Authors (including presenting author) :
Cheng SY(1),Kwan WM (1),Chin LF(1), Ho YK (1), Su MF (1)
Affiliation :
(1) In-patient-unit , Bradbury Hospice
Introduction :
Saliva plays a crucial role in maintaining oral health by facilitating essential functions such as swallowing, speaking, and taste sensation through its lubricating properties and the action of receptor cells (Nayebi et al., 2020). In palliative care (PC) settings, including PC in-patient unit , Medical and Geriatric (M&G) units, infirmaries (Infirm), convalescence and rehabilitation (CR) facilities, and oncology (ONCO) wards, many patients are often in the end-of-life stage. In these contexts, preserving quality of life becomes paramount. Numerous patients in these settings suffer from advanced cancers and organ failures, resulting in a high prevalence of xerostomia, or dry mouth. This project aims to explore the use of artificial saliva gel to enhance patient care and improve oral health outcomes.
Objectives :
The primary aim of this project is to enhance the quality of life for patients by improving oral hygiene practices through the use of an artificial saliva gel (Xerostom saliva substitute gel). This intervention seeks to alleviate dry mouth and promote oral moisture in patients. The specific objectives are as follows: 1. To evaluate the efficacy of the selected artificial saliva gel in alleviating symptoms of dry mouth. 2. To assess patient acceptance of the selected product.
Methodology :
The selected product for this study is a saliva substitute gel that contains olive oil, xylitol, glycerin, and betaine as its key ingredients. This is a multicenter prospective study conducted across various wards, including the BBH palliative inpatient unit (PC), SH M&G ward, PWH oncology ward, TPH M&G and CR ward, NDH CR ward, and SCH infirmary and CR ward. The study will utilize the Oral Health Assessment Tool (OHAT) to evaluate the health of patients' lips, tongues, gums, and oral tissues. A score of 0 indicates healthy status, 1 signifies changes, and 2 denotes unhealthy conditions. The evaluation period is scheduled from July 15, 2024, to December 15, 2024. Nurses will introduce the study and obtain verbal consent from patients or their families. Patients will be instructed to use the selected artificial saliva gel twice daily, with assistance from nursing staff, personal care assistants (PCAs), Temporary undergraduate nursing studentys (TUNs), and family members. Assessments will be conducted by ward nurses on Day 1 (baseline) and Day 4 for comparison. Data analysis will be performed using paired T-tests with SPSS version 26.
Result & Outcome :
A total of 403 patients were recruited for the program, of whom 373 completed both the pre- and post-assessments. This cohort included 217 females and 156 males, with 134 patients from the palliative care unit, 188 from the CR ward, and 51 from other units. The attrition rate was 7.44%. The overall results demonstrated improvement in all three observed items. The mean score for lip improved from 1.00 on Day 1 to 0.24 on Day 4 (mean diff. 0.756, S.D. 0.430, P <0.001). The mean score for tongue improved from 0.98 to 0.40 (mean diff. 0.576, S.D. 0.580, P<0.001). The mean score for gum improved from 0.73 to 0.38 (mean diff. 0.359, S.D. 0.497, P <0.001). These results suggest significant improvements in moisture retention, speech, oral intake, and patient comfort during speaking and swallowing. Improvements were observed across both palliative and convalescent patients. Furthermore, the enhancement in oral assessment scores has clinical significance. With moist lips, tongue, and gum, it would enhance patient comfort during oral intake is likely to improve, along with the ability to communicate effectively, enhanced oral hygiene, and a reduced risk of oral complications.
