106 Chapter 4 cussed the short-term effects of oral health interventions, although this systematic review only shows the evidence on dental health education until 1996. Additionally, it shows evidence in the general population and does not have a focus on dental health education in patients with a mental health disorder. Is does, however, display the importance of continuity in treatment, as well as long-term monitoring. Future research might take this into account. Included studies were focused on different interventions based on literature. Additionally, mental health nurses and patients with a mental health disorder should play an important role in the development of interventions so that an appropriate approach can be developed in co-creation with the end-users. Quality of Included Studies Interventions combining behavioural and educational elements appear to be effective in patients with SMI (diagnosis not further specified), psychotic disorder, and mood disorder. Of these studies, the methodological quality was good (n = 3) [46–48]. In one RCT, the methodological quality was moderate due to insufficient follow-up data [45]. In three RCTs, there was no blinding of participants and outcome assessors. Blinding is a measure in RCTs to reduce detection and performance bias and is an important measure in RCTs. There is evidence that lack of blinding leads to overestimated treatment effects. If participants are not blinded, knowledge of group assignment may affect participants behaviour in an RCT [58]. This means that the treatment effects in the included RCTs [45–47] can be overestimated. Blinding outcome assessors can be used in order to minimise distortion in the results of the study [34]. Detection bias can arise if the knowledge of patient assignment influences the assessment of outcome measurements. This detection bias can be avoided by the blinding of those assessing outcomes in an RCT [58,59]. For included RCTs, it is not known if knowledge of a patient’s assignment had influenced outcome measurements. Quasi-experimental studies show the effectiveness in interventions combining educational and physical elements in patients with a psychotic disorder, personality disorder, anxiety disorder, mood disorder and autism spectrum disorder [28]. Educational interventions appear to be effective in patients with SMI (diagnosis not further specified), eating disorder and substance abuse disorder [49,51–53]. Physical interventions appear to be effective only in patients with autism spec-
RkJQdWJsaXNoZXIy MTk4NDMw