Author ORCID Identifier

https://orcid.org/0000-0002-6794-110X

Semester

Fall

Date of Graduation

2022

Document Type

Dissertation

Degree Type

PhD

College

School of Nursing

Department

Not Listed

Committee Chair

Ubolrat Piamjariyakul

Committee Co-Chair

Roger Carpenter

Committee Member

Roger Carpenter

Committee Member

Usha Sambamoorthi

Committee Member

Rebecca Schmidt

Committee Member

Mary Jane Smith

Abstract

Introduction: Approximately 786,000 Americans are currently diagnosed with end-stage renal disease, 71% of whom are undergoing hemodialysis (HD) treatment. There is a bidirectional relationship between chronic kidney disease and periodontal disease. Among HD patients, poor oral health is prominent and can negatively impact general health and health-related quality of life. Appalachian residents experience extreme health and poverty inequities and limited access to healthcare and dental providers.

Method: The study was designed based on the Andersen Behavioral Model of Health Services Use. 120 participants from 6 outpatient HD centers were enrolled. Data were collected using a 34-item questionnaire including oral health and demographic questions. Electronic medical record review was also completed which provided additional demographic data and Kidney Disease and Quality of Life-36 scores. Data were analyzed using SAS 9.4 with alpha set at .05. Statistical analyses included chi-square tests, t-tests, multivariable logistic regression, and ordinary least squares regression.

Results: The study sample was almost evenly male and female (51.7% vs. 48.3%), mostly white (92.5%), and over half had not been to the dentist in the last three years (51.7%). Among study participants, those with obesity reported better oral health status, while those reporting self-consciousness about the teeth/mouth reported poorer oral health status. In the study, females, those with self-reported depression, current smokers, and individuals drinking alcohol reported lower overall health-related quality of life scores.

Conclusion and Implications: The findings support reinforcement of recommended nursing interventions for smoking cessation, health-related quality of life and depression screening, and oral health literacy education.

Download

Share

COinS