our understanding of the roles of context, the interactions between context and facilitation, and their influence on resident and staff quality outcomes. Importantly, findings will inform understanding of the mechanisms by which context and facilitation affect the success of implementation and offer insights into factors that influence the implementation success of interventions in nursing homes. International Registered Report Identifier (IRRID) DERR1-10.2196/40611
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Affiliation(s)
| | - Yuting Song
- School of Nursing, Qingdao University, Qingdao, China
| | - Ruth Anderson
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Anna Beeber
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Whitney Berta
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | - Greta Cummings
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Yinfei Duan
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Leslie Hayduk
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Alba Iaconi
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Holly Lanham
- Department of Medicine, University of Texas Health Sciences Center San Antonio, San Antonio, TX, United States
| | - Janelle Perez
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jing Wang
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Peter Norton
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada
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Wang J, Ding D, Wu B. Enhancement of Aging in Place: An Evolving Understanding of Person-Centered Dementia Care in Home Settings. J Alzheimers Dis 2022; 86:1315-1322. [PMID: 35213380 DOI: 10.3233/jad-215612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There has been a rich body of literature on informal caregivers of persons with dementia (PWD). However, little has been discussed on how to facilitate person-centered dementia care in home settings with spouses as primary caregivers. We tend to take it for granted that spouses provide person-centered care for PWD. However, being spouses of PWD and living with them for several decades does not necessarily mean that it is easier for them to provide person-centered dementia care and maintain valued and healthy relationships. OBJECTIVE The current study aimed to explore dyadic experiences of PWD and their spousal caregivers and develop a culturally and contextually-sensitive understanding of person-centered dementia care in home-based settings. METHODS A total of 20 dyads of PWD and their care partners were selected for this study. A trained qualitative interviewer conducted a one-on-one interview with each participant with dementia and their care partners separately. We adopted both conventional and directed content analyses. RESULTS Our findings provide examples of care partners provide person-centered care, resulting in a profound positive impact on their wellbeing. Adaptive leadership and collaborative work emerged as a key finding in facilitating person-centered dementia care. Cultural relevancy of person-centered dementia care was also interpreted from the data. The study findings provide implications for the evolving of person-centered dementia care model in home-based settings. CONCLUSION Findings from this study highlight the significance of facilitating person-centered dementia care in home-based settings between PWD and their primary family caregivers.
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Affiliation(s)
- Jing Wang
- Fudan University School of Nursing, Shanghai, China
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, NY, USA.,NYU Aging Incubator, New York, NY, USA
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[Dental care for older people: opportunities and challenges]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:802-811. [PMID: 34156484 PMCID: PMC8241673 DOI: 10.1007/s00103-021-03358-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/20/2021] [Indexed: 11/12/2022]
Abstract
Die Mundgesundheit der Bevölkerung in Deutschland konnte in den letzten Jahren verbessert werden; allerdings profitierten ältere und insbesondere gebrechliche sowie pflegebedürftige Menschen nicht adäquat von dieser Entwicklung. Dabei kann eine gute Mundgesundheit relevant dazu beitragen, die Herausforderungen bei Gebrechlichkeit und Pflegebedürftigkeit besser zu bewältigen. Der eingeschränkte Zugang zur zahnmedizinischen Betreuung, die manchmal eingeschränkte Kooperativität sowie die schlechtere Mundpflege in dieser Bevölkerungsgruppe erhöhen das Risiko für Karies, Parodontalerkrankungen, Zahnverlust und Zahnlosigkeit im Vergleich zur Durchschnittsbevölkerung. Der vorliegende Beitrag gibt eine Übersicht über die zahnmedizinische Situation älterer Menschen anhand bereits publizierter Daten aus der bevölkerungsrepräsentativen Fünften Deutschen Mundgesundheitsstudie (DMS V), die im Jahr 2014 erhoben wurden. Die mittlere Anzahl der fehlenden Zähne betrug bei den 65- bis 74-Jährigen 11,1 Zähne. Bei älteren Seniorinnen und Senioren (75–100 Jahre) mit Pflegebedarf (äSmP) war die Mundgesundheit schlechter als bei denjenigen ohne Pflegebedarf (äSoP). So hatten äSoP durchschnittlich 11,8 Zähne, äSmP dagegen nur 5,7 Zähne. Der Anteil zahnloser 65- bis 74-Jähriger hatte sich seit 1997 halbiert auf 12,4 %. Bei den äS waren 32,8 % zahnlos (äSmP: 53,7 %, äSoP: 26,7 %). Mehr als 75 % der äSmP waren abnehmbar prothetisch versorgt (äSoP: 51,7 %). Vor diesem Hintergrund werden in diesem Beitrag Schnittstellen benannt, an denen eine chancengleiche Anbindung dieser Bevölkerungsgruppen an eine zahnmedizinische Versorgungsstruktur etabliert werden könnte. Diese beinhalten akutgeriatrische Krankenhausstationen und die Entwicklung weitergehender Konzepte in der aufsuchenden Versorgung zur besseren Versorgung der Betroffenen und zur Erleichterung der Pflege.
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Wu B, Anderson RA, Pei Y, Xu H, Nye K, Poole P, Bunn M, Lynn Downey C, Plassman BL. Care partner-assisted intervention to improve oral health for older adults with cognitive impairment: A feasibility study. Gerodontology 2021; 38:308-316. [PMID: 33395734 DOI: 10.1111/ger.12528] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 12/11/2020] [Accepted: 12/12/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Older adults with cognitive impairment often experience poor oral health outcomes due to inadequate oral hygiene practices. This pilot study aimed to evaluate the feasibility of a care partner-assisted intervention to improve the oral hygiene of community-dwelling older adults with cognitive impairment. MATERIAL AND METHODS The 6-month intervention included 25 older adults with mild dementia or mild cognitive impairment, who were randomly assigned to Treatment Group 1 or Treatment Group 2. Treatment Group 1 (n = 7) received an educational booklet. Treatment Group 2 (n = 18) received a booklet, a tailored care plan for the participants with cognitive impairment and the care partner received four coaching sessions to learn to facilitate good oral hygiene. Both groups received electric toothbrushes. The study consisted of a 3-month active intervention and 3-month maintenance phase. The outcomes of gingival index, plaque index and overall oral health status based on the Oral Health Assessment Tool were measured at baseline, 3 months (end of active intervention) and 6 months of the study. RESULTS This study had very low dropout rate. Participants' oral hygiene improved in this study. In comparison to Treatment Group 1, participants in Treatment Group 2 had a greater reduction in plaque level and gingival inflammation, and greater improvement in overall oral health status. CONCLUSION This study demonstrates the feasibility of this intervention designed to improve the oral health of persons with cognitive impairment and it lays the foundation for using this protocol in a future large randomised clinical trial.
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Affiliation(s)
- Bei Wu
- Hartford Institute for Geriatric Nursing, Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Ruth A Anderson
- School of Nursing, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Hanzhang Xu
- School of Nursing, Duke University, Durham, NC, USA
| | - Kathleen Nye
- School of Medicine, University of California Davis, Davis, CA, USA
| | - Patricia Poole
- Adams School of Dentistry, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Melanie Bunn
- School of Nursing, Duke University, Durham, NC, USA
| | - Christine Lynn Downey
- Adams School of Dentistry, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
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Wu B, Pei Y, Zhang W, Northridge M. Immigrant Status, Resilience, and Perceived Oral Health Among Chinese Americans in Hawaii. Res Aging 2020; 42:186-195. [PMID: 32195629 DOI: 10.1177/0164027520912493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES This study aims to examine the associations among immigrant status, resilience, and perceived oral health for Chinese American older adults in Hawaii. METHOD Data derived from 430 Chinese American adults aged 55 years and older residing in Honolulu, HI. We compared the self-rated oral health and oral health problems between U.S.-born Chinese Americans and foreign-born Chinese Americans by using ordered logistic regression and ordinary least squares regression models. RESULTS Findings suggest that immigrant status and lower levels of resilience are associated with poorer self-rated oral health and more oral health problems for Chinese American older adults in Hawaii. Resilience is more strongly associated with self-rated oral health for U.S.-born Chinese American than for foreign-born Chinese Americans, but this pattern was not evident for oral health problems. DISCUSSION Older Chinese American immigrants in Hawaii are disadvantaged in terms of their oral health. Understanding their susceptibilities may lead to targeted interventions.
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Affiliation(s)
- Bei Wu
- Rory Meyers College of Nursing, New York University, NY, USA
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, NY, USA
| | - Wei Zhang
- Department of Sociology, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Mary Northridge
- NYU Grossman School of Medicine, New York University, NY, USA
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