Assignment of Dental Hygienists Improves Outcomes in Japanese Rehabilitation Wards: A Retrospective Cohort Study
Objectives To clarify the effectiveness of ward-assigned dental hygienists (DHs) on rehabilitation outcomes in rehabilitation wards. Design Retrospective cohort study. Setting The registry data from the Japanese Rehabilitation Nutrition Database. Participants 656 patients with hip fracture or stroke...
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| Veröffentlicht in: | The Journal of nutrition, health & aging health & aging, 2020, Vol.24 (1), p.28-36 |
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| creator | Suzuki, R. Nagano, Ayano Wakabayashi, H. Maeda, K. Nishioka, S. Takahashi, M. Momosaki, R. |
| description | Objectives
To clarify the effectiveness of ward-assigned dental hygienists (DHs) on rehabilitation outcomes in rehabilitation wards.
Design
Retrospective cohort study.
Setting
The registry data from the Japanese Rehabilitation Nutrition Database.
Participants
656 patients with hip fracture or stroke admitted to convalescent rehabilitation wards.
Measurements
The main outcome measures were the Functional Independence Measure (FIM), the Food Intake Level Scale (FILS), and the home discharge rate. Patients were divided into two groups based on the ward setting: with an assigned DH (DH group) and without an assigned DH (NDH group). Clinical characteristics and outcomes were compered between the groups. Between-facility differences were adjusted by generalized estimating equation. We performed post-hoc power analysis to confirm that there were enough samples included in this study to detect a significant difference.
Results
Of 656 patients (mean age, 77 years; 57.1% female; 65.5% stroke) from 10 facilities, 454 patients (69.2%) from 4 facilities were in the DH group. FIM score at discharge (107 vs 90, P |
| doi_str_mv | 10.1007/s12603-019-1284-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2331432022</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2331432022</sourcerecordid><originalsourceid>FETCH-LOGICAL-c415t-f2e38bd033d9f59bfdc82872547e87b97f31ad9019a9b9fd50ee35eb12abacb23</originalsourceid><addsrcrecordid>eNp1kUtv1TAQhS0Eog_4AWyQJTZsAn4ksc3u6hbaokqVeIilZSeTW1dJHDxOpfvv8dUtICGxmpH9zfEZH0JecfaOM6beIxctkxXjpuJC15V5Qk65allVK62fll4oUynF1Ak5Q7xnrG6Mbp-TE8m1bjVrTsmyQQy7eYI50zjQi1LdSK_2uwBzwIz0elpSfACkt2vu4lSaMNPPbnEzINAvcOd8GEN2OcSZ_nCpxw90U85zirhAl8MD0G28iynTr3nt9y_Is8GNCC8f6zn5_unjt-1VdXN7eb3d3FRdzZtcDQKk9j2TsjdDY_zQd1poJZpagVbeqEFy15uyujPeDH3DAGQDngvnXeeFPCdvj7rF_s8VMNspYAfjWIzHFa2QktdSMHFA3_yD3sc1zcXdgWJGtqbWheJHqiubYYLBLilMLu0tZ_YQhz3GYYsne4jDmjLz-lF59RP0fyZ-_38BxBHAcjXvIP19-v-qvwDq1ZZ1</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2330936948</pqid></control><display><type>article</type><title>Assignment of Dental Hygienists Improves Outcomes in Japanese Rehabilitation Wards: A Retrospective Cohort Study</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Alma/SFX Local Collection</source><creator>Suzuki, R. ; Nagano, Ayano ; Wakabayashi, H. ; Maeda, K. ; Nishioka, S. ; Takahashi, M. ; Momosaki, R.</creator><creatorcontrib>Suzuki, R. ; Nagano, Ayano ; Wakabayashi, H. ; Maeda, K. ; Nishioka, S. ; Takahashi, M. ; Momosaki, R.</creatorcontrib><description>Objectives
To clarify the effectiveness of ward-assigned dental hygienists (DHs) on rehabilitation outcomes in rehabilitation wards.
Design
Retrospective cohort study.
Setting
The registry data from the Japanese Rehabilitation Nutrition Database.
Participants
656 patients with hip fracture or stroke admitted to convalescent rehabilitation wards.
Measurements
The main outcome measures were the Functional Independence Measure (FIM), the Food Intake Level Scale (FILS), and the home discharge rate. Patients were divided into two groups based on the ward setting: with an assigned DH (DH group) and without an assigned DH (NDH group). Clinical characteristics and outcomes were compered between the groups. Between-facility differences were adjusted by generalized estimating equation. We performed post-hoc power analysis to confirm that there were enough samples included in this study to detect a significant difference.
Results
Of 656 patients (mean age, 77 years; 57.1% female; 65.5% stroke) from 10 facilities, 454 patients (69.2%) from 4 facilities were in the DH group. FIM score at discharge (107 vs 90, P<0.001), percentage improvement in FILS score from admission to discharge (44.5% vs 22.8%, P<0.001) and home discharge rate (72.5% vs 61.4%, P<0.001) were significantly higher in the DH group than in the NDH group. After multivariate analysis, the FIM score at discharge (P=0.007), FILS score at discharge (P=0.024), and home discharge rate (P=0.007) were significantly higher in the DH group than in the NDH group.
Conclusions
ADL and swallowing function were significantly improved at discharge and the home discharge rate was higher among patients in rehabilitation wards with DHs. Having a ward-assigned DH may lead to better rehabilitation outcomes in rehabilitation wards.</description><identifier>ISSN: 1279-7707</identifier><identifier>EISSN: 1760-4788</identifier><identifier>DOI: 10.1007/s12603-019-1284-9</identifier><identifier>PMID: 31886805</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Activities of Daily Living ; Aged ; Aged, 80 and over ; Aging ; Clinical outcomes ; Cohort analysis ; Deglutition - physiology ; Dental assistants ; Dental Hygienists - statistics & numerical data ; Dysphagia ; Female ; Fractures ; Geriatrics/Gerontology ; Hip Fractures - rehabilitation ; Hospitalization ; Hospitals ; Humans ; Inpatient care ; Japan ; Male ; Medicine ; Medicine & Public Health ; Neurosciences ; Nutrition ; Nutritional Status ; Older people ; Oral hygiene ; Outcome Assessment, Health Care ; Patient Discharge ; Primary Care Medicine ; Quality of Life Research ; Recovery of Function - physiology ; Rehabilitation ; Retrospective Studies ; Stroke ; Stroke - therapy ; Stroke Rehabilitation - methods ; Treatment Outcome</subject><ispartof>The Journal of nutrition, health & aging, 2020, Vol.24 (1), p.28-36</ispartof><rights>Serdi and Springer-Verlag International SAS, part of Springer Nature 2019</rights><rights>The journal of nutrition, health & aging is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-f2e38bd033d9f59bfdc82872547e87b97f31ad9019a9b9fd50ee35eb12abacb23</citedby><cites>FETCH-LOGICAL-c415t-f2e38bd033d9f59bfdc82872547e87b97f31ad9019a9b9fd50ee35eb12abacb23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12603-019-1284-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12603-019-1284-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,4010,27900,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31886805$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Suzuki, R.</creatorcontrib><creatorcontrib>Nagano, Ayano</creatorcontrib><creatorcontrib>Wakabayashi, H.</creatorcontrib><creatorcontrib>Maeda, K.</creatorcontrib><creatorcontrib>Nishioka, S.</creatorcontrib><creatorcontrib>Takahashi, M.</creatorcontrib><creatorcontrib>Momosaki, R.</creatorcontrib><title>Assignment of Dental Hygienists Improves Outcomes in Japanese Rehabilitation Wards: A Retrospective Cohort Study</title><title>The Journal of nutrition, health & aging</title><addtitle>J Nutr Health Aging</addtitle><addtitle>J Nutr Health Aging</addtitle><description>Objectives
To clarify the effectiveness of ward-assigned dental hygienists (DHs) on rehabilitation outcomes in rehabilitation wards.
Design
Retrospective cohort study.
Setting
The registry data from the Japanese Rehabilitation Nutrition Database.
Participants
656 patients with hip fracture or stroke admitted to convalescent rehabilitation wards.
Measurements
The main outcome measures were the Functional Independence Measure (FIM), the Food Intake Level Scale (FILS), and the home discharge rate. Patients were divided into two groups based on the ward setting: with an assigned DH (DH group) and without an assigned DH (NDH group). Clinical characteristics and outcomes were compered between the groups. Between-facility differences were adjusted by generalized estimating equation. We performed post-hoc power analysis to confirm that there were enough samples included in this study to detect a significant difference.
Results
Of 656 patients (mean age, 77 years; 57.1% female; 65.5% stroke) from 10 facilities, 454 patients (69.2%) from 4 facilities were in the DH group. FIM score at discharge (107 vs 90, P<0.001), percentage improvement in FILS score from admission to discharge (44.5% vs 22.8%, P<0.001) and home discharge rate (72.5% vs 61.4%, P<0.001) were significantly higher in the DH group than in the NDH group. After multivariate analysis, the FIM score at discharge (P=0.007), FILS score at discharge (P=0.024), and home discharge rate (P=0.007) were significantly higher in the DH group than in the NDH group.
Conclusions
ADL and swallowing function were significantly improved at discharge and the home discharge rate was higher among patients in rehabilitation wards with DHs. Having a ward-assigned DH may lead to better rehabilitation outcomes in rehabilitation wards.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging</subject><subject>Clinical outcomes</subject><subject>Cohort analysis</subject><subject>Deglutition - physiology</subject><subject>Dental assistants</subject><subject>Dental Hygienists - statistics & numerical data</subject><subject>Dysphagia</subject><subject>Female</subject><subject>Fractures</subject><subject>Geriatrics/Gerontology</subject><subject>Hip Fractures - rehabilitation</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Inpatient care</subject><subject>Japan</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurosciences</subject><subject>Nutrition</subject><subject>Nutritional Status</subject><subject>Older people</subject><subject>Oral hygiene</subject><subject>Outcome Assessment, Health Care</subject><subject>Patient Discharge</subject><subject>Primary Care Medicine</subject><subject>Quality of Life Research</subject><subject>Recovery of Function - physiology</subject><subject>Rehabilitation</subject><subject>Retrospective Studies</subject><subject>Stroke</subject><subject>Stroke - therapy</subject><subject>Stroke Rehabilitation - methods</subject><subject>Treatment Outcome</subject><issn>1279-7707</issn><issn>1760-4788</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kUtv1TAQhS0Eog_4AWyQJTZsAn4ksc3u6hbaokqVeIilZSeTW1dJHDxOpfvv8dUtICGxmpH9zfEZH0JecfaOM6beIxctkxXjpuJC15V5Qk65allVK62fll4oUynF1Ak5Q7xnrG6Mbp-TE8m1bjVrTsmyQQy7eYI50zjQi1LdSK_2uwBzwIz0elpSfACkt2vu4lSaMNPPbnEzINAvcOd8GEN2OcSZ_nCpxw90U85zirhAl8MD0G28iynTr3nt9y_Is8GNCC8f6zn5_unjt-1VdXN7eb3d3FRdzZtcDQKk9j2TsjdDY_zQd1poJZpagVbeqEFy15uyujPeDH3DAGQDngvnXeeFPCdvj7rF_s8VMNspYAfjWIzHFa2QktdSMHFA3_yD3sc1zcXdgWJGtqbWheJHqiubYYLBLilMLu0tZ_YQhz3GYYsne4jDmjLz-lF59RP0fyZ-_38BxBHAcjXvIP19-v-qvwDq1ZZ1</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Suzuki, R.</creator><creator>Nagano, Ayano</creator><creator>Wakabayashi, H.</creator><creator>Maeda, K.</creator><creator>Nishioka, S.</creator><creator>Takahashi, M.</creator><creator>Momosaki, R.</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>2020</creationdate><title>Assignment of Dental Hygienists Improves Outcomes in Japanese Rehabilitation Wards: A Retrospective Cohort Study</title><author>Suzuki, R. ; Nagano, Ayano ; Wakabayashi, H. ; Maeda, K. ; Nishioka, S. ; Takahashi, M. ; Momosaki, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-f2e38bd033d9f59bfdc82872547e87b97f31ad9019a9b9fd50ee35eb12abacb23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging</topic><topic>Clinical outcomes</topic><topic>Cohort analysis</topic><topic>Deglutition - physiology</topic><topic>Dental assistants</topic><topic>Dental Hygienists - statistics & numerical data</topic><topic>Dysphagia</topic><topic>Female</topic><topic>Fractures</topic><topic>Geriatrics/Gerontology</topic><topic>Hip Fractures - rehabilitation</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Inpatient care</topic><topic>Japan</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurosciences</topic><topic>Nutrition</topic><topic>Nutritional Status</topic><topic>Older people</topic><topic>Oral hygiene</topic><topic>Outcome Assessment, Health Care</topic><topic>Patient Discharge</topic><topic>Primary Care Medicine</topic><topic>Quality of Life Research</topic><topic>Recovery of Function - physiology</topic><topic>Rehabilitation</topic><topic>Retrospective Studies</topic><topic>Stroke</topic><topic>Stroke - therapy</topic><topic>Stroke Rehabilitation - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suzuki, R.</creatorcontrib><creatorcontrib>Nagano, Ayano</creatorcontrib><creatorcontrib>Wakabayashi, H.</creatorcontrib><creatorcontrib>Maeda, K.</creatorcontrib><creatorcontrib>Nishioka, S.</creatorcontrib><creatorcontrib>Takahashi, M.</creatorcontrib><creatorcontrib>Momosaki, R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of nutrition, health & aging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suzuki, R.</au><au>Nagano, Ayano</au><au>Wakabayashi, H.</au><au>Maeda, K.</au><au>Nishioka, S.</au><au>Takahashi, M.</au><au>Momosaki, R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assignment of Dental Hygienists Improves Outcomes in Japanese Rehabilitation Wards: A Retrospective Cohort Study</atitle><jtitle>The Journal of nutrition, health & aging</jtitle><stitle>J Nutr Health Aging</stitle><addtitle>J Nutr Health Aging</addtitle><date>2020</date><risdate>2020</risdate><volume>24</volume><issue>1</issue><spage>28</spage><epage>36</epage><pages>28-36</pages><issn>1279-7707</issn><eissn>1760-4788</eissn><abstract>Objectives
To clarify the effectiveness of ward-assigned dental hygienists (DHs) on rehabilitation outcomes in rehabilitation wards.
Design
Retrospective cohort study.
Setting
The registry data from the Japanese Rehabilitation Nutrition Database.
Participants
656 patients with hip fracture or stroke admitted to convalescent rehabilitation wards.
Measurements
The main outcome measures were the Functional Independence Measure (FIM), the Food Intake Level Scale (FILS), and the home discharge rate. Patients were divided into two groups based on the ward setting: with an assigned DH (DH group) and without an assigned DH (NDH group). Clinical characteristics and outcomes were compered between the groups. Between-facility differences were adjusted by generalized estimating equation. We performed post-hoc power analysis to confirm that there were enough samples included in this study to detect a significant difference.
Results
Of 656 patients (mean age, 77 years; 57.1% female; 65.5% stroke) from 10 facilities, 454 patients (69.2%) from 4 facilities were in the DH group. FIM score at discharge (107 vs 90, P<0.001), percentage improvement in FILS score from admission to discharge (44.5% vs 22.8%, P<0.001) and home discharge rate (72.5% vs 61.4%, P<0.001) were significantly higher in the DH group than in the NDH group. After multivariate analysis, the FIM score at discharge (P=0.007), FILS score at discharge (P=0.024), and home discharge rate (P=0.007) were significantly higher in the DH group than in the NDH group.
Conclusions
ADL and swallowing function were significantly improved at discharge and the home discharge rate was higher among patients in rehabilitation wards with DHs. Having a ward-assigned DH may lead to better rehabilitation outcomes in rehabilitation wards.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>31886805</pmid><doi>10.1007/s12603-019-1284-9</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Activities of Daily Living Aged Aged, 80 and over Aging Clinical outcomes Cohort analysis Deglutition - physiology Dental assistants Dental Hygienists - statistics & numerical data Dysphagia Female Fractures Geriatrics/Gerontology Hip Fractures - rehabilitation Hospitalization Hospitals Humans Inpatient care Japan Male Medicine Medicine & Public Health Neurosciences Nutrition Nutritional Status Older people Oral hygiene Outcome Assessment, Health Care Patient Discharge Primary Care Medicine Quality of Life Research Recovery of Function - physiology Rehabilitation Retrospective Studies Stroke Stroke - therapy Stroke Rehabilitation - methods Treatment Outcome |
| title | Assignment of Dental Hygienists Improves Outcomes in Japanese Rehabilitation Wards: A Retrospective Cohort Study |
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