44 Chapter 2 In practice, patients receive psychoeducation, but the psychoeducation is focused on specific topics, e.g., sports or life style, or psychotic symptoms and the effect of cannabis use [19]. To date, studies among psychoeducation have not taken oral health into account, and it is not known in what way psychoeducation on oral health is effective in patients after FEP. Here, the question of nurses’ oral health awareness arises. Research shows the overall lack of oral health awareness among nurses. Gillam et al. [20] tested a questionnaire on oral care knowledge and awareness in nurses and identified deficiencies in their knowledge of oral care and concluded that a basic awareness of conditions and medications that may affect the mouth would be of great value. This current research shows the importance of teaching oral care to nurses, which would enable nurses to provide a higher standard of oral care to patients. In this study, all participants were confronted with many risk factors (e.g., substance use, poor diet and financial problems) and experienced the consequences of bad oral health (e.g., pain and feeling insecure). Our research explored lived experiences and was not focused exclusively on assessing risk factors. The participants stated that there are financial problems, and the participants did not always have insurance. This was directly affecting their ability to pay for dental health care. The evidence showed that inappropriate decisions were a consequence of poverty and a scarcity mentality. Moreover, these consequences have a large cognitive impact on, for instance, working memory and flexibility (executive functioning) [21]. Participants were restricted by their short-term memory; long-term perspectives and appropriate long-term aims were limited. It is known that people stricken by poverty use less preventive health care, fail to adhere to drug regimens, are less likely to keep appointments, and are worse managers of their finances. This study confirms that patients after FEP are a high-risk group for whom support is necessary. This fits in the approach of the WHO, the importance of promotion of oral health to reduce burden and disability in poor and disadvantaged populations [22]. The participants in this study showed no negative experiences regarding dentists/ dental hygienists. We believe that it is important to realize that fear can be a reason for not going to the dentist. There is evidence in patients diagnosed with SMI: “One half of all dental patients experience some anxiety about their dental visits, and in
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