200 Chapter 6 To elaborate on the second finding, notable enhancements to the brochure would include providing a clinical lesson and offering patients a toothbrush and toothpaste. This suggests that additional tools and materials in a toolkit are needed to facilitate the implementation of interventions in a manner that is both actionable and potentially sustainable. Based on the present study, we cannot (yet) say anything about the actual effectiveness of these tools regarding knowledge and awareness about oral health among MHNs. Further research into the design of a more comprehensive toolkit to help MHNs with maintaining and improving oral health in patients with psychotic disorders is indicated. The third finding was that there are diverging opinions concerning the applicability of the brochure with the awareness screener when considering various populations. The content of the brochure was developed for MHNs who care for patients with psychotic disorders. A recent review shows that PTSD is a common problem among people with psychosis, with a prevalence of 14–47% [40]. The prevalence of trauma focused on the face or mouth is not known. When trauma is focused on the face or mouth, it might be important to develop alternative strategies in collaboration with oral care specialists. This also applies to patients with, e.g., eating disorders who frequently regurgitate and have other needs regarding oral health [41]. The prevalence of anorexia nervosa in patients with psychotic disorders has been approximated to be between 1 and 4% [42]. However, even though this pertains to relatively small groups, the expectation is that the brochure will be useful in most cases. The fourth finding was that there are diverging views concerning the level of language proficiency at which a brochure ought to be composed. A general recommendation is to write a brochure at the CEFR B1 level, which means using language that is understandable to virtually everyone [43]. This presents a complexity, however. The brochure is tailored to a target group: MHNs. In the Netherlands, MHNs operate at three distinct levels: secondary vocational education in nursing, bachelor’s level in nursing, and master’s level in nursing. Given these three distinct levels, for the purposes of this study and in the absence of explicit guidelines, it was decided to align the text with the demographic for whom it should be most easily comprehensible (i.e., CEFR B1).
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