A gaping hole: Oral health care for dependent older people
Notice bibliographique
Résumé
Following decades of improved oral health care, many people in New Zealand now reach older age with their own teeth. However, dependent New Zealanders (those who require regular care support through home-based care or aged residential care facilities) have poor oral health, suggesting that they are not receiving adequate oral health care. This affects their overall health and quality of life in ways that may be painful, debilitating or fatal. These problems are exacerbated by shortfalls in oral health services, which are frequently unaffordable and/or inaccessible.\n\nThis thesis explores the feasibility and acceptability of publicly-funded oral health care provision for dependent older people in New Zealand among key informants from the oral health and aged care sectors. The New Zealand oral health and aged care systems are compared and contrasted with those from Canada, Australia, the United Kingdom and Ireland. These comparable countries face similar issues in cost and access barriers for dependent older people, and have various approaches that could be applied in the New Zealand setting. The research was framed by Guay’s (2005) three-point model of addressing demand, expanded by Smith (2010) to include awareness. Semi-structured interviews were conducted with eight key informants, comprising experts in dentistry, aged care, health policy and older people’s advocacy.\n\nThis research confirmed that dependent older New Zealanders’ oral health is in a state of crisis. Oral health policy has not been sufficiently developed or implemented to guide oral health care for older people. Preventive oral health care is insufficient for purpose, while cost and access barriers frequently prohibit clinical treatment. The oral health and aged care workforces both require improved conditions, regulation, training and interdisciplinary alliances to meet dependent older people’s oral health needs. While the workforce is interested in making these changes, centralised public funding is necessary for their implementation, and to reduce cost barriers for patients. Accessibility can be helped through a combination of in-house, mobile and domiciliary care provision, and more widespread training in special care dentistry. Any oral health care programme must foreground the human rights of older people, disabled people, and other socioeconomic minorities such as Māori and Pasifika people.\n\nThis thesis concludes that publicly-funded oral health care for dependent older people is not only acceptable but urgently necessary, and highly feasible if effective political strategies are developed for its implementation. It therefore recommends a call to action by oral health and aged care professionals, older people’s advocates, disability rights organisations, and others concerned about dependent older people’s health and wellbeing.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,008 | 0,007 |
| Communication savante | 0,006 | 0,011 |
| Science ouverte | 0,002 | 0,011 |
| Intégrité de la recherche | 0,007 | 0,008 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».