Sonja Kuipers

16 Chapter 1 establish a precise nursing diagnosis, it is crucial to undertake a thorough collection of data followed by an analytical assessment of this information. This methodological approach is vital for accurately reflecting the patient’s current health conditions and facilitating the formulation of appropriate intervention strategies. MHNs often experience hesitation in addressing oral care issues in patients with psychotic disorders. Therefore, it is crucial to explore what oral health interventions are available for MHNs. Oral health in mental health Patients with mental illness have overall poor physical health [29]. The importance of attention to oral healthcare in patients diagnosed with a psychotic disorder is described and is poor in patients with SMI [30]. This indicates the importance of prevention at an earlier stage, such as during first-episode psychosis (FEP). Therefore, this research study starts with a primary focus on oral health in patients after FEP. A study among outpatients in Sweden who have been diagnosed with schizophrenia showed that a decrease in mental health is associated with an increased need for dental care [31]. This underscores the importance of thoroughly assessing the experiences and needs of patients with FEP. Population surveys show that impaired mental health is associated with an increased need for oral healthcare [31–34]. These studies also indicated that people with enduring mental health problems make less frequent planned visits to the dentist and report a greater number of missing teeth than the general population. Kilbourne et al. [32] demonstrated that 61% of patients diagnosed with psychotic disorders reported poor oral health and that over 34% of patients stated that oral health problems made it difficult to eat. Poor oral health (gum disease and tooth loss) impacts daily living (e.g., eating, social acceptance, self-esteem, feeling comfortable) and is also associated with chronic disorders: for example, diabetes; high blood pressure; and respiratory disease in patients diagnosed with a severe mental illness, such as psychosis [33–35]. A large cohort study (>one million participants) showed that patients with poor oral health have an increased risk of coronary heart disease, and smoking can be a confounder [36]. This finding shows that oral care is an important part of general health in patients diagnosed with a psychotic disorder. Risk factors for poor oral health are also known, and inferences can be carried out from syntheses of the literature. These risk factors include the following: the type and stage of mental illness; a lack of motivation and low self-esteem; a lack of perception with respect to oral health problems; lifestyle (e.g., smoking, drinking alcohol, substance use,

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