244 Summary settings, and there are no practical tools relevant to this issue available in the mental health care sector. This dissertation consists of three parts: firstly, the needs of patients and risk factors are mapped; secondly, a review of existing interventions reported in the literature is provided; and, finally, the development of a nursing tool that MHNs could use to support patients with their oral health is described. Part I: Experiences of oral health in patients experiencing a first psychosis How is patients’ oral health following their first psychotic episode, and what are their needs with respect to this area? (Chapter 2) Chapter 2 presents findings from semi-structured interviews conducted with 30 patients who have recently experienced their first psychotic episode, focusing on their personal experiences and specific needs regarding oral health. This qualitative study found that patients were initially satisfied with their oral health but noticed a decline from the onset of their first psychotic symptoms. Four main themes emerged from the interviews, reflecting the experiences and needs of such patients with respect to oral health: 1) general experiences with dental care, 2) risk factors, 3) experiences with dentists/dental hygienists, and 4) specific needs regarding oral health. Theme 1 showed that, after initial psychosis, patients were more likely to have difficulty taking good care of their teeth and needed help remembering how and when to take care of their teeth. The risk factors mentioned in theme 2 included smoking, drug use, and a lack of insurance and/or financial resources. Examining theme 3, it emerged that financial problems lead to patients often not having dental insurance and often forgetting dental appointments (despite receiving reminders). Finally, it was found that patients find it important that MHNs actively contribute to improving oral health (theme 4). The main conclusions from the study were the need for education on the importance of good oral care and the risk factors associated with oral care in order to raise awareness. It also proved important to conduct follow-up research on risk factors and the extent to which young adults with psychotic disorders are at greater risk of poor oral health than other young adults.
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