150 Chapter 5 This combination of interventions was shown to be effective for oral health (Q.H. plaque index and oral health knowledge) in patients with severe mental illness [11,57]. Therefore, the development of interventions that combine behavioral and educational elements to support MHNs to motivate and encourage patients with a psychotic disorder should be prioritized. Moreover, interventions suggested by the MHNs were shown to be effective, but there are important differences in context and population. This means that insights from these studies, while respecting differences, should take them into account during the design process when developing oral health interventions in co-creation with this patient group, MHNs, and designers. Providing oral care to patients with a psychotic disorder to maintain and increase oral health is an important role for MHNs, as oral health in mental health is part of the holistic perspective of nursing [18]. However, the availability of tools alone does not automatically encourage a behavioral change in MHNs regarding maintaining and increasing oral health in patients with a psychotic disorder. Therefore, it is important to develop interventions in co-creation with MHNs to obtain input on the appropriate content, timing, and scope of these interventions so that they fit into their workflow as well as possible. We also found that, in contrast with the fact that almost no attention is given to oral health in daily practice, the MHNs recognized themselves in a persona that encourages a holistic perspective that included oral health. We asked participants about which persona they identified the most with. The MHNs frequently reported that they recognized the persona of “Monica” (e.g., not concerned with oral health, focus on psychological or psychiatric issues, no awareness) in colleagues, demonstrating its validity and the significant prevalence of this type of colleague. We did not find any MHNs who recognized themselves as a “Monica” and were able to formulate the needs of “Monica” (e.g., raising awareness and gaining more knowledge). It remains unclear whether no Monica-type professionals exist, or whether participants felt too uncomfortable to associate themselves with a person that represents a rather negative attitude. Due to the high variation in participants and the results of this study, there were no indications this affected the results.
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