A Visual Metaphor for Oral Health Education in Hemodialysis Patients: A Pilot Study

The aim of this study was the comparison of PRISM (Pictorial Representation of Illness and Self-Measure) with an interview-based oral health education during a 4-week follow-up.

Patients under chronic hemodialysis (HD) were recruited and randomly assigned either to PRISM or a control group. At baseline, after the first intervention (T1), after 2 weeks (second intervention, T2) and after 4 weeks (third intervention, T3), three parameters were evaluated: gingival inflammation by papilla bleeding index (PBI), patient perspective (specific questionnaire), Oral health impact profile (OHIP-G5). Fifteen patients each group finished the follow-up. In PRISM group, neither after two (T2, p = 0.23) nor after 4 weeks (T3, p = 0.63), significant differences in PBI were found. In the Control, PBI values significantly increased between baseline and T3 (0.71 ± 0.52 vs. 0.95 ± 0.54, p = 0.02). Mainly non-significant changes in the specific questionnaire were observed. The sum score of OHIP-G5 did not differ between time points. Regarding the question whether the taste has worsened, a decrease was found in the control between T0 and T2 (p = 0.04). In the PRISM group, this decrease was apparent between T0 and T2 (p = 0.04) as well as between T0 and T3 (p = 0.04).

Oral health education in HD patients appears challenging and offers a need for novel patient-centered approaches.