Correlates of attitudes and perceived behavioural control towards oral care provision among trained and untrained nursing home caregivers in Singapore

AIMS AND OBJECTIVES: To investigate the perspectives of nursing home caregivers towards oral care and the determinants of their attitudes and perceived behavioural control. BACKGROUND: There are few studies analysing nursing home caregivers' perspectives on the provision of oral care and factors correlated with these perspectives. DESIGN: Cross-sectional study. METHODS: Interviewer-administered survey questionnaires were completed by caregivers from five nursing homes in Singapore (n = 94). The rating-scale questionnaire items explored caregivers' attitudes, subjective norms and perceived behavioural control, as guided by the theory of planned behaviour. Demographic characteristics, oral care training received, years of work experience, oral hygiene behaviour and dental visit frequency of the caregivers, as well as organisational characteristics such as a requirement for oral care and the number of patients under their care, were obtained. RESULTS: Caregivers had very positive attitudes towards the provision of oral care. Half of the caregivers lacked confidence in providing oral care without harming the patients and this was not different by oral care training received. Multivariable linear regression analysis found that receiving oral care training and having a requirement by the nursing home to provide oral care were related to higher attitude scores but not perceived behaviour control. Having more residents under their care and on-the-job caregiver training were associated with lower perceived behavioural control. CONCLUSIONS: This study found that nursing home caregivers had positive attitudes towards providing oral care, but more modest perspectives about their ability to perform that behaviour. RELEVANCE TO CLINICAL PRACTICE: These findings have useful implications for the oral care training of nursing home caregivers. While attitudes towards the importance of oral care may be positive among nursing home caregivers, our study suggests that future interventions should include practical skills training for oral care management and consider organisational strategies for encouraging oral care provision.