195 The Development of an Oral Health Nursing Tool in Patients with a Psychotic Disorder be challenging to implement in a high intensive care (HIC) environment, where patients often have short stays and return home as soon as their most severe symptoms subside. When patients transition to a different department following a crisis, the brochure could be helpful as they commence their recovery process. Participants had varying opinions regarding the department where the brochure could be implemented. Some participants thought it would be suitable for HIC units, others only for clinical treatment wards. Conversely, a few believed it is not appropriate for long-term care units and should be limited to the HIC setting. However, all participants agreed that the brochure would certainly add value in the outpatient setting. In discussions with participants, the tools needed for implementation were explored. Participants suggested that the topic of oral care and the brochure should be included in routine somatic screenings, which occur monthly or sometimes annually, to ensure follow-up. Some participants proposed integrating it into patients’ daily schedules, akin to medication routines. They also mentioned its compatibility with the WHO’s International Classification of Functioning, Disability and Health (ICF) framework, though this model has not yet been implemented [35]. Furthermore, all participants agreed that merely placing the brochure in a department is insufficient. They stressed the importance of providing a simultaneous clinical lesson so that the brochure can serve as a reference. Additionally, an eye-catching factsheet could be created to spark curiosity among MHNs. Participants indicated that there are circumstances for patients that make it more challenging for them to address their oral care. These include the following: (1) Some patients, due to traumatic experiences or re-experiencing a trauma, may find it intolerable to have a toothbrush in their mouth. (2) Patients with psychotic disorders often use medication that leads to frequent thirst and hunger. They tend to compensate for this by consuming excess sweet beverages and making poor dietary choices. MHNs do not always have control over this, especially in a home setting. Therefore, employing motivational interviewing as a technique with patients is crucial. (3) Patients who are not insured for dental care must bear the costs of treatment themselves. They are often financially incapable of doing so. This also applies to simpler materials such as mouthwash. (4) For MHNs, it is essential to ascertain whether patients possess basic oral hygiene items such as a toothbrush 6
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