Nurse practitioners' promotion of oral health care practices in underinsured and uninsured adults

Abstract

The purpose of this study was to explore how nurse practitioners promote oral health care in their underinsured and uninsured adult patients, as well as to identify factors that discourage and encourage the integration of oral health promotion. The lack of access to oral health care is a complex problem facing many Americans, especially the economically disadvantaged. The Surgeon General's Report on Oral Health emphasizes a need for a collaborative effort and call to action in promoting oral health. Many times nurse practitioners serve as an individual's point of first contact with the health care system. Nurse practitioners are in a position to influence the oral health care practices of individuals who otherwise may receive no oral health care. Pender's Health Promotion Model (HPM) was used as a framework for this study. The HPM is based on assumptions that clients play an active role in their health care behavior and health maintenance (Pender, 1996). This study used a descriptive design. The convenience sample was nineteen nurse practitioners who provided preventative and acute health care services, and are practicing in several clinics serving the underinsured and uninsured adult population in the Midwest. Data collection consisted of a demographics and an open-ended questionnaire relating to oral health care promotion practices. This questionnaire was mailed to participants. Anonymity and confidentiality was maintained by using numbers to identify questionnaires and asking participants not to sign their names. A narrative analysis of answers provided in the self report was implemented to identify categories and connection from the narrative content. Respondents reported that their awareness of the connection between oral health and general health was the main reason they incorporated oral health care promotion in practice. They also reported many barriers the underinsured and uninsured adult populations face which make it difficult to help them with their oral health care needs. Mentioned throughout the data are lack of access, lack of time, patient and provider priorities, and cost. Over half of the respondents felt they needed more knowledge about how to screen for and promote good oral hygiene among the underinsured and uninsured patients.