246 Summary Part II: State of the art What interventions aimed at improving oral health in patients with psychotic disorders are described in the existing literature? (Chapter 4) A systematic exploratory review was conducted to identify interventions focused on the oral health of patients with psychotic disorders. Eleven studies were included: four randomized controlled trials, six quasi-experimental studies, and one cohort study. These studies targeted interventions directed at patients (n=8) or both patients and their caregivers (n=3). We identified four types of interventions for oral health in mental health care: I) educational interventions; II) physical interventions; III) interventions that combined behavioral and educational elements; and IV) interventions that combined educational and physical elements. Nine studies demonstrated short-term (≤12 months) positive effects on oral health knowledge, behaviors, or physical outcomes (such as reduced dental plaque). Based on the literature, it can be concluded that, currently, there is no gold standard regarding the type of intervention (types 1-4) or the observed effects, particularly the lack of long-term effects which are relevant to our target population. Given the potential effects reported in the included studies, developing a toolkit with interventions focused on oral health may be of great interest to the mental health sector. However, it is still unknown what MHNs need. Because it is important to involve both MHNs and experts in the follow-up research, a design-oriented study was chosen for the follow-up study. The follow-up question therefore focused on what MHNs need, what barriers they experience, and what they need in terms of interventions focused on oral health. Part 3 of the thesis focused on addressing these uncertainties and the development of a tool for MHNs and other stakeholders. Part III: Development of a supportive nursing intervention for oral health What are the attitudes, barriers, needs, and suggestions for interventions of MHNs regarding oral health in psychosis? (Chapter 5) In this design-oriented study, efforts were made to gain a deeper understanding of the attitudes, barriers, and needs of mental health nurses concerned with the oral health of patients with psychotic disorders. Additionally, participants provided suggestions for potential interventions. The findings are derived from contextual interviews with mental health nurses and peer specialists (N=10). These outcomes
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